• Shared medical appointments – where patients are grouped – could tackle increasing strain on healthcare sector
• New research from ESMT Berlin shows shared appointments are effective in reducing the time it takes to see patients
• They also improve patient satisfaction, learning, and medication compliance, without compromising follow-up rates or clinical outcomes

The world is currently facing a global healthcare shortage. Not only are medical facilities still facing huge backlogs from COVID cancellations, but on a wider scale, the sheer number of medical professionals to members of the general public is getting smaller and smaller.

In Europe there are around 3 doctors per 1000 patients on average. However, that number becomes much smaller when you move into the context of developing countries such as India, Indonesia and South Africa, where it’s estimated there is around one doctor per 1000 patients.

The healthcare sector is struggling to cope in giving an adequate service to everybody in need – and, after all, the right medical service is a human right. This problem is further amplified by strikes. In the UK, for example, junior doctors continued to strike over pay conditions throughout 2023 and into the start of 2024.

So, other than training more medical professionals – a long-term strategy which will likely only see results in a decade’s time – how can we create a short-term fix to this medical emergency?

New research from ESMT Berlin suggests that ramping up the level of shared medical appointments could be a solution.

What is a shared medical appointment?

In shared medical appointments (SMAs), patients with the same medical condition meet with the physician in a group, with each patient receiving attention in turn. The physician shares information customised to a patient’s specific needs as well as standardised information relevant to other patients with the same condition.

SMAs have been touted as a potentially effective way to meet healthcare demand worldwide, especially in countries facing significant strain on their healthcare systems.

Exploring the benefits and drawbacks of SMAs

The limited adoption of SMAs in the healthcare sector can be attributed to patient concerns regarding loss of privacy, which may impede open discussion of sensitive medical issues and dampen learning, satisfaction, and engagement.

However, ESMT Berlin’s research, conducted by Nazl? Sönmez, alongside Kavitha Srinivasan and Rengaraj Venkatesh of Aravind Eye Hospital in India, Ryan W. Buell of Harvard Business School, and Kamalini Ramdas of London Business School shows that shared medical appointments can improve patient satisfaction, learning, and medication compliance, without compromising follow-up rates or clinical outcomes.

The researchers wanted to examine the impact of shared medical appointments on patient experience. To do this, they looked at the knowledge gained, patient satisfaction, and behaviour, looking at follow-up rates and medication compliance rates.

Testing the potential for SMAs

To better understand how SMAs could be used in practice, the researchers conducted a large-scale randomised controlled trial at the Aravind Eye Hospital in India. India has almost a fifth of the world’s population but spends only one percent of its GDP on health and faces a dire shortage of healthcare capacity.

In the study, 1,000 patients with primary glaucoma were randomly assigned to either one-on-one appointments or SMAs with five total patients in four successive routine follow-up visits scheduled four months apart.

At the end of each appointment, patients were surveyed to assess their satisfaction with the appointment, their knowledge about glaucoma, and their intention to return for a follow-up appointment. Patients were also tracked for their medication compliance rates. 

“The demand for healthcare worldwide is soaring and exceeds supply,” says Sönmez. “In underdeveloped countries, especially, the patient-to-doctor ratio is staggering, and patients face high barriers to receiving care. We must use innovative solutions, like shared medical appointments, to meet this demand. Failure to do so would deprive a huge number of people of their fundamental human right to healthcare access.”

Increased client engagement

There is potential for shared service delivery to increase client engagement and enhance service performance, particularly within healthcare, the study found.

The design of SMAs enables patients to spend more time with the physician, albeit alongside other patients. Providers also spend more time with each patient – over six times more in this study – a driver of quality and value.

What does this mean in practice? SMAs could also expand access to public healthcare, lower costs for private care, and significantly improve medical outcomes for various conditions, particularly for Type 2 diabetes, in both primary and secondary care settings.

The innovative utilisation of SMAs could ensure that more patients receive access to healthcare faster, facilitating healthcare for all. 

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