SOUTH AFRICAN LIFESTYLE MEDICINE ASSOCIATION

Shared medical appointments: An effective and efficient approach to lifestyle medicine

By: Dr Megan Michaux

As healthcare professionals, most of our training focuses on the classic one-to-one consultation. We’re taught how to listen actively, show empathy, and keep the conversation centred on the patient in front of us. But what happens when the consultation room isn’t just one doctor and one patient? What if it’s a room full of people with shared concerns, questions, and goals? Group consultations, or shared medical appointments, are becoming more common, yet many of us haven’t had much guidance on how to make them work. They can build community, improve access to medical care, and help patients feel more supported. The catch? They require a whole new set of skills. Success depends on having the right people, the right skills, and a clear understanding of how to manage these more complex consultations.

What are shared medical appointments?

Shared medical appointments, sometimes referred to as SMAs or group consultations, involve consulting with a group, usually 8 to 15 patients, who share a similar condition or set of challenges.1 They include 1-to-1 routine care within the group setting, as well as lifestyle advice and medical education. Most sessions last about 90 minutes. It is important to remember that these sessions are designed to replace routine 1-to-1 visits, not to be an extra visit.1 2 They include reviews of laboratory and/or imaging results, checking of measures of chronic disease progression and control, and medication-related queries and dose adjustments. SMAs are not simply education groups or peer support groups; they are full medical appointments conducted within a group setting.1 3

Why have shared medical appointments at my practice?

Healthcare worldwide faces challenges like long waiting times, overworked staff, and poor patient satisfaction. Shared medical appointments could be one way of tackling some of these issues.

Efficiency, especially in primary care settings, is important. However, rushing through as many patients as possible in a day can lead to errors, burnout, and patients who feel neglected. A shared medical appointment means that the physician (or other healthcare professional) does not need to repeat the same information to 15 different patients. With this one simple change, a physician can create more time to discuss factors (like the pillars of lifestyle medicine) that would not fit into a normal 10-minute 1-on-1 appointment. 1 4

Patient groups are logically designed to bring together people with a shared struggle. These people will likely have similar questions and concerns about their diagnoses, and sharing the information with the group will benefit everyone. It also means more questions can be addressed in the same amount of time. 1 3

This leads to another obvious benefit of shared medical appointments: social connection. Patients realise they are not alone; they feel supported by their medical team AND their fellow patients, and they often form friendships that help them with accountability and social support when they get home. The discussions fostered within these appointments can build confidence and empower patients, and the group setting highlights the importance of shared decision-making. The teamwork involved in running SMAs also positively impacts work satisfaction amongst the healthcare workers.1

The most pressing question, of course, is whether SMAs improve outcomes for the patients. And the answer is: Yes!

While the research into the benefits of group appointments could do with some more work, the results so far are resoundingly positive. Diabetics improved their HbA1c, and in some cases achieved remission. Weight loss and pain management were both more successful compared to 1-on-1 interventions, and blood pressures were more likely to improve in people attending group appointments. In antenatal clinics, SMAs improved pregnancy outcomes (including preterm births!), and in the elderly, hospital admissions were reduced. 1 5 6 7 To date, there have been no outcomes that were worse in the SMAs when compared to the usual 1-on-1 consultations.1 3 4 5

How do SMAs work?

While the benefits of SMAs are quite compelling, integrating them into your workday can be a challenge.

To run a successful group consultation, 3 major roles need to be filled. Firstly, the administrator. This person would be responsible for booking and coordinating appointments and might also help with recruiting patients. Consenting procedures are usually done by the administrator, and the patient must understand how the appointment works and that some information will be shared within the group. Next, a facilitator will introduce the group, start the review of any patient results, discuss any concerns, and gather questions from the patients. Finally, the clinician, who might be a physician, physiotherapist, health coach, or specialist nurse, then joins to provide individual consults in front of the group and leads a group discussion to address remaining questions and introduce relevant topics. Despite the group setting, each patient is given an individualised plan, including any need for follow-up testing, reviews, or changes in medication at the end of the appointment. Bookings for the next consultation, which might be with the same group, can also be arranged.1

