A business case for shared medical appointments in dermatology: improving access and the bottom line

To evaluate the economic viability of shared medical appointments (SMAs) in dermatology. Secondary objectives include a comparison of the hourly adjusted census levels generated by SMAs compared with regular clinic appointments (RCAs), as well as a comparison between the economic viability of dermatology SMAs and SMAs in other fields of medicine.

Cost-benefit analysis.

Outpatient clinics within an academic medical center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.

No patient-identifying information was obtained or reported. The SMA census data included 301 SMAs (11 different programs and 5 separate departments), representing 2045 appointments over 16 months. Comparisons between patient groups were based on data from the SMA census and mean provider census (MPC) for RCAs, matched on reason for appointment.

Hourly adjusted census levels and profit differences (charges less costs) between SMAs and MPC for RCAs.

All individual and departmental SMAs generated significantly higher mean census levels and profits per hour than the respective non-SMA MPC of the health care provider leading the SMA (individual, P < .05; departmental, P < .001). All dermatology SMAs generated significantly greater differences in hourly adjusted census levels and profit in comparisons between SMAs and MPC for RCAs than the respective measures in all other departments (P < .001).

Taken together, the results of this study provide strong evidence to support a business case for SMAs in dermatology as a means of simultaneously improving access, productivity, and the bottom line.