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Doctors Cite Time, Low Reimbursement As Barriers To Providing Comprehensive Diabetes Care, Survey Results Show
Date:11/19/2009

medical and administrative time, facilities, staff and materials -- to ensure multi-disciplinary team care (32 percent), to provide lifestyle and behavior modification counseling (28 percent), or patient education on self-care and preventing complications (15 percent). Fewer than half (47 percent) of doctors surveyed said they had adequate resources to provide psychological and social status assessments.

The most common service that doctors provided their patients with diabetes was instruction in, and evaluation of, self-monitoring blood glucose levels. Blood glucose monitoring is critical for patients to prevent serious complications such as hypoglycemia, the leading cause of diabetes-related hospitalizations. While 89 percent of all doctors surveyed said they or their staff provided this service, fewer than half provided other services important to managing diabetes, such as medical nutrition therapy (36 percent) and multi-disciplinary care coordination (49 percent). Nearly three-quarters of all doctors surveyed said their practices provided annual eye exams and blindness education (74.5 percent) and weight loss counseling and physical activity instruction (76 percent).

Primary care physicians (92.5 percent) and their staff were more likely than endocrinologists (54 percent) to provide smoking cessation counseling. Yet endocrinologists were more likely (95 percent) to provide intensive insulin therapy instruction than primary care doctors (58.5 percent).

"Physicians who cannot provide comprehensive diabetes services within their own practices can and do refer patients elsewhere," said Alyssa Pozniak, PhD, study co-author. "But this fragments the care of the diabetes patient, as we learned from the research."

Data for the study was collected via a web-based survey of primary care physicians and endocrinologists as well as during a follow-on, online discussion group of a sample of physicians representing the t
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SOURCE National Changing Diabetes Program
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