Reimagining Diabetes Care: Addressing the Gaps and Pioneering Solutions
In this post, we discuss the pressing issue of diabetes care in America—why it falls short, the impacts on individuals and communities, and the innovative solutions that can make a difference. Let’s dive into the current challenges in diabetes care, explore their broad effects, and discover how we can work towards more effective and compassionate solutions.
The Problem: Why Diabetes Care Falls Short in the U.S.
Diabetes is an incredibly common yet complex and life-threatening disease. Unfortunately, in the U.S., it often gets brushed aside until too late. The focus on prevention is minimal because it isn’t profitable for our large health insurance companies and hospitals, leading to an unfortunate acceptance of the disease. People might start with a "touch of sugar" that eventually progresses to severe complications, such as heart attacks, before our reactive healthcare system acknowledges the problem.
For many diseases, we consult specialists when initial treatments fail. If someone’s ear infection doesn’t clear up with antibiotics, they see an ENT specialist. However, for diabetes, many patients with poorly managed disease—suffering complications like amputations, retinopathy, or heart disease—never see a specialist. Astonishingly, 85% of diabetics never consult an endocrinologist despite evidence showing that specialist care significantly improves outcomes.
Why Is Access to Endocrinology So Poor?
Access to quality endocrinology is alarmingly limited. Approximately 75% of U.S. counties don’t have an endocrinologist. Clinics often have 3-6 month wait times and require stringent referral criteria. Patients face long phone hold times, confusing referral requirements, and appointment delays.
Even when patients manage to see an endocrinologist, they often encounter non-endocrinologist providers rather than an endocrinologist. This is a result of alarmingly low reimbursement by insurance. For example, an endocrinologist would have to see approximately nine patients with diabetes for every one patient a cardiologist performs a heart catheterization on to be reimbursed a similar amount. Both visits take a similar time and years of training. The endocrinologist also has a substantial amount of unpaid paperwork and follow-up required for each patient they see — that procedure-focused specialties do not. The specialty’s low pay relative to other fields further deters new physicians from entering the field.
The Cost of Poor Access to Quality Diabetes Care
The consequences of poor access to high-quality diabetes care extend far beyond individual patients. Diabetes is the costliest chronic disease in the U.S., with employers and patients bearing the financial and emotional burdens. Individuals with diabetes face higher medical costs, more frequent time off, and reduced productivity. In some areas, such as South Texas, diabetes affects up to 25% of adults— that’s one in every four people.
A Path Forward: Solutions and Hope
Diabetes is a major problem for all of us. Yet, I remain hopeful. Diabetes is not our patients’ fault. Let me tell you how I know.
5 years ago, I was asked to take on my first employer client. I was super green and thought why do they want me? These patients have failed primary care. What can I do?
Within 3 months, I had my answer. The clinic added my expertise to their primary care clinic model that valued time, access and support. I was afforded an hour to establish care with patients and sufficient time for follow ups. Staff responded promptly to the patient's questions and looped me in quickly when needed.
We lifted the expertise, time and access barriers and voila, it worked! By giving these patients expertise, time and access:
These patients reduced their A1c by an average of more than 2%, more than 3% for the very poorly controlled ones.
85% of them lost weight, they stayed out of the hospital, they changed their eating and exercise habits.
They were healthier, happier, empowered.
In 2020 COVID came along and we switched to telemedicine. With telemedicine we had sustained outcomes as well as high patient satisfaction with telemedicine.
Falling into telemedicine opened up a huge opportunity for us because we realized we could create access for busy, working people (aka employees), even those in the majority of the US without a local endocrinologist.
Now, we have grown our team and added several employers in Texas and Oklahoma to our group who we care for via telemedicine with sustained results by providing expertise, time, and access. At HeyHealthy, we help self-insured businesses who want to save money and time on employee healthcare by providing accessible, supportive diabetes and hormonal care to employees so they can be healthy, stay out of the hospital, and have renewed energy and productivity.
We’re extremely grateful for this work, and we are passionate and ready to serve your groups. Check out our new website HeyHealthy.com to learn more and get in touch!
