Recently we had a group of patients in the office for a shared medical appointment. I had been trying this idea to see if they could learn more than in a normal appointment. We started off the visit by having all of the patients introduce themselves and give one example of a problem they had recently had….
As we went around the group it seemed like everyone was in agreement whenever there was a problem mentioned and they all seemed to have experienced it and they discussed what they had done to work through the problem. I was beginning to see why these visits work and was actually enjoying the opportunity to practice medicine the way we used to. I left them to talk as I had a call from another physician. I returned to the room in a few minutes to find that the whole attitude had changed and no one was willing to talk anymore. I knew that something had happened but I could not get anyone to tell me what was going on. I decided to go ahead and start discussing individual therapy with each patient as that is the next step in the appointment process and when I got to the third patient I found that her A1c had gone up from 6.9 to 7.3 prompting me to make a decision to add a new medicine. As I was discussing this with her she started to cry. It seems that when I was out of the room one of the other patients had told the room that if you come to this appointment it means you have to go on insulin, as that had happened to her and she was warning everyone if I told them they needed more medicine that they would have to go on insulin.
It was then I learned that I need to separate these patients and when I explained that we have many different medications and that insulin is not always the choice, the attitude of the of the group changed back and the appointment was a success.
We often have no idea how much value our patients put on what other patients tell them or how they will react to what we do, it is important to set the record straight from the beginning.
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