PCPs outshine peers when it comes to diabetic care

Primary care physicians (PCPs) provide better diabetes care than other providers, according to a new study performed at Brigham and Women’s Hospital in Boston.

“We found that [PCPs] provide better care to diabetes patients when compared [with] other providers in a primary care setting because they were more likely to alter medications and consistently provide lifestyle counseling,” says Alexander Turchin, MD, a physician and researcher at Brigham and Women’s Hospital and senior author of the paper.

The full study, published in Diabetes Care, reveals that the odds of medication intensification occurring were 49% higher when PCPs provided care than when covering doctors did, and they were 26% higher when PCPs provided care than when midlevel providers did. The odds of lifestyle counseling occurring were 91% higher under PCPs than under covering physicians and were 26% higher under PCPs than under midlevel providers, the study notes. During office visits for acute complaints, covering doctors were 52% less likely than PCPs to intensify medications. 

The study, which was funded by the Agency for Healthcare Research and Quality, the National Library of Medicine, and the Diabetes Action Research and Education Foundation, evaluated more than 27,000 diabetic patients who were cared for in the primary care setting at two academic medical centers. More than 80% of the encounters studied were with PCPs. The study notes that covering doctors were the next most likely to see diabetic patients, accounting for 13% of interactions, and they were most likely to see patient for acute issues.

“Access to care is important, and covering physicians and other providers play an important role in increasing access, especially in patients with acute complaints,” Turchin says. “With growing focus on a team-based approach to practicing medicine, this finding should help guide the development of new models of primary care, especially in the care of diabetic patients. Based on this finding, we would suggest better documentation and communication of the treatment plan through the electronic medical record to other care providers in efforts to help bridge the gaps that were observed in this study.”

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