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Sports Medicine and Shared Medical Appointments – The Perfect Match

Q: What are the ways in which shared medical appointments can work in sports medicine?

Sports medicine is an ideal place for shared medical appointments!  SMAs are limited only by your imagination.

Injury Shared Medical Appointments

My ideal setup would have shared medical appointments each geared to specific injuries or conditions.  Let’s take the example of the common ankle sprain.  These patients:

  • Have a lot of downtime
  • Have a high recidivism rate
  • Need therapy, but not necessarily expensive and time consuming PT

I’d suggest doing shared follow-up medical appointments and shared rehabilitation for these patients.  Athletes especially are used to being a part of a team and would thrive on the support that shared medical appointments offer. The team that works with these groups might include a clinician, an athletic trainer and/or a physical therapist along with the support staff. The sessions might include education regarding the nature of the injury, dealing with the psychological effects of the injury, regaining motion and strength and stability and, of course, a return to play progression.

Chronic Condition Shared Medical Appointments

Another huge need is for management of chronic conditions like osteoarthritis (knees and hips in particular).  Shared medical appointments could address many issues, including:

  • The critically important role of physical activity
  • Home exercise programs
  • Understanding what OA is and is not
  • How to overcome limitations
  • How/when to decide on replacement surgery (i.e. help with shared decision making)
  • Tips and tricks
  • Coping mechanisms

Shared medical appointments offer a number of advantages: they allow for a great deal more education in self management – a key component of all major guidelines, re-enforcement of exercise programs and, importantly, a forum where participants can voice frustrations and learn from each other. SMA’s might help alleviate the frustration that comes from feeling alone and, perhaps, incapacitated - that these patients, and other sports medicine patients, often deal with. The loss of independence and self-identity that often accompanies a debilitating physical injury or process like arthritis can be overwhelming. Having a group forum to understand that others share these experiences and the chance to learn coping strategies from others in similar situations can be very powerful.

Arthritis Management Shared Medical Appointments

I am currently involved, as a representative of the American College of Sports Medicine, with the Coalition on Arthritis Management Initiative (COAMI), sponsored by the US Bone and Joint Initiative, in a national effort to develop a new paradigm for osteoarthritis management.  Nurses, physicians, physical therapists, physiatrists, exercise specialists, athletic trainers, researchers and others are putting together a national blueprint for shifting the paradigm in osteoarthritis management.  We are working on treating it more like a chronic condition – moving from reactive to proactive management.

Shared medical appointments could play a huge role in this.  The cornerstones of treatment are physical activity and self-management.  Shared medical appointments are the ideal forums to foster both of these. This has been demonstrated with SMAs for diabetes, blood pressure, and other chronic conditions.  Additionally, these patients need emotional support, something one-on-one visits simply can’t offer.

As more and more physicians move away from the nihilistic view that joint degeneration is an inevitable part of aging and simply prescribing medication as a primary treatment, different strategies are going to need to be used to help patients manage these conditions.  Shared medical appointments offer education, support, and more appointment time for physicians and patients to move through these issues together.

Doing More with Less

With the move to Pumps and ACOs, healthcare providers are being charged with continuing to "do more with less".  Physicians and the systems we work in are being challenged to improve outcomes – in every facet of medical care.  SMAs are a way to achieve multiple organizational goals: improve care, improve patient satisfaction with care, improve work satisfaction for providers and staff and (not least of all) improve the organizations bottom line.  Sports medicine and musculoskeletal care practices and clinics provide an opportune place to set, and achieve, these goals.