Primary Doctors for Diabetes Care

Diabetes patients with consistent primary care physician may receive better care

(RxWiki News) If you're living with a chronic disease like diabetes, it's important to have the help of healthcare professionals. According to recent research, it may be especially important to have a consistent primary care doctor.

Researchers found that diabetes patients with a consistent primary care physician may receive better care than those without a primary care physician.

Compared to nurse practitioners, physician assistants or covering physicians, primary care physicians paid more attention to prescribed drugs and offered more lifestyle advice to their diabetes patients.

"Find a doctor that works well with you."

Past research has shown that patients with a consistent primary care provider have better outcomes than those without.

Alexander Turchin, MD, MS, of Brigham and Women's Hospital, and colleagues wanted to see how these primary care physicians may provide better care.

"We found that primary care physicians provide better care to diabetes patients when compared to other providers in a primary care setting because they were more likely to alter medications and consistently provide lifestyle counseling," said Dr. Turchin.

From their study of more than 27,000 diabetics, the researchers found that 83 percent of healthcare visits were with a primary care physician. That is, the most common healthcare provider was a primary care physician.

The next most likely provider to see a patient was a covering physician, or a doctor that provides care to another doctor's patients when the doctor is not available.

Covering physicians accounted for 13 percent of all patient visits in the study. These providers were also more likely to see a patient for problems like pain or infection.

When the researchers looked at all patient visits together, healthcare providers gave lifestyle advice 40 percent of the time. Healthcare providers altered medication by adding a new drug or increasing a drug dose only 10 percent of the time.

Compared to covering physicians, primary care physicians had 49 percent higher odds of altering medications.

Compared to nurses and physician assistants, primary care physicians had 26 percent higher odds of altering medications.

In addition, primary care physicians had 91 percent higher odds than covering physicians and 21 percent higher odds than nurses and physician assistants of giving lifestyle advice.

"Access to care is important and covering physicians and other providers play an important role in increasing access, especially in patients with acute complaints. With growing focus on a team-based approach to practicing medicine, this finding should help guide the development of new models of primary care, especially in the care of diabetes patients," said Dr. Turchin.

"Based on this finding, we would suggest better documentation and communication of the treatment plan through electronic medical records to other care providers in efforts to help to bridge the gaps that we observed in this study," he said.

In other words, all healthcare providers play an important role in the management of diabetes. When patients do not always have access to their primary care physician, they may need the help of these other providers. However, it is important that all providers communicate with each other to keep track of their patient's progress.

The study included 584,587 patient visits among 27,225 diabetes patients.

The research was funded by the Agency for Healthcare Research and Quality, the National Library of Medicine and the Diabetes Action Research and Education Foundation.

The study was published December 10 in Diabetes Care, a journal of the American Diabetes Association.

Review Date: 
December 13, 2012