Re: Endo Shortage

On Wed, 9 May 2007 19:51:22 -0500, "William C Biggs MD"
<MIQMRBIKFCMU@spammotel.com> wrote:

>
>"Kurt"
>
>>In your opinion, do you think that it behooves all diabetics to have
>>an endo on their team, at the very least for consultation and to
>>oversee their treatment?
>
>I don't think that every type 2 necessarily needs to see an endocrinologist.
>Many well controlled people with diabetes opt for that. Even if we don't
>change much because the primary care doctor is doing a good job, they like
>the reassurance. If a person is not well controlled or developing
>complications, then seeing an endo can be a good idea.
>
>IMHO, all type 1 patients should see an endo. Type 1 patients tend to be
>somewhat more complex, and can potentially benefit from the more intensive
>insulin programs or insulin pumps that generalists don't have.
>
>>How do you feel about lack of patient compliance when it comes to following
>>diet, >medication, and diabetes advice from a doctor?
>
>You need to find out why they aren't following instructions.
>
>Did they simply not understand them? Then it's our fault we didn't explain
>them properly. Are they afraid that our recommendations will make things
>worse? Then we need to talk about it. Are they unable to control their
>appetite, or won't get off their backside and exercise? We need to find
>alternate motivational methods. It's too easy to sit back and blame the
>patient for everything without trying to find out why the patient is
>behaving that way.
>
>> And finally: What percentage of diabetics do you think actively seek out
>> an endo?
>I really don't know how many seek one out. The latest numbers I saw was that
>8% of all diabetics saw an endo. For type 1's it is certainly much higher,
>probably well over 60%. Some don't see an endo because they don't have one
>in their city, others never realized they could benefit. Most type 2's are
>managed by PCPs, and they usually don't come to see us until there are
>issues. Even so, we see more type 2's than type 1's.
>
>Cheers,
>William C Biggs MD FACE
>
>

Very interesting.

--
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