Physicians as Disease Management Referrers

Tuesday, January 17th, 2006
This post was written by Melanie Matthews

Late last week, my colleagues and I were discussing the NY Times series on diabetes. Our discussion centered on a statistic quoted in the article “Diabetes and Its Awful Toll Quietly Emerge as a Crisis:” — “One in three children born in the United States five years ago are expected to become diabetic in their lifetimes, according to a projection by the Centers for Disease Control and Prevention. The forecast is even bleaker for Latinos: one in every two.”

My colleagues and I wondered how parents can let their children take the risks of not exercising and not eating right when there is so much at stake. But for these parents who are unable or unwilling to take the responsibility for the children, health plans and healthcare providers have to step in. These are hard conversations, but they need to take place.

When these children visit a primary care doctor, make an emergency room visit or have any type of interaction with the health system, we need to take advantage of the opportunity and broach the subject as delicately, but as strongly as possible. Physicians have to be willing to address the risks that lifestyle choices that in most cases parents are making and the impact that they can have on the future health of their children. Providing information on a disease management program or a lifestyle management program could make the difference for these families.

Physician behavior can influence the success of disease management programs, said Dr. Maureen Mangotich, medical director, provider and community outreach, McKesson Health Solutions, during a recent audio conference, we hosted on the role of Primary Care Physicians in Disease Management.

“They can influence our enrollees’ decisions to participate,” said Dr. Mangotich. “They are a necessary component for us to involve improving quality in a meaningful way, certainly clinical quality.”

The New York Times article provided a frightening look at the impact diabetes is having on New York City — An estimated 800,000 adult New Yorkers – more than one in every eight – now have diabetes, and city health officials describe the problem as a bona fide epidemic. Montefiore Medical Center officials estimates that on any given day nearly half the patients are there for some trouble precipitated by diabetes. Public health officials in New York are warning that left unchecked this epidemic could overwhelm the public health system in New York.

This is just one city. We have to reach these at risk people before it’s too late. And maybe one physician interaction at a time, we can begin to stem this tide.

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