HomeWhat's NewA Conversation with...A Conversation with Lauri Morales, MA

A Conversation with Lauri Morales, MA

Carondelet Medical Group
Tucson, Arizona

Lauri Morales, MA, who conducts group visits for Carondelet Medical Group in Tucson, Arizona, talks candidly about her experience with patients in group settings.

How do patients react to Group Medical Appointments?

I find that patients who have never attended a group medical appointment do tend to be resistant to the idea. They think it's going to be something like group therapy. But once someone's actually been to one, they like the warm, supportive setting and they realize that they've learned a lot by learning from each other, by hearing the real-life experiences of other people.

Group medical appointments are especially good for our elders because they can bring a family member and the long time format allows them to remember questions they may have forgotten they wanted answered. Everyone gets one-on-one time with the doctor and they build bonds with other participants. We try to make sure everyone is comfortable and keep it upbeat.

I encountered a gentleman the other day who had not understood that he would be attending a group medical appointment — even though we train our staff to communicate about group medical appointments both when the visit is scheduled and then when we do reminder phone calls. Regardless, this patient didn't understand that he would be attending a GMA and was adamant that he would not "sit in some silly circle and chit-chat." (I find that older men tend not to be as open to group medical appointments as older ladies.)

I always make an effort to encourage patients to stay. I ask them to at least try it once and then fill out our survey to help the practice understand why a patient doesn't wish to be scheduled for group medical appointments.

"Nope," he said, "I'm not sharing my personal business with these other people." So I asked him if he'd be kind enough to allow me to get everyone else settled before taking him back to the desk to schedule him for a private appointment. He took a seat near the door while I finished up the check in — but the next thing you know, he was in the thick of it! He just couldn't resist the group discussions and ended up scooting his chair over and jumping right in!

Was it difficult getting the practice set up for GMAs?

When I first started doing group medical appointments, I was a little nervous. Dee Ann Schmucker, the consultant who trained our staff and mentored the group visit facilitators for a few days, had a background in mental health and she emphasized that. My training as a Medical Assistant and is more clinically-focused, so I was initially concerned that I didn't have enough behavioral health training to deal with some of the issues that might arise in group visits. But when I actually started facilitating GMAs, I was surprised and delighted to discover that it just wasn't a problem. Keeping the focus on patient needs and their interactions makes the group almost seem to run itself. And the people really support each other. After a few visits I noticed patients were coming back, which was a real confidence-builder.

I call them "my regulars." They come in every couple weeks and they really help to diffuse the anxiety of some of the new folks. I get them to help me steer the group by calling on them to tell the group about their experiences and concerns. It also gives me the opportunity to mention that they've been coming bi-weekly for however many months. That really helps people who are there for the first time because they say to themselves, "Well, if she's come back again and again, there must be something good to it."

What are some tips you use to make your GMAs successful?

I make sure to tell the new folks that they can share as much or as little as they want. There's no pressure. And I always make sure to personally invite them back to the next group medical appointment.

Is facilitation of a GMA an art or a science?

I don't know for sure, but I do know that you have to have the personality for it. As the GMA facilitator, you are at center stage-- like a master of ceremonies-- because it's really about the patients, not about you. It's a balancing act: you have to be in control and keep things on track so that the doctor gets everyone taken care of in a timely manner...but you also have to be friendly and respectful. It can sometimes be like walking in the dark because you never know what you're going to encounter. I love people and I find it easy to be flexible and "move with it" so the role works for me.

What do you like about GMAs?

I enjoy facilitating group medical appointments and I am learning as I go. I learn from our patients and the rest of the team, as well as from our other GMA facilitator at our practice. And doesn't that seem appropriate? Learning to share and learning from each other is the reason we're doing this! It's what group medical appointments are all about.

Interview by Rhondda Francis