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Interesting, but this is exactly what we do in our monthly 'Parkinson's Resource Organization' (PRO) support group meetings. Sometimes we have presentations, sometimes we have sales pitches, but most often and most important we have discussions about medications, exercise, alternative treatment options (who has tried what, and with what success), and generally get to know and care for each other. I guess all we are missing is a nuerologist billing us for his time: "A neurologist found he learned more about how his Parkinson's patients were faring by watching them interact with others than when he had them one-on-one." I could reverse this and say I have found out more about treatment successes and failures from this group than from any of the 5 nuerologists we have gone to! John and Sue ----- Original Message ----- From: "Kathleen Cochran" <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, May 04, 2011 7:35 AM Subject: Fwd: Fw: Exploring Group Checkups for Diabetes, Parkinson's (NYT 5/2/11) > ---------- Forwarded message ---------- > From: Kathleen Cochran <[log in to unmask]> > Date: 4 May 2011 10:15 > Subject: Fw: Exploring Group Checkups for Diabetes, Parkinson's (NYT > 5/2/11) > To: [log in to unmask] > > > Exploring Group Checkups for Diabetes, Parkinson's > > By THE ASSOCIATED PRESS > Published: May 2, 2011 at 4:22 PM ET > *WASHINGTON *(AP) — Wait a minute, Doc. You want me to share my > appointment > with 10 other patients? > > Group appointments aren't just for psychotherapy anymore. Put > diabetes<http://health.nytimes.com/health/guides/disease/diabetes/overview.html?inline=nyt-classifier> > , high blood > pressure<http://health.nytimes.com/health/guides/disease/hypertension/overview.html?inline=nyt-classifier> > and > maybe even Parkinson's > disease<http://health.nytimes.com/health/guides/disease/parkinsons-disease/overview.html?inline=nyt-classifier> > on > the list. > > Shared checkups aim to help patients who are battling certain chronic > diseases, and they're far from the typical 15-minute office visit. They're > stretched over 90 minutes or even two hours, offering more time to quiz > the > doctor about concerns, learn about managing the disease — and get tips > from > fellow patients. > > What's in it for the doctor? A neurologist found he learned more about how > his Parkinson's patients were faring by watching them interact with others > than when he had them one-on-one. > > "I can see if you're getting worse over the course of the visit, your > ability to eat, to walk, to converse and to think," says Dr. Ray Dorsey, > who > led a pilot study of group checkups for Parkinson's patients at the > University of Rochester Medical Center. > > "This is a new way of delivering health care," adds Dorsey, now at Johns > Hopkins > University<http://topics.nytimes.com/top/reference/timestopics/organizations/j/johns_hopkins_university/index.html?inline=nyt-org>. > "People are thirsting for better ways." > > It's a small but slowly growing trend that promises to get more attention > with the tight supply of primary care physicians, who find it hard to > squeeze in time to teach their patients how to deal with complex chronic > illnesses like diabetes. An American Academy of Family Physicians survey > found more doctors trying the group approach — about 10 percent of its > active members in 2009, up from fewer than 6 percent in 2005. > > Peer pressure among patients helps, says family physician Dr. George > Whiddon > of Quincy, Fla. He has about 40 diabetic patients divided into groups for > shared checkups at Tallahassee Memorial Family Medicine Quincy, and he > wants > to add more. > > One woman with uncontrolled diabetes for years confessed to fellow > patients > that she'd ignored Whiddon's "eat better, take your meds" advice for too > long. > > "Now I only have one toe left. I should have listened," Whiddon recalls > her > saying. "That had more impact than anything I said all day." > > Group appointments don't replace the patient's annual in-depth physical. > But > many people with chronic illnesses, especially if they're not > well-controlled, are supposed to have additional follow-up visits about > every three months — an opportunity for shared checkups that stress > patient > education. > > But how well do these group visits work? Evidence is mixed. An Italian > study > published last year found that diabetics who took part in them lowered > their > blood sugar, blood > pressure<http://health.nytimes.com/health/guides/test/blood-pressure/overview.html?inline=nyt-classifier> > and > cholesterol<http://health.nytimes.com/health/guides/nutrition/cholesterol/overview.html?inline=nyt-classifier> > more > than similar patients who got regular individual office visits. > > A separate study at two Veterans Affairs Medical Centers, in North > Carolina > and Virginia, tracked people with poorly controlled diabetes and blood > pressure and also concluded shared appointments can improve care for some > people. Those in group visits significantly improved their blood pressure > and needed less emergency care, but there was no difference in diabetes > improvement between patients who had shared checkups or regular ones. > > Parkinson's marks the newest attempt. Dorsey recruited 30 Parkinson's > patients and assigned half of them to 90-minute group checkups, and the > rest > to regular private visits that lasted a generous half-hour. During group > visits, everyone got a few minutes for private discussion with the doctor. > Then Dorsey gave an educational talk about a Parkinson's topic the > patients > had previously requested — from the newest research, to why symptoms vary > so > widely, to how patients cope at work — and took group questions. > > Medically, both sets of patients fared equally well during the year-long > study, showing that group visits are a feasible to offer, Dorsey reported > last week in the journal Neurology. > > What the study couldn't measure, Dorsey says, was how he watched patients' > interactions for subtle signs that they needed > prescriptions<http://health.nytimes.com/health/guides/specialtopic/getting-a-prescription-filled/overview.html?inline=nyt-classifier> > adjusted, > things like cognitive problems or if medications wore off too quickly. One > meeting even devoted 45 minutes to the pros and cons of implanted brain > stimulators to curb tremors. > > "Many heads are better than one. They think of questions you wouldn't > normally think of by yourself," says Jim Euken, a retired judge and > Parkinson's patient from Belmont, NY. He began exercising on a bicycle > after > one of Dorsey's group visits discussed research showing some patients > still > can bike when they can barely walk, for unknown reasons. > > Euken joined some fellow study participants who petitioned the hospital, > unsuccessfully, to continue group visits when the study ended: "It's not > that I don't get good care. I do. But I still think I learned more and I > think the process was better doing it in a group format." > > More research is needed to determine which patients fare better with group > visits, plus they take a lot of doctor preparation, cautions study > co-author > Dr. Kevin Biglan of the University of > Rochester<http://topics.nytimes.com/top/reference/timestopics/organizations/u/university_of_rochester/index.html?inline=nyt-org> > . > > Medicare<http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier> > will > reimburse the doctor for each patient in a shared checkup with proper > documentation that the visit includes certain elements, says Florida's > Whiddon. For his office, that means breaking even, as long as at least six > people show up for his two-hour diabetes groups. > > ___ > > EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The > Associated Press in Washington. > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: > mailto:[log in to unmask] > In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn