Patient Satisfaction in Shared Versus Individual Medical Appointments for Third Molar Surgery

With continually increasing healthcare costs, providers are striving to increase practice efficiency while providing high quality care to their patients¹. Shared medical appointments (SMA), where patients with a similar medical condition are evaluated in a group setting, provide an alternative to individual medical appointments (IMA). Although SMAs have been adopted by many medical and surgical specialties over the years^2,3, this model has not yet been explored in the field of Oral and Maxillofacial Surgery. The purpose of the current study was to evaluate patient satisfaction in the setting of SMAs as compared to IMAs for third molar surgery consultations. It was hypothesized that there would be no difference in patient satisfaction between the SMA and the IMA groups. 

Participants included were patients who visited the Section of Oral and Maxillofacial Surgery in the Head and Neck Institute at the Cleveland Clinic during 2015-2016. Patients seeking consultation for third molar surgery were assigned randomly to either of the two groups by the scheduling administrators.The satisfaction surveys were composed of 8 questions, 7 of which had numerical answers ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Patients were asked to complete the survey at the end of the appointment. Thirty total surveys were collected, fifteen surveys for each of the two groups. The patients’ age, gender, race and socioeconomic class were not considered when analyzing the results of these surveys. The data were analyzed by calculating the average response for each of the 7 numerical questions and performing a student t-test between the two sets (n=30, n_SMA=15, n_IMA=15). 

The results indicated that SMAs and IMAs were equally easy to schedule (SMA=4.30, IMA=4.38, p>0.05), that the patients’ medical needs were equally met in both formats (SMA=4.43, IMA=4.69, p>0.05), and that the patients found equally ample time for questions (SMA=4.60, IMAl=4.92, p>0.05). Despite the group format in SMAs, no difference was found in the sense of privacy patients experienced between the two settings (SMA=4.47, IMA=4.84, p=0.09). However, it was found that patients perceived gaining  more valuable information from individual appointments (SMA=4.04, IMA=4.92, p<0.05), and that they would recommend an IMA to others more so than a SMA (SMA=4.21, IMA=4.92, p<0.05). Numerous positive comments were received from patients in regards to SMAs. However, these data indicated that patients would rather participate in an IMA than a SMA (SMA=4.13, IMA=4.92, p<0.05). 

Based on this study,  it was concluded that overall patient satisfaction was similar in SMAs and IMAs. By accommodating multiple patients in the SMA format, practitioners can utilize their time and resources in a more cost-effective manner. Therefore, SMAs should be considered by oral and maxillofacial surgeons in private or hospital/academic practices when evaluating third molar surgery candidates. 

1. Bartley KB, Haney R. 2010. Shared medical appointments: improving access, outcomes, and satisfaction for patients with chronic cardiac diseases. J Cardiovasc Nurs. Jan-Feb;25(1):13-9.

2. Giladi AM, Brown DL, Alderman AK. 2014. Shared medical appointments for preoperative evaluation of symptomatic macromastia. Plastic and Reconstructive Surgery. May; 134(6):1108-1115.

3. Knackstedt TJ, Samie FH. 2015. Shared medical appointments for the preoperative consultation visit of Mohs micrographic surgery. J Am Acad Dermatol.  Feb; 72(2):340-344.