Group Checkups

By Young1s Latest Reply 2012-02-15 22:02:38 -0600
Started 2012-02-11 16:10:20 -0600

I recently read that some doctors are now thinking about or experimenting with having group checkups for their patients with "certain chronic diseases". Here's a link to the article that I found.

Given how well this dynamic works for us here, as far as sharing information and experiences are concerned, I was wondering if this could transfer over successfully in the real world. Would you ever share your doctor visits?

56 replies

Dr Gary
Dr GaryCA 2012-02-15 21:24:20 -0600 Report


Wow, this is a really interesting idea. Especially if the medical professional is trained to facilitate group discussion, get people sharing information and supporting each other.

Thanks for sharing this!


Young1s 2012-02-15 22:02:38 -0600 Report

Thanks for stopping in Dr. Gary. I guess this sounds a lot like what you do. Have you seen or been a part of anything like this with any type of disease?

draco59 2012-02-13 21:17:16 -0600 Report

I find the concept very interesting from a couple of different points. First, from be on DC and some of the connections, is that a lot of us here on DC, have some other medical problems in common. I don’t think it’s a coincident. A lot of them are a cause and/or effect of each other. So I see where a group session would be very useful. Secondly, a lot of people just need the personal interaction with other people, face to face. Now don’t get me wrong, I love it here on DC and the other connections I’m on. I’ve meet a lot of wonderful people here, that I consider friends, that I would not probably have ever meet other wise. Plus I live in a rural town; the closest big city is 60 miles away. I have to take at least a half of day off of work to see the doctor, which really sucks. So this is about a close as might get to a group checkup. I wouldn’t trade you all for anything. But I would give it a try. I do have support from my family, my wife’s a BSRN, but she does pediatrics, one daughter just got her RN, our other daughter just stared nursing school, and our oldest granddaughter, will start premed, this fall. I would welcome a group like that here. So let’s not shoot something down because it new and different. I don’t think one time there gives it a fair chance.
This one person’s opinion.

Young1s 2012-02-14 08:10:57 -0600 Report

I don't think anyone is shooting the idea down, Ryver. My intention for opening the discussion was to get the opinions of everyone from all sides; and I believe that's what we're getting. Giving what you've just described, as far as your proximity to medical attention is concerned, I think this would absolutely be beneficial to some people in your community. BTW: 3 nurses and a premed student, wow.

draco59 2012-02-14 12:00:07 -0600 Report

YA, and I'm also Lab Tech too. Very proud of them all.
I'm sorry if it sound that way, but I did get that feeling from a couple of the posts. If I was wrong, I apologies to you and to them….

jayabee52 2012-02-14 15:56:28 -0600 Report

Since you are a lab tech would you be willing answer a couple of questions a active poster here on DC put to me in an email? If not I understand.

If you would be willing, I'll introduce the 2 of you so she could ask the question from a real live lab tech.

jayabee52 2012-02-14 16:56:14 -0600 Report

Thanks Brian! Thought You might but thought I'd better ask.

I'll set up a 3 way email on DC. watch your inbox.

jayabee52 2012-02-15 07:48:41 -0600 Report

thank you so much for your reply. I got it this morning. Hey you're entitled to have a life outside of DC! LoL!

Young1s 2012-02-14 15:25:27 -0600 Report

No apology necessary. I'd be surprised if there weren't some people who said they wouldn't want to attend one.

Nick1962 2012-02-14 12:33:13 -0600 Report

You bring up a good point ryver. Would it be advantageous to isolated folks like you to possibly have a professional come to your community on a regular basis for a group meeting? Don't know if this is what Young1s had in mind specifically.

Young1s 2012-02-14 15:32:06 -0600 Report

Nope, I was asking in a general sense but can see the benefits to people in rural communities and maybe people in assisted living communities. The article wasn't geared specific to diabetic patients, so it could be applied to other chronic diseases as well.

