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Examining Office Visit Trends for Diabetes

Examining Office Visit Trends for Diabetes

According to recent estimates, diabetes affects nearly 29 million people in the United States, putting these individuals at risk for other chronic conditions, such as cardiovascular disease, stroke, and other conditions. Diabetes ranked as the seventh-leading cause of death in the U.S. in 2009 and 2010, and costs for managing the disease are nearly $245 billion each year. Studies indicate that patients with diabetes have medical expenditures that are about 2.3 times higher than those without the disease. Considering the growing epidemic of diabetes, the U.S. Department of Health and Human Services has set one of its Healthy People 2020 goals to reduce the burden of the disease. In a recent data brief from the CDC’s National Center for Health Statistics, Jill Jacobsen Ashman, PhD, and colleagues set out to examine trends for visits to office-based physicians by patients with diabetes from 2005 through 2010. The data brief also described age differences in the utilization of healthcare by patients with the disease in 2010. All estimates were made using data from the 2005–2010 National Ambulatory Medical Care Survey. Office-Based Visits According to the data brief, the overall number of visits by patients with diabetes increased by 20%, rising from 94.4 million in 2005 to 113.3 million in 2010 (Figure 1). “Visits by patients with diabetes represented about 11% of all office-based physician visits in 2010,” adds Dr. Ashman. From 2005 to 2010, the number of visits by patients with diabetes increased across all age groups except for those younger than 25, with the largest percentage increase (34%) occurring among individuals aged 25 to 44. Researchers also found that the...
Alcohol Abuse Among Physicians: Taking Control

Alcohol Abuse Among Physicians: Taking Control

Physicians, like many adults in the general public, enjoy drinking an alcoholic beverage in a socially-appropriate context when they are not taking call. But what happens when casual drinking becomes a problem? Nine out of 10 doctors recognize when they’ve reached their alcohol limit and stop drinking. However, an estimated 10% of doctors allow alcohol to adversely affect their overall well-being, health, and medical practices (1). The National Institute of Health (NIH) suggests a man—younger than 65 years of age—not have more than 14 drinks a week, and a woman—who is not pregnant or attempting to become pregnant—not exceed more than seven drinks per week (2). If you or a colleague drink more than that, an unhealthy drinking habit may be emerging. Rigorously honest self-evaluation or peer-reporting is the next necessary step to avoid developing more serious issues of alcoholism. Reporting Harmful Behaviors Benefits the Medical Community The American Medical Association (AMA) Code of Ethics, considered the most widely accepted ethics guide for physicians, requires all doctors to promote personal health and wellness and to promptly inform relevant authorities of an impaired or incompetent colleague (3). Yet, one in three (36%) physicians surveyed in a recent national poll said they’ve had firsthand knowledge of a physician struggling with drug and/or alcohol misuse and yet did nothing. Some of the reasons these surveyed doctors gave for ignoring harmful behaviors included: “someone else would take care of the problem,” “nothing would happen as a result of the report,” “fear of retribution,” and feelings of being ill-prepared to deal with an unstable colleague (4). If we are to continue safeguarding patients’ care...
Physician Rapport With Obese Patients

Physician Rapport With Obese Patients

Recent studies suggest that obese patients may be vulnerable to poorer physician–patient communication because some doctors may hold negative attitudes toward these individuals. “Prior studies have shown that some physicians have less respect for their obese patients, viewing them as being lazy or unmotivated,” explains Kimberly A. Gudzune, MD, MPH. “These negative attitudes may come across during patient encounters.” Yet, no studies had previously assessed whether patient obesity altered physician–patient interactions with regard to biomedical and psychosocial dialogue and rapport building. In a study published in Obesity, Dr. Gudzune and colleagues sought to address this research gap by analyzing audio recordings of visits by 208 patients with high blood pressure who saw 39 primary care physicians (PCPs). Empathy Matters According to the study, patient weight did not appear to play a role in the quantity of physicians’ medical questions and advice, counseling, or treatment regimen discussions. However, PCPs built significantly less emotional rapport with their obese patients than with those who were normal weight. PCPs were more likely to show empathy, concern, and understanding with patients of normal weight by using words and phrases that reassured and legitimized patients’ feelings, regardless of the medical topic being discussed.   The findings raise concern about how these low levels of emotional rapport may impact obese patients, according to Dr. Gudzune. “This may weaken the physician–patient relationship,” she says. “It may also reduce the likelihood that patients will adhere to their doctor’s recommendations and may decrease the effectiveness of behavior-change counseling, which are vital elements to helping obese patients lose weight and improve health.” Building an Alliance Patients usually resent feeling that they are...
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