Group Visits Could Reshape Chronic Disease Care, Expert Panel Finds

Chronic diseases now account for the overwhelming majority of healthcare spending and mortality in the United States, yet the standard fifteen-minute office visit was never designed to address the behavioral and social roots of conditions such as type 2 diabetes, obesity, and cardiovascular disease. A new expert consensus statement from the American College of Lifestyle Medicine argues that a long-standing but underused care model, the shared medical appointment, could help close that gap. Published in the American Journal of Lifestyle Medicine, the statement distills the collective judgment of a multidisciplinary panel into 56 formal recommendations on how clinicians can deliver lifestyle interventions through group-based medical visits that combine individualized care with peer support.

A shared medical appointment, or SMA, is a group visit in which multiple patients receive medical care at the same time from one or more clinicians. Rather than replacing the one-on-one encounter, the model extends it: patients in the room typically receive individualized assessment and treatment planning while also benefiting from the education, discussion, and mutual encouragement that emerge when people with similar conditions work through health challenges together. The format has been applied across a striking range of clinical settings, including type 2 diabetes, cardiovascular disease, obesity, chronic pain, behavioral health conditions, well child care, and prenatal care, suggesting a flexibility that few other delivery innovations can claim.

The consensus statement was produced through a validated Delphi process, a structured method in which experts answer questionnaires in successive rounds, receive anonymized feedback on the group’s responses, and revise their positions until stability is reached. The panel evaluated 106 candidate statements and ultimately reached consensus on 56 recommendations. Delphi methodology is widely regarded as a rigorous way to establish best practices in fields where randomized evidence is still maturing, because it systematically aggregates expert judgment while minimizing the influence of dominant individuals. Panelists represented leading healthcare and academic institutions, including Cleveland Clinic, Vanderbilt University Medical Center, UConn Health, and Harvard Medical School, and drew on expertise spanning lifestyle medicine, primary care, public health, and health coaching.

One of the strongest areas of agreement concerned access to care. The panel concluded that shared medical appointments can improve access to healthcare, increase patient satisfaction, and serve as an effective model for treating chronic disease. The logic is partly arithmetic: when a clinician sees several patients simultaneously in a structured group format, each patient receives more total contact time than a conventional visit allows, without requiring a proportional increase in clinician hours. For health systems struggling with specialist shortages and long waiting lists for diabetes management, weight management, and other lifestyle-sensitive conditions, that efficiency gain could translate into meaningful reductions in time to treatment.

Equally compelling to the panel was the social dimension of the model. Experts found strong consensus that shared medical appointments foster community, peer support, and social connectedness among participants, helping to address isolation and loneliness while supporting health behavior change. This finding arrives amid growing scientific recognition that social isolation is itself a risk factor for morbidity and mortality, comparable in magnitude to better-established behavioral risks. In an SMA, patients witness others confronting the same struggles with diet, physical activity, sleep, and stress, which can normalize setbacks, model successful coping strategies, and create accountability relationships that persist between visits.

The statement also endorsed the model’s capacity to support sustainable lifestyle change. Panelists agreed that lifestyle medicine-focused shared medical appointments can help patients set goals, build self-efficacy, and adopt healthier behaviors across the pillars of lifestyle medicine, which include nutrition, physical activity, sleep, stress management, avoidance of risky substances, and positive social connections. Self-efficacy, the belief in one’s own ability to execute the behaviors required to reach a goal, is one of the most robust predictors of long-term behavior change in health psychology research. Group settings appear to strengthen it by providing repeated exposure to peers who are succeeding, along with immediate feedback and problem-solving from both clinicians and fellow patients.

Beyond the benefits to individual patients, the panel found consensus that shared medical appointments can reduce healthcare utilization and costs while supporting provider well-being and broader healthcare quality goals. Clinician burnout has become a central concern in American medicine, driven in part by the emotional toll of managing complex chronic disease within visit lengths that make genuine behavior change counseling nearly impossible. Practitioners who lead SMAs frequently report that the format restores the intellectual and relational satisfaction that drew them to medicine, because they can teach, observe group dynamics, and track patient progress over a longer arc of contact. Reduced emergency department use and hospital admissions among well-managed chronic disease populations would add a financial incentive for payers and systems to adopt the model.

The consensus statement arrives at a moment when lifestyle medicine itself is scaling rapidly. The American College of Lifestyle Medicine, the professional society behind the statement, has trained more than 100,000 health professionals since 2004 and made more than 1.75 million hours of accredited continuing education available through courses and conferences. The organization’s premise is that healthcare must move from a system designed to manage disease to one capable of restoring health, by treating root causes rather than symptoms. Shared medical appointments fit that mission because they create the time and structure that intensive lifestyle intervention demands, something the traditional visit schedule structurally cannot provide.

The clinical framework outlined in the statement is intended to be practical rather than aspirational. By specifying agreed-upon best practices for patient selection, visit structure, clinician roles, and integration with primary care, the recommendations give health systems a template for piloting SMAs without having to invent their own protocols from scratch. First author Paula Gardiner, MD, MPH, emphasized that the statement is strengthened by the participation of panelists from a diverse range of professional medical organizations that are actively supporting clinicians nationwide in championing shared medical appointments as a vehicle for high-quality and accessible care. That breadth of institutional buy-in matters, because delivery-model innovations historically succeed or fail on the willingness of professional societies, payers, and training programs to align behind them.

For patients, the message of the consensus statement is that chronic disease care does not have to be a solitary, rushed, and fragmented experience. For clinicians and health system leaders, it is a signal that group-based care has matured from a niche experiment into a model with a formal evidence-informed framework behind it. As ACLM President and co-author Padmaja Patel, MD, put it, shared medical appointments have the power to redesign how care is delivered, providing a clinical framework for putting whole-person care into practice by expanding access, supporting sustainable behavior change, and fostering meaningful connection among patients and their care teams. Whether the model achieves that scale will depend on reimbursement policy, clinician training, and health system willingness to experiment, but the expert panel’s verdict is clear: the evidence and the enthusiasm now justify treating shared medical appointments as a serious instrument in the fight against chronic disease.

Subject of Research: Expert consensus on shared medical appointments for lifestyle-based chronic disease care

Article Title: Expert consensus statement highlights promise of shared medical appointments for chronic disease care

Article References: Expert consensus statement highlights promise of shared medical appointments for chronic disease care. (n.d.). Original publication

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Keywords: shared medical appointments, lifestyle medicine, chronic disease, American College of Lifestyle Medicine, expert consensus statement, Delphi method, peer support, behavior change, primary care, healthcare access, clinician burnout, patient satisfaction