Making the Connection
Strengthening the Doctor-Patient Relationship and Improving Care
Taking Control Of Your Diabetes is taking on a challenge that, to my
knowledge, has never been attempted, successfully or unsuccessfully, by anyone,
anywhere. This autumn we are excited to launch a new kind of continuing medical
education program (CME) for healthcare providers. Educating physicians on the
most up-to-date strategies in diabetes management is a very slow and difficult process.
One of the biggest challenges in improving diabetes care in this country is to change the
attitudes of caregivers towards their patients struggling with diabetes. With these programs,
TCOYD hopes to foster a more empathetic atmosphere and more open communication between people with
diabetes and their healthcare providers.
I feel quite strongly that if the general caregivers in this country really knew
what it is like to have diabetes, both emotionally and physically, their level
of care would greatly improve. Better care means better communication. When
communication between the doctor and the patient strengthens, this diminishes
the commonly experienced brow beating and inappropriate labeling of patients as
"non-compliant".
It is amazing to me that frequently during medical rounds in the hospital,
the younger resident doctor in training presents a case by starting with something
like this: "This patient is a 56 year old non-compliant male with a history of type
2 diabetes for 5 years". After the presentation is completed I calmly ask the resident,
"Why do you say the patient is non-compliant?" The answer is usually, "Well-the last doctor
who saw this patient wrote it in the chart and the blood sugar levels
are not under good control." I have never in my life met a person with
diabetes who did not want to live a long and healthy life, free of complications
like blindness or kidney failure! The residents and interns
in the hospital now know very well not to use the word "non-compliant"
when presenting to me.
Our new Making The Connection initiative puts the doctors' learning
environment smack in the middle of a TCOYD patient conference.
The doctors will hear 3 cutting edge lectures from experts in their fields.
They will also join participants of the TCOYD patient conference to hear
my lecture and to hear a psychologist present on the emotional barriers to
good diabetes control. They will have lunch with the patient participants -
listening to a motivational speaker living with diabetes. At the conclusion
of the conference, the providers will come together to discuss all that
they learned and observed. We will monitor the success of these programs
by doing follow up questionnaires immediately following and 3 to 6
months after the program. Information on TCOYD's CME programs can
be found at www.tcoydcme.org or by calling our office at (800) 998-2693.
In the fourth quarter of 2004, we published the first draft of the
TCOYD Patient Consensus Statement in our newsletter. Its origin comes
from a workshop entitled, "What People with Diabetes Want Their
Caregivers To Know," from our 7th Annual North Carolina TCOYD
conference, moderated by Kathryn Britton who has been living with
diabetes for over 27 years. It is our intention to give this consensus
statement to physicians and other professionals taking our CME courses.
I will close with the 10th statement:
We have deep emotions about dealing
with our diabetes and are fearful of
complications. We worry about being
a burden to our family and loved ones.
We feel like failures when our blood sugar
levels and/or our A1c levels are not good.
This sense of failure makes things worse
and we sometimes give up on taking our
medications regularly, testing frequently,
exercising and being careful of what we
eat. We need help from you in keeping
our complications and numbers in
perspective without blame or judgment.
If we are truly failing, we want to know.
But if we are not, give us positive reinforcement
and help us moderate our self-blame.
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