Patient Satisfaction with Shared Medical Appointments for Pre-Operative Evaluation of Macromastia

OBJECTIVE:  Shared medical appointments (SMAs) combine individual patient-physician encounters with an educational segment held in a group setting.  This approach allows for the patients' unique needs to be addressed individually, while taking advantage of the benefits of shared learning.  For patients with various health conditions, SMAs have enhanced knowledge, understanding, and management of disease by providing a variety of perspectives and experiences from others with the same condition.  In addition, total physician contact time is increased by this group session.  The physician benefits can also be significant - increasing clinic efficiency through patient appointment volume and clinic billing per hour.  The purpose of this study was to assess patient satisfaction and provider efficiency with SMAs for macromastia.

METHODS:  Patients requesting an evaluation for macromastia at the University of Michigan are offered the opportunity to participate in a SMA. Patients receive a HIPAA letter stressing the confidentiality of the appointment, and are permitted to bring along one female friend or family member.  Patient satisfaction with information received and overall experience was measured using a self-administered written survey with 5-point Likert scales.  A similar survey was also given to patients who elected traditional individual appointments for initial evaluation of macromastia with the same providers.  Efficiency was measured by comparing patient visits/hour in SMAs versus traditional preoperative appointments. 

RESULTS: In five SMA groups, 26 of 28 patients completed the survey.  Nine of 10 patients completed the individual appointment survey. Satisfaction corresponded to score of 4 or 5 on 5-point Likert scale.  Patients reported nearly 100% satisfaction with individual appointments.  Patient satisfaction with SMA was also high.  89% rated the overall visit very good or excellent, with 92% provider satisfaction. 77% said that it was very or extremely likely they would participate in a SMA in the future (see Table 1).  Provider efficiency increased nearly 300% with SMAs - patients-per-hour averaged 6 for SMAs versus 2 for traditional appointments. 

CONCLUSION:  Traditional appointments had exceptional patient satisfaction.  Although a select few expressed their reservations, SMAs for macromastia still resulted in very high overall patient satisfaction with education and with the clinic visit.  None were dissatisfied.  SMAs have unique benefits in patient education without significantly compromising thoroughness or overall satisfaction, and offer an alternative healthcare delivery model that improves professional efficiency.