Healthcare providers often lack the confidence to start working with groups, and patients may be resistant to the idea initially. Starting with smaller groups, working with a mentor to learn the ropes, or potentially getting some training, could help build confidence. Getting a few outgoing patients to join in and directing others to resources explaining the benefits of SMAs might encourage others to follow suit.1 3

SMAs and lifestyle medicine

Shared medical appointments can be used in many settings, but they’re a natural fit for lifestyle medicine. By design, SMAs bring people together, which helps build social connection—a key part of health and wellbeing.1 4 They’re especially helpful for patients managing lifestyle-related, non-communicable diseases. One of the biggest challenges in lifestyle medicine is time pressure during standard consultations. SMAs address this by creating additional time for patients to learn more about the core pillars of lifestyle medicine, while still receiving clinical care. They’re also flexible. For example, a group of patients with diabetes might join a session with their physician for one session and their dietitian for another.1 5 Similarly, patients recovering from orthopaedic surgery might see a GP in one SMA and a physiotherapist in a follow-up group. 1 4  SMAs also highlight a key aspect of lifestyle medicine: patient-centred care. While the sessions are led by a facilitator, the patients provide input that directs the discussions. Bouncing ideas off other patients with similar problems helps people to come up with their own solutions, a key factor in coaching principles that can foster confidence and self-efficacy.1 3

Shared Medical Appointments: Efficiency Meets Connection

While SMAs take planning, training, and patient engagement to implement, the benefits for both patients and clinicians can make the effort worthwhile. Sharing a session with others allows patients to gain more information in less time, hear different perspectives, and gives the clinician extra time to discuss lifestyle changes relevant to their group. When well-run in primary care settings, SMAs can help address some of the biggest challenges facing healthcare workers today: patient dissatisfaction, growing backlogs, overwhelmed clinicians, and time-pressured appointments.

 

References

  1. British Society of Lifestyle Medicine. Core Accreditation Course. Lifestyle Medicine Skills: Module 7: Group Consultations. Accessed September 2025. https://bslm.org.uk/core-accreditation/.
  2. Sikon A, Bronson DL. Shared medical appointments: challenges and opportunities. Ann Intern Med. 2010;152(11):745-746. doi:10.7326/0003-4819-152-11-201006010-00012.
  3. Wadsworth KH, Archibald TG, Payne AE, Cleary AK, Haney BL, Hoverman AS. Shared medical appointments and patient-centered experience: a mixed-methods systematic review. BMC Fam Pract. 2019;20(1):97. Published 2019 Jul 8. doi:10.1186/s12875-019-0972-1
  4. Edelman D, McDuffie JR, Oddone E, et al. Shared Medical Appointments for Chronic Medical Conditions: A Systematic Review. Department of Veterans Affairs (US), Washington (DC); 2012. PMID: 22916369.
  5. Jones T, Darzi A, Egger G, et al. PROCESS AND SYSTEMS: A systems approach to embedding group consultations in the NHS. Future Healthc J. 2019;6(1):8-16. doi:10.7861/futurehosp.6-1-8
  6. Unwin DJ, Tobin SD, Murray SW, Delon C, Brady AJ. Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care. Int J Environ Res Public Health. 2019;16(15):2680. Article.
  7. Tokuda L, Lorenzo L, Theriault A, et al. The utilization of video-conference shared medical appointments in rural diabetes care. Int J Med Inform. 2016; 93: 34‐Article .
  8. Shibuya K, Pantalone KM, Burguera B. Virtual shared medical appointments: a novel tool to treat obesity. Endocr Pract. 2018; 24: 1108‐Article .
  9. Edelman D, Gierisch JM, McDuffie JR, Oddone E, Williams JW Jr. Shared medical appointments for patients with diabetes mellitus: a systematic review. J Gen Intern Med. 2015;30(1):99-106. doi:10.1007/s11606-014-2978-7