Many family doctors in British Columbia are holding group medical visits to see patients with similar conditions in a larger setting, but for Dr Karin Blouw of Smithers, group visits are a chance to expand her work in geriatric psychiatry. She is the first BC doctor to hold group visits for patients with dementia and their caregivers.
“We’re holding these group visits monthly for 6 months, and while we’ve only had three so far, to date it’s been very successful,” says Blouw. “The group dynamic is working better than I expected.”
Group medical visits are one of the practice innovations popularized by the Practice Support Program (PSP), a joint initiative of Doctors of BC and the BC Ministry of Health that provides training and support for physicians and their MOAs designed to improve clinical and practice management and to support enhanced delivery of patient care.
Blouw attended PSP learning sessions on practice efficiency methods such as group medical visits.
Blouw is a family doctor and she consults in geriatric psychiatry. She has many patients with dementia, so she decided to start holding group sessions for them. Her first sessions had six to eight patients per visit, along with one or two caregivers per patient. Each monthly session features a speaker, such as a dietician, occupational therapist, mental health expert, or pharmacist.
The group visits are held in a large, central space at the community healthy living centre, and snacks are served. First, confidentiality agreements are signed; then there is a presentation from the speaker. Blouw then holds a round-table discussion to find out how things are going for each patient, and there is time for questions, medical checks, and prescription renewals.
“At first, it was tough to adjust to the group setting with patients,” says Blouw. “I’m used to doing things one-on-one in a closed office. But after doing a couple, I see that the group dynamic is working better than I expected, and I’m getting used to it. The participants are very comfortable discussing their issues together.”
The patients in Blouw’s group have mild to moderate dementia. “They are all very respectful of each other, and there is good interaction, lots of interest, and positive feedback,” she says.
Kim De Sensi has been bringing her father to Blouw’s group visits and finds they offer a different level of interaction.
“At first, I wasn’t sure what the group visit was about, but by the second one, we were sharing medical information and feeling completely comfortable about that,” says De Sensi. “The speakers offer great information, and this is definitely more medical than my usual caregiver support group. I’m glad to see new stuff like this.”
While Blouw admits she is in the early stages of incorporating the group format into treatment, she believes it is valuable for the patients and for her so far. “I’ve already had requests from others wanting to join the next group,” she says.
The PSP began as an initiative of the General Practice Services Committee (GPSC) – a joint committee of Doctors of BC and the BC Ministry of Health (the ministry) – and now receives additional direction, support, and funding from the Shared Care Committee and the Specialist Services Committee (also partnerships between Doctors of BC and the ministry).