Nick1962 2012-02-14 16:02:29 -0600 Report

I agree, not just for diabetics. I can see where this might take hold given the new ways information is being distributed these days. I imagine many are being left out of the loop, and as the article stated too few physicians or time.

draco59 2012-02-14 13:05:48 -0600 Report

Thanks Nick, We do have a hospital and Drs. Here, I worked there for 10 yrs. That Is why I go 60 miles to see a Dr. the hospital is up for sale, again, Docs come and go. Also we have a very elderly resident base here. There's nothing wrong with that, but about a good 30% is over 75. Young people are leaving; family's come and go depending on the oil and gas jobs. I love to have group checkups here, but realistically I don't see it happening.
Thanks Young1s for the article, it was great, sorry I didn't mention it before.

Nick1962 2012-02-14 13:51:15 -0600 Report

I guess that's where I was headed. My hometown was much the same - a bedroom/retirement town with the nearest "specializing" hospital an hour away. We had two hospitals but couldn't support an MRI department so we had a mobile unit once a month, and Bloodmobile also. Any diabetic instruction came from a dietician (who usually only put you on a 1200 cal. diet) or the health department (who basically handed out pamphlets).

draco59 2012-02-14 16:35:06 -0600 Report

We got little more than that. We do have a CT, MRI, Life star helicopter, stationed here, because the Amarillo’s too big hospitals has to cover such a big area, having one here makes response times faster. We do have a Medical group, that has a group of Drs. Cardiologest, Ortho, etc. But there very choosie about the patients they see. That's why most drive the 60 miles.

jayabee52 2012-02-13 22:08:37 -0600 Report

the idea is not new, however. It has been around for about 20 years that I know of. It hasn't gotten "traction" in all this time. It has had a fair chance, IMO

TsalagiLenape 2012-02-13 08:31:22 -0600 Report

I want my medical kept private yet I get more from here than any group per se I have been too thus far. I attended only one for people with Diabetes in my area. I left feeling like an unwanted visitor. No one reached out. No was any area other than the usual being addressed there. Hence i rather come here. That way if I wish to choose to share my medical info its on my own head than the Doctor or nurse. Hence they are not viloating the Hippa Law. IMO

red flower lady
red flower lady 2012-02-13 15:46:07 -0600 Report

So sorry. What did you do to make yourself a participant? Did you just sit there, or did you ask the questions for what you needed and were ignored? Sometimes, you need to be the one to take the first step and speak up. You could always talk to the person in charge and address your concerns, I'm sure you would get answers or be directed to person/site to get them.

Young1s 2012-02-13 10:29:18 -0600 Report

Sorry you didn't feel welcomed but what do you mean by no one was in any area other than the usual being addressed?

Young1s 2012-02-12 20:01:05 -0600 Report

In case you're all wondering about what my feelings are on the subject, they are just as mixed as some of you. I think it could have great benefits for those who are struggling with D on their own. If, as some of you said, there are clear guidelines to be followed. On the other hand though, I meet with my doctor about every 2-3 months now and I almost always have questions or concerns that I would not want addressed amongst non-medical professionals. Even still, I've been known to ask her nurse to leave the room on a couple occasions. So yes, I take my medical privacy very seriously.

I guess what it boils down to is my curiosity. I've learn so much from all of you and wanted to pick your brains once again to see if you thought the idea of this is doable. I mean, it works so well for us here, right? Maybe Tom's right, with anonymity comes comfort of disclosure. (Sorry if I put words in your mouth Tom)

Nick1962 2012-02-12 18:53:11 -0600 Report

I could see how the concept may be advantagous for folks like the elderly who are not computer competent. However, having attended several "support group" sessions when first diagnosed, it was clear that those who wanted to take control quickly became disenchanted with others who were just passively existing. If there were an agenda given by the doctor for goals and things like food education, learning to cook properly (my neighbor's wife did all the cooking, and he was just left to flounder after she passed), and possibly some form of group incentive for lower BG and A1c (like discounted supplies), it might have merit. Otherwise it would simply devolve into a coffe club i think.

Young1s 2012-02-12 19:31:10 -0600 Report

Sounds like you encountered some of the no-it-alls that Tom mentioned below. I can see how, without structure or some agreed upon rules of etiquette, the group discussions could become one sided and/or geared towards the needs of the participants who seem to demand the attention. Thanks for the input, Nick.

