Doctors find quality time with patients in groups

Dr. John Lu with a patient in his examining room

By Rusty Dornin
CNN Correspondent

(CNN) -- When was the last time you went to the doctor and were able to see and talk to him or her more than 10 minutes or so?

Time is money. And for doctors, that means patient visits seem to get shorter and shorter. As many physicians feel the pressure by managed care groups to see more patients to increase the bottom line, the frustration mounts for both patients and doctors. But now some are coming up with alternative prescriptions.

In Palo Alto, California, Stuart Berman made his doctors appointment at the last minute. Not only will he get to see his doctor quickly but he'll go into some detail about his neck and shoulder problems. The length of his visit with the doctor -- 90 minutes. The tradeoff? There are ten other patients in the room with similar problems. All decided that, rather than wait four or five weeks for an appointment, it was worth it to try what's known as the 'drop-in, group appointment.' Stuart Berman was at first somewhat skeptical, but says it worked in his case. "Even though there were a bunch of other people around, I was having the time to describe what happened... what's going on with my particular illness."

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In Berman's group, most patients had back, neck and shoulder problems. After having their vital signs taken, patients joined the group and then one at time told the doctor and the other patients their symptoms. For some, sharing their pain brought relief of a different kind.

After all, misery does like a little company. For David Faltiseck, it put his chronic back problems in perspective. "It always helps me when I see someone who's worse off than I am."

Psychologist Ed Noffsinger came up with the drop-in, group appointment when he was at Kaiser Permanente in 1996. He was suffering from a major illness and found that talking about it with other patients was a huge help.

Dr. John Lu conducting a group session with patients

It was then, Noffsinger says, that he "saw there was clearly a need for medical patients to have a different type of care that provides more access, more time with their doctor. It's almost unheard of in this day and age to sit down with your doctor for 90 minutes . Granted there are other people in the room and granted there are some tradeoffs in confidentiality because other people are there but it really brings back that old time relationship."

The group appointment doesn't work for everybody. Patients having procedures; suffering from infectious illness or those coming for an initial consultation with the doctor can't really sit down with a bunch of other patients.

"The group is only for people who've I've seen before," says psychiatrist Dr. John Lu, who has tried the group appointment three times. He says it takes a few times to figure out how to make sure everyone gets a turn - then things move along smoothly. Lu says there are some big advantages for doctors and patients. "Access is really one of the big promises for using this type of a group, from a number of different angles. The promise of the group is that it will allow people to share things, it will allow some problem solving in a group setting."

Gloria Rhodes has tried the group appointment twice, once with her primary care physician and once with a specialist. Rhodes says 90 minutes may be a chunk out of your day, but that's how long doctor's appointments seem to take anyway. "Usually you're in a waiting room and usually you wait that long because they're running behind time in their appointments and maybe they have an emergency and can't see you right away. So the time element isn't anything and sometimes you end up with more time with a group like this."

As Dr. Lu explains the physiology of one patient's problem and draws a picture of another on a board, the group sits in rapt attention. The setting looks and sounds more like a relaxed medical school class than a doctor's appointment. After the group session, patients can request to see the doctor privately, an important aspect for patient Gloria Rhodes. "It's good to have private time with your physician but you do learn other things from other people's experiences."

Those experiences are rarely discussed in a crowded waiting room. The group appointment may be one way patients and doctors are beating the rush of the modern medical appointment.

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