Submitted to the Castlegar News
In a nondescript meeting room at the Castlegar and District Community Health Centre, seven patients gather in a horseshoe arrangement around a white board.
They chat together amicably and, from a health perspective, they have a lot in common: they are patients of Dr. Keith Merritt, they all have Type 2 diabetes, most have hypertension, and they’re here to attend a regular group medical visit hosted every three months by Dr. Merritt and Interior Health.
“I am used to a regular office practice so dealing with patients in a group setting was initially a little stressful, given concerns around confidentiality, speaking in a public forum, record keeping, and other differences,” says Dr. Merritt.
“We are all timid about trying something new. However there is satisfaction on both sides. At the end of a session I feel we have dealt with a number of issues productively. This has been a positive experience for me and my patients.”
The patients share blood glucose levels, albumin/creatinine ratios, blood pressure and cholesterol readings with Dr. Merritt, who discusses each case individually and updates prescriptions during the visit. Anecdotes are shared and questions are answered. At the end of the appointment patients leave with a lot of information — more than they would get in a regular 10-minute appointment — and that information helps build their confidence.
“We are seeing more group medical visits being introduced as we continue to develop integrated care models,” says Darlene Arsenault, integrated primary care director for Interior Health. “The benefits include increased efficiency and improved access. Physicians report increased professional satisfaction and patients report increased confidence in their ability to self-manage their conditions.”
Group medical visits have been particularly well developed in the Kootenay Boundary region. Since being introduced in 2007 they have been embraced by five Castlegar physicians. Space is provided by Interior Health in the local hospital or health centre. Integrated primary and community care staff help organize the visits, which include a medical visit component, as well as an education component, often focused on self-management and facilitated by Interior Health staff.
During Dr. Merritt’s group, education topics such as foot care and exercise are identified by dietitian Jennica Hague.
“Group Medical Visits allow patients more time to discuss and learn about their condition with their doctor, dietitian, and nurse in a relaxed, friendly, and collaborative setting,” says Hague. “I appreciate being able to work collaboratively as part of a team with the doctor and nurse.”