The American Association of Clinical
Endocrinologists 21st Annual Meeting and Clinical Congress in
Philadelphia, PA has had some interesting topics coming out of its
sessions. While they are not of an official nature until something
shows acceptance or is passed through peer review, some topics are
interesting just the same. Telemedicine is an acceptable way to
deliver care to endocrinology patients in rural areas, according to a
study given at the meeting.
Even with many states passing laws
requiring patients to be seen by doctors before being issued
prescriptions, this still should not stop this proposal from gaining
traction. In a conversation with a friend from a northwestern state,
he mentioned that a few doctors were considering and doing this, but
another group of doctors is opposing them. He commented that this is
very amusing for several reasons. Doctors bickering with doctors,
but he found that it was the better doctors that were wanting to do
this and the doctors losing patients that were in opposition.
I asked if these were endocrinologists
and he said they were from a variety of specialties and primary care.
He said that a few were already doing this with success and others
were hoping this could be a big help for patients that needed to
travel long distances in cutting down their travel. He also stated
that another doctor had several patients that needed to travel over
long distances and did not have computers, so he was consulting with
them on the telephone.
I agree that it is time for doctors to
take the initiative and this statement is true. "There is an
increased prevalence of diabetes in rural compared with urban areas,
which is compounded by the problem of a lack of endocrinologists,"
said Rabia A. Rehman, MD, an endocrinology fellow at the University
of Tennessee Health Science Center in Memphis.
The study took place in Tennessee and
the telemedicine unit of the University of Tennessee. There were 66
patients from five rural areas that were referred by their primary
care providers. The study lasted two and one-half years.
Patients were interviewed and examined
using the video conferencing in the telemedicine studio. A nurse was
used at the patient site and assisted the physician in assessing the
general condition of the patient. The nurse looked for swelling in
the legs and did a thyroid exam. Laboratory tests and management
strategies were sent to the patients' primary care physicians for
follow-up.
The study author stated that, "We
think it may be a little costly to set up the equipment up front.
However, in the long-run, this will be cost effective, not only for
the patients but for overall healthcare," She continued,
"This will save patients from traveling long distances,
resulting in timely consultation and leading to better control.
Improvement of HbA1c will also result in prevention of the multiple
morbidities and complications that result from uncontrolled
diabetes."
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