Nick1962 2012-02-13 09:06:39 -0600 Report

No, not so much the “know-it-alls” but rather the apathetic attitude. I worked in a hospital that had meeting space for just such meetings. I’d see weight loss groups attend dinner meetings, then hit the cafeteria line for a second meal or two “diet” desserts. My experience with the small T2 support group was much the same. The first half hour information and recipes were presented by an educator, and the last half was discussion. Rarely did anyone try the recipes and report back on them, and there were several members who quite simply couldn’t cook to begin with, and made no effort to learn. We had to report our average BG for the week, and after six weeks, only two of our group of 12 made any change. They didn’t even bother to lie. Much of the discussion centered around who “failed” during the past week, and there was a lot of hand-holding and back-patting and “there, there, you’ll do better next week”. There was little positive movement (if there was some, it was so slow I couldn’t see it), and the majority of the folks just accepted they had it, tested daily and they were resigned to the fact they’d always be running at about 175 daily or worse. This same apathy applies to any group. My weight loss group was the same way – 12 started, 4 finished.
I think as stated here it would be a great venue to form a sort of camaraderie with others, but as an effective tool in an effort to improve lives, things like hands-on cooking demonstrations, effective shopping trips, turning in food journals and testing results, or some form of accountability would be required.

Young1s 2012-02-13 10:55:24 -0600 Report

Well that is different. They were cheating themselves and accepting what is instead of working towards what could be. I've sat in on a couple of AA meetings like that. They focused on what it felt like when they were drinking and the situations they found themselves in because of it, instead of reflecting the positives that come from making a change. It left me feeling empty and on one occasion more hopeless than when I walked in. Needless to say, I stopped going to those particular meetings. Those are some great suggestions in your last paragraph. I think a group like that would go a long way towards educating and putting the newly diagnosed on the right track. As well as those who have been dealing for years to no avail and may have given up hope.

Nick1962 2012-02-13 11:21:16 -0600 Report

I can agree with that. I know often I left depressed because I was getting the impression I would be doomed for life. I wasn’t really in the correct frame of mind to begin with, so it was actually a toxic group.
There were those in the group who simply didn’t listen to the presenter because she herself wasn’t diabetic, and the few successful “PWD’s” that came in were looked at as lucky aliens or BS’ers.
Ooooh I’ll stop here before the full on rant surfaces – I can feel it building.
With proper moderation it could be a godsend. That’s what I like about DC here. I don’t think you could get away with being apathetic here for long and still participate. I’m starting to think we should take DC on the road and make it a TV reality show (but that’s a different thread).

Young1s 2012-02-13 11:41:32 -0600 Report

LOL! I agree with James. Besides, even though the airwaves are continually being bombarded new realitly shows on a regular basis (seems like there's one for everything now, don't get me started), I don't think people will tune in to see us clicka clacking on our keyboards.

jayabee52 2012-02-13 11:26:57 -0600 Report

I think something would be lost in "translation" to a reality show, especially if presented to folks who were NOT PWDs

Nick1962 2012-02-13 12:30:20 -0600 Report

Agree with you both, but I had thoughts in another direction. If I sort them out I may start another post.

dietcherry 2012-02-12 13:40:38 -0600 Report

Patricia I think this idea has a great many benefits. There are also drawbacks involved but I think for just check-up types of appointments, which you identified in your Discussion title, and nothing more involved, it could provide a sense of community among diabetics who often feel alone in their struggle :)

Young1s 2012-02-12 14:28:37 -0600 Report

It could get some diabetics to become more proactive in their own personal efforts. And for others, it may may make them aware of the fact that what they are currently doing isn't enough. Of course that would be a reflection on the doctor's part, but we all know it happens. Thanks for your thoughts Renee.

Old-n-Grey-n-Wiser 2012-02-12 11:42:02 -0600 Report

Anonymously and proximity are two different things. While we become friends and share things here the chance of coming face to face with each other is very slim, so it is as if we are anonymous. But if a group of people met face to face in an live group the chance of their paths crossing is great so, due to the close proximity of the group there would be very few useful discussions take place. Guess what I am trying to say is while we tend to bare our soul here, if we were in a room full of the same people we would be very guarded as to how much we open up.

Young1s 2012-02-12 13:13:14 -0600 Report

True enough, Tom. But wouldn't it also be an opportunity to bond with fellow/local diabetics whom you could possible develop friendships with and help each other along your journeys?

