"Real Life is Often Suboptimal": Delivery of Diabetic Patient Education in Family Medicine Practice
Diabetes is a growing public health concern in the United States that affects 21 million Americans and costs the United States $245 billion a year, including lost productivity. As the rates of diabetes increase, family physicians are finding themselves as the sole healthcare provider. As such, family physicians are now expected to provide diabetic care and lifestyle counseling to help their patients best manages their disease. Physicians have their own approach and philosophies about lifestyle counseling which could be influenced by their practice environment. To date, there are no published studies to determine if diabetic patient education given by family physicians differs between physicians in a private practice and academic medicine. There is likely a difference in how the two groups approach patient education since academic physicians are in a setting that facilitates improving patient encounters and, therefore, may be more comfortable in a teaching role. The data in this qualitative project included family medicine physicians in private and academic settings in eastern Nebraska. Data were analyzed via the grounded theory method to identify patterns amongst physicians and determine differences between groups. Audio, video, and transcribed recordings of patient encounters and post-encounter interviews were synthesized in to memos and coded for aspects of diabetes education. Memos allowed for continuous analysis of patterns until saturation was reached. The majority of physicians lamented that they were not formally trained in lifestyle counseling and thus drew on personal experiences to give recommendations. Establishing rapport was found to be important prior to discussing lifestyle modifications. Physicians began discussions of diabetic education using lab results. This study also identified the concept of patients wanting a short cut to lifestyle modification. There were no clear patterns of difference among the physicians groups however, since they were on a spectrum, it is possible any further studies in patient education could be conducted in either environment and extrapolated to all family physicians. As this study was a small sample size in one location, further studies are needed to confirm these results.
Bramblett, Taylor Anne, ""Real Life is Often Suboptimal": Delivery of Diabetic Patient Education in Family Medicine Practice" (2018). Texas Medical Center Dissertations (via ProQuest). AAI10790362.