Shared Medical Appointments (SMAs) — Shift the Health Care Paradigm

Shared Medical Appointments


Imagine increased productivity and morale!

A successfully implemented SMA program will pay massive returns on your investment.  

Shift the paradigm, and welcome the new era of HEALTH & CARE, quality improvement, efficiency, and effectiveness with one tool — Shared Medical Appointments (SMAs).

SMAs (Group Visits) continue to improve the patient experience, and progress towards the gold standard for chronic disease management, and innovative health care delivery for multiple measures. Engage with Brent Jaster, M.D. as your SMA Consultant or Speaker at your next Health event.

Exponential Benefits

The Shared Medical Appointment (Group Visit) sets a high standard in health care improvement and innovation, as a single mechanism with exponential direct, indirect, even existential benefits. Typical benefits (likely transferable to other populations) documented in the medical literature are:

  • Less hospitalizations, emergency visits, professional services
  • Superior quality of life, Hemoglobin A1c (7.0% vs. 8.7%), knowledge, self-management, and weight loss, with medication reduction
  • Lower A1c (7.3% vs. 8.8%), cholesterol/LDL, triglycerides, blood pressure, Body Mass Index, and creatinine, and higher HDL cholesterol
  • Decreased preterm births with increased breastfeeding success
  • Cost savings and/or increased productivity
  • Improved patient satisfaction with physician and quality of care, better quality of life and self-management
  • Better access to specialty appointments
  • Enhanced trust in patients/physicians
Other benefits include:
  • Reduced patient disenrollments from health plan
  • Less pre-diabetes advancement to diabetes
  • Shorter waiting times in clinic
  • Decreased (dramatically) patient phone calls to clinic
  • Enhanced accountability and peer support
  • Less isolation/Community building
  • Improved morale/Enthusiasm and JOY!
Common participant statements and experiences reaffirm the power of group dynamics:
  • “I am not as bad off as I thought I was.”
  • “I realized I am not alone.”
  • “I learned answers to questions I never thought to ask!”
  • “May I walk with you in the mornings?”
  • “I like learning from/helping others.”
  • “After decades resisting my doctor’s recommendations, the group changed me.”
  • “Despite a group of strangers, I never knew I could feel so at home.”

Shared Medical Appointments (SMAs), also commonly known as Group Visits, have an interesting and successful history. SMAs were first documented in the medical literature in 1907. Dr. Joseph Pratt, an internist, and a nurse, Mrs. Oreon, developed a model to treat tuberculosis cases effectively, economically, and efficiently. Dr. Pratt also helped establish group psychotherapy, which became popularized by Irvin Yalom, MD, after World War II.

In 1976, Dr. Lucy Osborn, a pediatrician, instituted SMAs for well child checks. John Scott, MD, a geriatrician, created a continuity model called the Cooperative Health Care Clinic (CHCC) in 1991 for chronically ill seniors. Sharon Schindler Rising, CNM, BSN, launched CenteringPregnancy® in 1993 for group prenatal care. Marina Trento in Turin, Italy, designed a very successful model for Type 2 diabetes in the mid-1990s. Edward Noffsinger, PhD, developed the Drop-In Group Medical Appointment (DIGMA) model in 1996, and the Physicals Shared Medical Appointment model in 1999. New and blended models continue to be created, with Brent Jaster, MD, at the forefront of innovation and spread of Shared Medical Appointments (Group Visits).


There is no perfect name for what has been called various combinations of the words Group, Shared, Medical, Visit, Clinic, Care and Appointment. At JasterHealth we prefer the term Shared Medical Appointment because the words clearly delineate that it is a medical appointment and not a class, support group or therapy group. However, a Shared Medical Appointment is educational, supportive, and therapeutic for the participants. In addition, the health care provider or physician assesses each patient.

The most important factor to understand about Shared Medical Appointments (SMAs) is that different models achieve different results. And no model will be successful without thoughtful and proper implementation. Many organizations have failed or will fail in their efforts to implement SMAs by overlooking important details, or using the wrong model for the wrong reasons.