That means the solution needs to begin at home. Sequist is conducting a randomized trial to see if such measures as cultural-competence training, community tours so physicians will know more about disease management outside of the 20-minute office visit (for instance, exercise and diet options in the neighborhood), and performance feedbacks.
"From our organization's perspective, the solution meant that we had to implement programs that affected all of our doctors, not a program that identified 10 to 20 lower-performing physicians and do some sort of boot-camp, quality-improvement strategy," Sequist said. "Instead, we decided to try and increase awareness amongst all physicians, and try to provide tools to deliver better diabetes care to minority patients amongst all our physicians."
More information
The Agency for Healthcare Research and Quality has more on racial disparities in diabetes.
SOURCES: Thomas Sequist, M.D., general internist, Harvard Vanguard Medical Associates, and assistant professor, Harvard Medical School and Brigham and Women's Hospital, Boston; Joel Zonszein, M.D., director, clinical diabetes center, Montefiore Medical Center and Albert Einstein College of Medicine, New York City; June 9, 2008, Archives of Internal Medicine
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