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Redesigning Diabetes Care: Defining the Role of Endocrinologists Among Alternative Providers

  • Health Care Delivery Systems and Implementation in Diabetes (EB Morton-Eggleston and ME McDonnell, Section Editors)
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Abstract

The current diabetes epidemic threatens to overwhelm the healthcare system unless we redesign how diabetes care is delivered. The number of endocrinologists is grossly inadequate to provide care for all individuals with diabetes, but with the appropriate utilization of the primary care workforce and alternative healthcare providers working together in teams, effective diabetes care can be provided to all. We propose a patient-centered, goal-based approach with resources devoted to care coordination, measurement of outcomes, appropriate use of technology, and measurement of patient satisfaction. Financial incentives to healthcare systems and providers need to be based on defined outcome measures and reducing long-term total medical expenditures, rather than reimbursement based on number of visits and lengthy documentation. Endocrinologists have a responsibility in setting up effective diabetes care delivery systems within their organizations, in addition to delivering diabetes care and serving as a resource for the educational needs for other medical professionals in the community. There are major challenges to implementing such systems, both at the financial and organizational levels. We suggest a stepwise implementation of discrete components based on the local priorities and resources and provide some examples of steps we have taken at our institution.

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Authors and Affiliations

  1. Diabetes Center of Excellence, UMass Medical School, AC4-127, 55 Lake Avenue, Worcester, MA, 01655, USA

    Samir Malkani & David M. Harlan

  2. Department of Medicine, UMass Medical School, 55 Lake Avenue, Worcester, MA, 01655, USA

    Sheri A. Keitz

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  1. Samir Malkani
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Correspondence to Samir Malkani.

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Samir Malkani, Sheri A. Keitz, and David M. Harlan declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Health Care Delivery Systems and Implementation in Diabetes

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Malkani, S., Keitz, S.A. & Harlan, D.M. Redesigning Diabetes Care: Defining the Role of Endocrinologists Among Alternative Providers. Curr Diab Rep 16, 121 (2016). https://doi.org/10.1007/s11892-016-0818-3

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