Clinician perspectives on group medical visits

Background: Group medical visits are an increasingly common approach to providing care for pregnant women and people with diabetes, among other populations.  Advocates of group visits have promoted them as an effective care model for reducing health disparities. While some studies have found that group medical visits improve health outcomes (including for low-income people and people of color), little research has examined the perspectives of clinicians who provide group visits.   Study objectives:  This study seeks to (1) describe perspectives of health care providers (physicians, nurse-practitioners, and nurse-midwives) about their roles in group medical visits, and how they see these roles as different from individual care; (2) identify how clinicians define quality of care in group visits and determine appropriate staff and patient populations for this approach.  Methods: This qualitative pilot study included clinicians who provide group medical visits in northern California safety-net clinics (n=6).  In-depth interviews were conducted, coded and analyzed using grounded theory methods.  Results: Four primary themes emerged: differences in clinician roles between individual and group care; group care as better care; tensions over what counts as medical care, and group care as both institutionalized and ad hoc. These findings provide insight into how clinicians view benefits and challenges of providing care in group visits within safety-net settings. Conclusions:  Giving interested providers the opportunity to provide care in group visits may increase their job satisfaction while providing quality care and increasing social support for low-income patients.   Consistent and ongoing organizational support is required to sustain group medical visits.