Shared medical appointments... a new way of consulting?
25th Mar, 2021


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In this episode with Sophia Gerontakos, we discuss shared medical appointments in clinical pratice and their benefits for the management of various health conditions. 

Specifically, endometriosis is explored for potentially suiting this group consultation model. 

Could this make naturopathy more accessible to the wider community and from the research, how do group consultations compare to one on one? 



Jacqui Fahey (00:01): Welcome to Common Ground, a weekly podcast discussing new research and interesting projects in the field of complementary medicine. Hello, my name is Jacqui Fahey, Head of education at Joining us today on Common Ground is Sophia Gerontakos. Sophia is a naturopath, writer and Southern Cross University PhD candidate. Sophia is currently conducting research on naturopathic shared medical appointments for women with endometriosis, we shall explore this further in Common Ground today. Welcome Sophia.

Sophia Gerontakos (00:35): Hi Jacqui, thank you for the lovely introduction. It's really nice to be here.

Jacqui Fahey (00:40): Thank you. Sophia, shared medical appointments in clinical practice. What are they in, where has this interest come from?

Sophia Gerontakos (00:49): Yeah, so shared medical appointments are a patient-centered model of delivering medical care or health care where multiple patients usually who share a similar medical condition consult with one or more health professionals simultaneously in, in a group setting. So it includes everything you'd expect to see in a one-on-one consultation. So every patient will have a medical consultation, medication review, and then it also includes patient education and sometimes it combines, integrative medicine disciplines. So it can be a good way of combining conventional and integrative medicine. It also provides an environment where patients have peer support, which is, as I see it, quite an integral component of this model because it empowers patients. So they have an opportunity to connect with other people who have similar issues to them. So they feel less alone and they can learn from each other, connect with each other, share the journey in a way, share the challenges to overcoming the barriers, to change and really support each other on the journey.

Sophia Gerontakos (02:11): That's been one of the factors that's been really successful or making this model really successful. So what brought me or stemmed my interest in this, comes from my own practice as a naturopath. So ever since I started practicing, I sort of started noticing there seems to be a significant proportion of the community who either can't or don't access naturopathy. So I've always been pondering, okay, how can we make naturopathy more accessible to the broader community? And that's led me to do a little bit of research into what other people are doing and what's happening in other areas of medicine to address issues of access, in both in Australia and in over other countries. And that's how I came across group consultations that have showed some quite promising results.

Jacqui Fahey (03:14): Fantastic, what a very important project. So have other approaches to consultation been explored for other health conditions?

Sophia Gerontakos (03:25): Yeah. So there's a lot of really promising research with group visits with conditions such as diabetes, chronic pain. There's a bit in weight management, particularly in Australia and in diverse populations and also in maternal care. So prenatal care, there's a lot of evidence for group prenatal care being equally or actually more effective than one-on-one care.

Jacqui Fahey (03:58): So what brought you to endometriosis and shared consults?

Sophia Gerontakos (04:07): Well, endometriosis is an area of women's health that has been recognized as insufficiently managed by conventional medicine alone. So, and that was, that was acknowledged by the government and the health department with the release of the National Action plan to endometriosis back in 2018. So there's an unmet health care need there with people with endometriosis. It's also an area that people commonly consult with naturopaths for. So you've got the unmet healthcare need, we know people will consult with naturopaths for this condition, and there's already a lot of evidence for the acceptability of group visits in the area of women's health being maternal care. So we know women will, will take up group consultations. So it's, it's a good condition for us to examine, to see if naturopathic group consultations are feasible. And, you know, if we can determine whether or not we can address an unmet healthcare need in these patients along the way, then that's a great thing too.

Jacqui Fahey (05:13): Yes. To true, could group visits improve access of medical care to underprivileged populations. And if so, how would that be?

Sophia Gerontakos (05:24): Yeah, so there's quite a lot of research in diverse and under privileged or marginalized populations where group visits have worked really well. There's a lot coming from the United States. So there's things to consider there in terms of transferability of results, because they have a very different healthcare system to us. There's always challenges with the billing of different consultation types in systems but definitely there's a lot of promising research there from all around the world where group visits have been really successful in diverse populations. And even in Australia, there's been some work done on what Australian researchers are calling ‘programmed shared medical appointments’. They've looked at weight management programs with Aboriginal men and that was a really, really promising study. So there is quite a lot of work there that shows. Yeah, there's a lot of potential.

Jacqui Fahey (06:33): Fantastic and what are some of the benefits of shared medical appointments?

Sophia Gerontakos (06:39): They've been shown to be equally or more effective than one-on-one consultation models. So, and there's also some studies that have shown them to be both cost-effective and time efficient. There's a lot of qualitative evidence that show that group consultations are really well received and well accepted both by patients and providers. So people like them.

Jacqui Fahey (07:05): Fantastic, so for your research, what stage are you at?

Sophia Gerontakos (07:10): I'm in the early stages at the moment. So I'm just beginning to recruit participants who have endometriosis and who have consulted with the naturopath before, for the co-design phase. So we're going to design the intervention in consultation with these people and as well as naturopaths. So where we're just in the beginning of recruiting participants with endometriosis to have those discussions with, to try and determine what a group naturopathic intervention for people with endometriosis might look like.

Jacqui Fahey (07:45): So where could practitioners go to find out more if they wish to set up a similar arrangement with integrated practice clinics?

Sophia Gerontakos (07:53): I'd suggest the first place to check out would be the Australasian Society of Lifestyle Medicine because some of the pioneers in shared medical appointments in Australia have actually got quite a lot of resources up on the website there and there's also a training and they really, as well as all their research, you can find that all there too, but they really encourage naturopaths in particular, but also other Allied health providers to get involved in the area of group consultations. So they'd be really excited to hear from anyone who was wanting to get into that or just learn more about it.

Jacqui Fahey (08:40): That's helpful, good to know for our audience listening today. What do you think the timeline is from wo to go? how do you phase out phase one and the various stages of your research? How long will this take?

Sophia Gerontakos (08:56): I’m hoping to complete phase one by mid-year. So that's the design of the feasibility trial where we actually run a group naturopathic intervention with patients. So we will, we're working on that now, we will get an ethics approval for the next phase of the research, which will be the trial and I'm hoping to actually begin that this year, so later in the year.

Jacqui Fahey (09:21): Well, fantastic. Thanks so much for your time today and we wish you all the best in this project. And we certainly look forward to hearing further into time. Thank you.

Sophia Gerontakos (09:30): Thanks Jacqui, it was really nice to chat with you.


Resource: Group consultations - ASLM