Old-n-Grey-n-Wiser 2012-02-12 13:39:39 -0600 Report

Yes, for some people it could help them very much, but it would need to be in a group support setting with a very strong moderator in charge to keep no-it-alls and egos in control.

Lizardfan 2012-02-12 15:16:27 -0600 Report

I attend Weight Watchers class and whenever I meet someone who also has diabetes it gives me a chance to learn a lot. It also blows my mind how uninformed some people are about their treatment and just diabetes in general. It is like they don't have a clue! My Joslin clinic has classes for diabetics lead by a certified diabetes educator that patients can use. I never attended those classes. I just researched and read everything I could get my hands on, plus keeping a food diary helped me tremendously.

I would be comfortable doing a group visit if I were NOT having any issues, otherwise no way!

Young1s 2012-02-12 16:34:57 -0600 Report

Seems to be the growing consensus. You've brought a question to mind though. If more and more doctor's started this, would that take away from the great work that CDE's do, or would it enhance it?

jayabee52 2012-02-12 07:26:19 -0600 Report

This idea has been around for at least 20 yrs. ( I think Ecclesiastes said there is nothing new under the sun. ) I think it had failed for the same reasons that grannysophie listed below.

Young1s 2012-02-12 09:15:03 -0600 Report

Didn't know it is a repeated concept, if you will. Have you ever attended one? Would you ever consider it now if it was an extended visit and personal issues weren't discussed unless initiated/divulged by the participants themselves?

jayabee52 2012-02-12 09:17:32 -0600 Report

never have and I doubt I would. I would wonder how the HIPPA laws might affect those. Personal isssues not discussed? Then it would not be a Dr visit!

Caroltoo 2012-02-12 23:40:57 -0600 Report

You sign a consent to be in group and promise to hold all said in group confidential to that group.

The biggest impact is in the recordkeeping aspect, where each person's comments go in their own file and only the broad generalities of the group process go in the group file.

Young1s 2012-02-13 11:35:00 -0600 Report

I hear what you're saying Carol, but can you really trust that someone is going to abide by the confidentiality? Even if I did sign something, it would probably be a while before I felt comfortable or safe enough to reveal personal medical issues, if at all.

Caroltoo 2012-02-13 16:22:09 -0600 Report

You are only open to the degree that you feel comfortable being open. As you get to know the group and trust developes, most are willing to share more intimate details.

Caroltoo 2012-02-13 14:36:34 -0600 Report

I've done groups with sex abuse victims, so it was pretty nasty stuff and rather graphic. Folks took a couple weeks to warm up, but as they saw others getting relief from sharing, they would join in. Never had any blow back due to lack of confidentialily.

This is actually pretty pro forma in the mental health field and believe me, it is all very confidential.

Young1s 2012-02-12 10:18:19 -0600 Report

I see your point James. It would essentially just be a suppot group, but with your doctor. But that wouldn't necessarily be a bad thing. Thanks for your replies.

granniesophie 2012-02-11 20:54:59 -0600 Report

Oh, G-d, I hope not! I don't ever want to share anything medical with other people in an office setting, I have a hard enough time telling some of it to my doctor as it is! Some things are just better one on one.

Young1s 2012-02-11 21:57:04 -0600 Report

I hear what you're saying because there are things I discuss with my doctor that I would want kept just between us. But what if it wasn't every visit, just every once in a while? Would that still seem too impersonal to you or feel like it's eating into you're one on one time?

granniesophie 2012-02-12 05:01:29 -0600 Report

I only get about 5 minutes with my doctor anyway, the other alloted 10 minutes is with his nurse. So I cram as much as possible into that 5 minutes as I can, and he is ususally trying to get out the door the whole time I am asking questions! Not that he doesn't want to answer, necessarily, he isn't allowed the time! So, I am not going to even address sharing my 5 minutes with anyone else, and try to discuss my own stuff! I'm not even comfortable asking them sometimes. I come away with unanswered questions each vist, and have to find my own answers anyway :)

Young1s 2012-02-12 10:15:04 -0600 Report

Sorry you have such short visits. I can understand now why that time is very precious to you. Thanks for your responses.

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