Discussion: An SMA visit for the preoperative consultation visit of Mohs surgery was designed to enhance patient education, increase patient access to care and maximize efficiency. This survey was designed to capture patient satisfaction with the structure, education, and overall SMA visit model. Our demographic data for SMA visit attendees is consistent with the described epidemiology of nonmelanoma skin cancer as a group of malignancies of the elderly with a male predominance.12, 13
Our data show that patient satisfaction for SMAs can be high. Overall, survey respondents answered the Likert scale survey questions with a mean value of 4.29 ± 0.09 (on a scale of 1 to 5, where 1 is the worst and 5 is the best). One of the primary goals of the SMA was to improve patient education. The majority of survey respondents strongly agreed that the SMA educated them on the diagnosis and potential treatment options of their condition. As in other educational ventures, the group dynamics of individual SMA sessions can be unique, ranging from engaged, active groups, with long discussions to meetings with predominantly quiet listeners. Recognizing this variability, it is reassuring that patients felt comfortable or very comfortable in the SMA in 82.2% of cases and would opt to attend another SMA to a similar degree (80.6%). Nevertheless, it should be noted that although patient satisfaction can be high, SMAs are suitable for most but not all patients. As the prevalence of SMAs will likely increases in the future, respecting these differences in the patient population and patient autonomy will be important.
Although the appointment date was included on the post-visit survey to make it possible to track responses over time, this did not prove n...
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...t to this survey including a small sample size, a homogenous patient population extracted from an academic referral center and a possible response bias. This survey was anonymous in order to obtain the most accurate survey responses. Consequently, precise characterization of nonresponders was not possible.
Conclusions: Successfully implemented SMAs for the Mohs preoperative consultation visit can result in high patient satisfaction. Ultimately, we believe that the goal of a successful SMA should always be to give patients more, not less. Physician benefits such as increased productivity, decreased repetition, and increased surgical time should always be secondary to the primary goal of enhancing the physician-patient relationship, improving patient education, providing a relaxed environment and pace of care, and decreasing appointment wait times for the patients.