Abstract
Integrative Medicine for the Underserved (IM4US) is honored to serve as a partner organization for this issue of JACM focused on innovation in group visits. We are an interprofessional organization that is committed to equitable affordable integrative health (IH) care for all. Promotion of group-delivered integrative services is one of our top policy priorities.
This prioritization flows from our mission. We support those who care for the underserved by providing educational resources through our annual conference, online toolkit, and other activities. Membership is affordable for all students, researchers, and practitioners, many of whom are low income. In addition, IM4US advocates for health policy that will make IH care accessible to all by promoting group visits and allowing the whole range of IH providers to provide care within their full scope of practice and be reimbursed accordingly.
IM4US was founded on a belief that equity is fundamental to health. We believe that IH care, especially when delivered through group visits, is uniquely positioned to address the devastating effects of social inequities on health. Providing group visits is not only a way to improve access to care but also, importantly, to mediate power in relationships and increase the provider's awareness of structural and social barriers that underserved patients face. These include lack of transportation to the clinic, 1 discrimination in health care encounters, adopting a healthy diet in a food desert, 2 and of course the profound impact of adverse childhood and community experiences. When providers sit in a circle with patients actively listening and learning about their patient's life experiences, facilitating interaction through experiential exercises and meaningful dialogue, they are better able to make a significant impact on trauma, chronic disease, and behavior change. 3 –5
As providers who have conducted group visits, we can say it has been one of the most gratifying ways we have provided care in our decades of practice. The focus is no longer on the distractions of modern health care such as electronic medical records, unreasonably short medical visits, repeating the same health information, and so on. During group visits, the provider's focus is on being fully present for the 1–2 h spent together. The result is a profound deepening of the patient–provider relationship and of the patient's understanding of themselves and their health issues. It is a privilege to witness patients transformed by the group process: being validated by other group members, problem solving together, and offering support to each other. 6 The benefits rebound to the practitioner. An overworked provider depleted by working in an under-resourced health care setting may find that group visits are a form of self-care.
IH providers who conduct group visits for the underserved face many challenges. These include a shortage of private space for groups, staff inadequately trained to provide groups, lack of staff and provider time, limited administrative support, and sometimes ambiguous guidelines for documentation and billing. 7 –9 IM4US is advocating for policy changes that validate group visits as a legitimate reimbursable mode of health care delivery. To support policy, we need more innovative high-quality qualitative and quantitative research that examines the group process, structural barriers impacting health outcomes and whole value of group visits. Patients need to drive the research process focusing on outcomes that are meaningful to them.
Just as in group medical visits, we are better together. Join us at