The doctor is ready to see you all now

Sharing is good. We’re brought up to believe that almost everything is better if shared - food, toys, music, books, life’s highs and lows. For some people nothing seems to remain private – especially on social media. But for most of us some things remain off-limits for sharing – personal information like PIN numbers and website passwords, a virus (our own or our computer’s), a consultation with our GP.

“Not necessarily,” claims Kamalini Ramdas, Professor of Management Science and Operations and Deloitte Chair of Innovation and Entrepreneurship at London Business School (LBS). She says we automatically assume that the best healthcare comes from one-to-one time with a doctor: “It’s because of how we’ve been brought up – what the norm is.”

For over a decade Professor Ramdas has been at the forefront of research into Shared Medical Appointments (SMAs), an innovative approach to patient care that’s already proved successful in the some US and Australian hospitals. Although embracing SMAs requires a “brain shift” by doctors and patients alike, she says it’s a model that’s been long tried and tested in education – “I never think twice about walking into a class where there are 60 students. They’re all getting a ‘group delivery’.”

Group delivery could be a way to help the NHS face challenges never foreseen at its inception seven decades ago - an ageing population and an increase in people suffering from long term conditions (like diabetes, hypertension, liver disease and arthritis ) that require regular monitoring and take up over 50% of GP consultations.

Usually attention centres on the “free” part of the NHS’s founding principle of “free at the point of delivery” but Professor Ramdas’s research is revealing that shifting focus instead onto the method of delivery and shaking up long-held beliefs about how health care is provided might be a way to safeguard the ‘free’.

Shared medical appointments in practice

So how does an SMA actually work? The first hurdle to overcome when introducing the concept is the suspicion that they involve baring your all in a room full of strangers. “One of the things you need to realise is that you’re not going to be sitting in your underwear if you’re in a shared annual physical exam appointment,” says Professor Ramdas. “You’re going to be in a very socially acceptable setting.”

A shared appointment usually involves a group of around eight to 12 patients; depending on the specialism and group size it lasts for around 90 minutes and is run by a doctor assisted by another member of the practice staff who takes notes and keep records. Any tests or examinations are done privately and then the doctor sees each patient individually but with other group members present and listening to the consultation. Patients, like the medical professionals present, are bound by confidentiality agreements.