According to this article in the NY Times, sounds like your diabetes care providers ought to reflect your current therapy preferences and your diagnosed condition. Makes sense to me!

(forwarded to me by email - original source unknown. If this is yours, please let me know and Challenge Diabetes Blog (CDB) will be more than happy to give credit where it’s due.)

AMA president suggests consumers may benefit by selecting physicians based on shared interests.

In the New York Times’s (1/3, G1) Personal Best column, Gina Kolata asks if consumers should select physicians based on shared interests. For instance, should obese people seek “fat friendly” physicians, or should athletes consult only physicians who are also athletes? There is no clear answer at this time, but according to Ronald Davis, M.D., AMA president and a specialist in preventive medicine at the Henry Ford Health System, “[t]here are some hints.” For instance, one study surveyed “about 4,000 female doctors, and found that those who were at least moderately active were much more comfortable advising patients about exercise, and encouraging them to exercise.” Such physicians are “more likely to provide advice on exercise that will be meaningful to patients,” Dr. Davis stated. Similarly, William Kraus, M.D., 53, “a cardiologist who is a professor of medicine at Duke, and runs 35 miles a week and finishes five-kilometer races in about 20 minutes,” said that “athletic doctors are less likely to take the easy way out, and tell an active person who is injured or ill to stop exercising.”

As a follow up to our virtual endo visit via web-based video conferencing supported by HomeCheck-A1c and our ADMS for automatic blood sugar logbook collection, formatting and reporting, I thought I would post the patient’s perspective:

“It was awesome, I told Dr. Ponder I felt like we were landing on the moon!! I want to recreate the moment and place a little flag in the webcam field of vision. Dr. Ponder’s pics were dragging, a little pixel slow? We thought the internet traffic was probably heavy at that time of day? Thanks so much. I am so glad to be a part of this.” - Rhonda Lanclos, Houston - Texas

This patient-endo encounter on November 30th, 2007 was in fact very unique. On the surface, it was a video call between a person in 1 location and 2 people in another location over 200 miles away connected via the Internet. No big deal. Happens all the time.

However, in this case, the diabetes specialist was armed with highly accurate and insightful data. The patient did almost nothing to generate this data as well as nothing to share it. Nobody had to drive anywhere at any time. Neither party on either end did anything to share an accurate picture of blood sugar control. Yet, the visit happened because there was a reason to have a visit. There was data that created a need and it was available to be acted upon. That’s so different than just having a visit because of the passage of time.

Admittedly, very few people can comprehend what I’m talking about since they’ve never experience true automation when it comes to diabetes care. Give a person a taste however and they understand. It’s like the difference a day makes between describing real-time glucose alerts via GlucoMON and talking to the mother after she receives one on her phone. It’s funny but some things truly do require you to have the experience first and no amount of explanation can be the substitute.

The ramifications of this test are far reaching and must be related to the current estimate of over $132 Billion dollars every year spent on direct and indirect costs attributable to people with diabetes. I’ve been told before that if you want to get someone to buy into your idea, you must do at least one of three things: make them money, save them money or improve their quality of life. On this day I think we got all three.

November 30^th 2007 just became a milestone in my 20+ year career as a pediatric endocrinologist. I hope it will also become a milestone in the care of all children with type 1 diabetes as well. This was the day I performed my first high speed Internet based pediatric diabetes care follow up visit using a pilot service called Diabetes HouseCall™. As a first of its kind event, it involved having my patient and their parent comfortably ensconced in their living room 220 miles away from me, yet fully in my view (and theirs) as their pediatric diabetologist. Full visual and audio contact was maintained for a 30 minute plus encounter.

Even better, all my patient’s blood sugar data was automatically collected with accurate and reliable time stamps and presented in my preferred color-coded format by the Diabetech® Automated Diabetes Management System™ which includes the GlucoMON® wireless blood glucose meter device and GlucoDYNAMIX™ software. In addition, the patient’s highly accurate Homecheck-A1c™ results including the %A1c value were provided to me in advance allowing time for my careful review prior to the visit.. Having this data in the patient’s record in advance probably saved 15 - 20 minutes vs. the typical patient visit.

During the encounter, I was able to perform a complete pediatric diabetes follow up visit, including the chance to answer all patient and parent questions. A follow up care plan was defined and in three weeks I will receive an updated blood sugar logbook highlighting trends resulting from this visit automatically forwarded to me via GlucoDYNAMIX. Our next virtual visit will take place in 3 months with scheduling handled efficiently online.

With Diabetes HouseCall, actual face to face visits need only be done yearly since the patient has a regular physician to manage any non-diabetes related medical problems if they arise. HouseCall is pure time with the diabetes specialist, unencumbered by a crowded and noisy waiting room (during flu season no less) and no time spent performing tasks such as downloading meters and blood sample collection. Families will also forgo that long drive to the clinic and back and for many families who drive longer distances or fly, no hotel and meals. While we’re at it, no missed time at work for these parent’s either. And one last benefit for the families with two involved parents that I see is making it easier to have both parents available to attend the visit thus avoiding the stress of one spouse trying to re-enact the visit later that evening.

Therefore, November 30^th 2007 marked to me the beginning of a new era in diabetes care: the virtual visit with inexpensive and easy to use, commercially available PC equipment and broadband access that can be had for as little as $15/mo in many areas of the Country. Most importantly, a comprehensive high quality pediatric endocrinology visit was conducted in the home of my patient, without the need for:

1. Taking as much of their time away from parent’s work or the child’s school;
2. A tedious waiting room stay and registration process; and,
   
3. A 450 mile round trip (it’s green!).
   

They were also able to spend more quality time with their diabetes doctor (30+ minutes of face to face time: match that with most diabetes office visits!). From my standpoint, my patient’s glucose, A1C and ancillary test data were seamlessly transferred to me in my preferred format and the appointments were made online by the family. This is the future of high technology diabetes care, but it’s not meant to be a total replacement for all face to face encounters. Once yearly visits are preserved, which allows full access to the entire diabetes team, including me. Diabetes HouseCall was just a dream a little over 2 years ago. Now it’s a reality