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Item #8 

Multiple Benefits to Group Diabetes Model in Physicians Office

Patients form their own support group. 

Over time, patients develop relationships with others in a way that is very difficult with the 15-minute drop-in visit a couple of times a year. 

Group visits in one St. Petersburg family practice residency program are providing patients with better care and residents with an innovative learning experience.
 
The St. Peter model earned the 2002 Patient Care Award for Excellence in Patient Education Innovation, presented at a conference on patient education sponsored by the Society of Teachers of Family Medicine 

Dr. Devin Sawyer, first encountered the group visit model during his family practice residency at Providence St. Peter Hospital in Olympia, Wash. That group, for pregnant teenagers, combined individualized prenatal care with group teaching in a setting that fostered the growth of a support network among the young mothers.

After residency, Dr. Sawyer joined the St. Peter's clinic and expanded the group visit model to include a similarly structured diabetes group. Like the prenatal group, the diabetes group focuses on extended group teaching, combined with individualized patient care.

The bonds patients form during group visits benefit them outside of the clinic setting as well.  Patients of like characteristics meet for an extended visit that is composed of a didactic session followed by individualized patient care. Each group has its own provider team that includes physicians as well as health professionals whose expertise is useful to the patient population.

Before each group visit, the medical team reviews charts and chooses the focus of the visit. Because the chart review is done before the group convenes, physicians can spend more time actively focused on patients and less on review.

Patients meet quarterly for a 2-hour session that begins with checking of vital signs, body mass index, and immunizations, and blood and urine collection. Each patient has a brief meeting with a physician who reviews the results and performs a foot check. The didactic session focuses on concepts of self-efficacy and self-management, often with guest speakers. Frequently, patients who have been in the program longer serve as role models for patients just beginning to come to terms with their disease.

“The idea is that, over the years, you have patients who develop relationships with others in a way that is very difficult with the 15-minute drop-in visit a couple of times a year,” Dr. Sawyer said.

While patients certainly benefit from the extended teaching they receive, residents are also taking home some valuable lessons, Dr. Sawyer said.

“It's an innovative way to deliver patient care. It's not the usual format where you're ‘double-booked’ and stressed and giving the same talk over and over. My hope is that when they graduate, they'll have an appetite for innovation.”

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FACT: 

Cardiovascular disease is the most costly complication of diabetes, accounting for more than $17.6 billion of the $91.8 billion annual direct medical costs for diabetes in 2002.

Item Cost of Diabetes

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