A new survey has found that nearly one-third of doctors surveyed said they did not have enough time and did not receive sufficient reimbursement to provide comprehensive care to their patients with diabetes.
According to the results of a study of endocrinologists and primary care doctors published today in American Health & Drug Benefits, 32 percent of physicians felt unable to provide comprehensive diabetes care, and most cited time or reimbursement as the major barrier. Furthermore, 83 percent of physicians surveyed said Medicaid reimbursement was inadequate, while 67 percent said private insurance reimbursement was inadequate.
Physicians surveyed said they did not have adequate resources — including 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.
Self-monitoring blood glucose levels
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).
“Diabetes requires multidisciplinary care and a team-based approach for the best outcomes,” Lana Vukovljak, Chief Executive Officer of the American Association of Diabetes Educators, said. “In addition to aggressively managing their blood glucose levels and monitoring their overall health, these patients benefit when provided substantial education on nutrition and the importance of weight loss, physical activity and smoking cessation,” said Ms. Vukovljak.
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 two specialties.
Source: National Changing Diabetes Program