Dr Daphne Tam has a busy Vancouver family practice that includes many patients whose first language is Mandarin or Cantonese. Tam is able to communicate with these patients in their native languages and decided to combine this ability with a new approach to treating patients with similar conditions: She held a group medical visit conducted in Cantonese to help some of her patients with cholesterol issues learn better diet habits.
Group visits are one of the practice innovations physicians are learning about through the Practice Support Program (PSP), a joint initiative of Doctors of BC and the BC Ministry of Health that provides training and support for physicians and their MOAs designed to improve clinical and practice management and to support enhanced delivery of patient care.
Tam attended PSP learning sessions on practice efficiency methods such as group medical visits and improving office efficiency.
Tam notes that the Chinese community has a high incidence of diabetes and pre-diabetes. With many of her patients showing signs of high cholesterol, Tam decided to hold her first group visit for Cantonese-speaking patients, focusing on diet tips related to the Chinese diet. The local health authority helped her find a Cantonese-speaking dietician, who was at the group visit to teach and to answer questions.
“It was great to have the patients all together so we didn’t have to rehash the same thing over and over, which saves me time later in individual visits,” says Tam. She held the group visit in the early evening in her office waiting room and had about 18 people attending, including some family members who came along to help older patients better understand what was being discussed.
“I told my patients to come prepared to take notes and to bring their reading glasses,” says Tam. The dietician taught them to read package labels, and many questions were asked, allowing for group learning and exchanges.
“In the Chinese culture, a lot of people don’t speak up, so I was concerned that people wouldn’t get involved and ask questions,” she notes. “But once we got going, I was surprised at how people did speak up. It worked out really well, and there was quite a bit of sharing of experiences. Some things came up that wouldn’t have in a one-on-one office visit, when we don’t usually have time to discuss those details.”
Elizabeth Wan was one of the patients at this group visit. She said she enjoyed having Dr Tam bring a dietician to increase her knowledge and noted that many people came with questions about specific diet items as well.
“I brought my own peanut butter, which was bought in the US, because I didn’t know if it was healthy,” said Wan. “The dietician told me it’s okay and also taught us how to read labels so we can judge for ourselves too. I asked a lot of questions, and it was helpful to get answers.”
Tam is looking for other topics on which she can hold group visits conducted in Cantonese or Mandarin.
“My patients are really attached to me,” she says, “so I want to be able to extend what they can get from my office to improve their health.”
The PSP began as an initiative of the General Practice Services Committee (GPSC) – a joint committee of Doctors of BC and the BC Ministry of Health (the ministry) – and now receives additional direction, support, and funding from the Shared Care Committee and the Specialist Services Committee (also partnerships between Doctors of BC and the ministry).