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

Image Credits: AI Generated

DOI: Not provided

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

Group medical visits, sometimes called shared medical appointments, bring together multiple patients who live with the same condition to receive clinical care, health education, and peer support in a single session. The model has gained traction in primary care settings as a way of extending scarce clinician time while addressing the psychological and social dimensions of illness that individual visits often leave untouched. For chronic pain, the promise is especially significant, because isolation and stigma can intensify pain perception and deepen disability. Patients with conditions such as fibromyalgia, chronic back pain, and persistent joint pain frequently report feeling dismissed or disbelieved, and that sense of invalidation can erode both mental health and engagement with care. The study set out to understand, in detail, exactly how a group format counters those forces.

The research was conducted within a randomized trial based at safety-net clinics in San Francisco, which serve patients regardless of their ability to pay. Safety-net populations carry a disproportionately heavy burden of chronic pain, along with the social stressors, limited access to specialists, and economic precarity that make multimodal treatment difficult to deliver. The intervention evaluated in the trial consisted of twelve weekly sessions, each lasting two hours, that combined clinical care with structured pain education, mindfulness practice, gentle movement, and group discussion. Rather than being led by a single provider, the sessions were co-facilitated by a team that included primary care and behavioral health clinicians alongside a movement and mindfulness instructor, an arrangement designed to reflect the biopsychosocial nature of chronic pain itself.

The research team, led by corresponding author Maria T. Chao of the Osher Center for Integrative Health and the Department of Medicine at UCSF, collected qualitative data from participants in the trial to map the social dynamics that unfolded inside the groups. Their analysis was organized around a well-established framework in social science that distinguishes four types of social support: emotional, appraisal, informational, and instrumental. Emotional support refers to empathy, warmth, and a sense of being cared for. Appraisal support involves honest feedback that helps a person evaluate their own situation and coping efforts. Informational support is the exchange of practical knowledge and advice, while instrumental support is tangible assistance, such as goods or services. The qualitative findings showed that all four types emerged robustly within the group visit setting, and that each reinforced the others.

Emotional support was anchored in what participants described as a nonjudgmental space built on trust. In conventional clinical encounters, patients with chronic pain often feel pressure to perform wellness or apologize for their limitations. Within the groups, that pressure visibly dissolved. Participants reported, for example, that arriving late or missing a session was met not with reproach but with understanding, which removed a layer of shame that can otherwise drive people away from treatment altogether. The trust also allowed patients to name and discuss grief, an emotion that chronic pain researchers have long identified as central to the experience of losing function, identity, and future plans. Being able to voice that grief among peers who genuinely understood it transformed the group from a medical appointment into a community of recognition.

Appraisal support flowed in part from the facilitators themselves. In a striking reversal of the traditional clinical hierarchy, facilitators disclosed their own setbacks and struggles, modeling honest self-assessment and showing participants that difficulty is part of every coping journey rather than a sign of failure. Peers then amplified this effect by offering affirmations that encouraged self-compassion, gently challenging the harsh self-judgment that so often accompanies chronic illness. This kind of feedback is delicate work; too much criticism can wound, and too much reassurance can ring hollow. The study suggests that the combination of credible facilitator disclosure and peer affirmation created a calibrated environment in which patients could reevaluate their progress without feeling judged, an effect that is difficult to reproduce in a fifteen-minute individual visit.

Informational support emerged from two complementary channels. The first was the formal curriculum, which delivered structured pain education, mindfulness training, and movement instruction in a way that patients could absorb gradually over twelve weeks. The second, and perhaps more distinctive, was the informal exchange among peers, who traded practical tips born of lived experience. One example highlighted in the study was the suggestion to use frozen water bottles as an inexpensive aid for plantar fasciitis, a simple hack that no clinician had mentioned but that a fellow patient had discovered and tested. These exchanges transform patients from passive recipients of expert knowledge into contributors, and the credibility of advice from someone who shares the same condition can make it more persuasive than equivalent information delivered from a position of authority.

Instrumental support, the most tangible of the four types, also flourished. Peers brought food to share, a small gesture with outsized social meaning, signaling care and mutuality across the group. Facilitators, meanwhile, used their clinical roles to connect participants with additional services, referring them for counseling and other forms of care that addressed needs beyond what the group sessions themselves could provide. In this way, the group visit functioned not only as a therapeutic space but as a conduit into the broader health system, helping safety-net patients navigate resources that often remain fragmented and hard to reach. The interplay was mutual: emotional safety made information sharing possible, and shared practical help deepened emotional bonds.

The study’s authors frame these findings through the lens of the biopsychosocial model of chronic pain, which holds that pain is produced and sustained by an interaction of biological, psychological, and social factors, and that effective treatment must therefore address all three. Group medical visits, they argue, are one model of biopsychosocial chronic pain management in primary care, and the four forms of social support they mobilize should be understood as core therapeutic processes rather than pleasant side effects. Through deliberate facilitation and structured peer exchange, the group format activates mechanisms, reduced stigma, honest appraisal, practical knowledge, and tangible aid, that are otherwise scattered or absent from conventional care. The implications for a health system confronting a national chronic pain epidemic and a shortage of pain specialists are considerable, pointing toward a scalable, humane, and evidence-informed way to deliver whole-person care where it is needed most.

Subject of Research: Social support mechanisms in group medical visits for chronic pain management in primary care

Article Title: Patients with chronic pain may benefit from group medical visits

Article References: Patients with chronic pain may benefit from group medical visits. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: chronic pain, group medical visits, primary care, social support, biopsychosocial model, integrative health, mindfulness, peer support, safety-net clinics, pain education, self-compassion, Annals of Family Medicine