The Article in Brief

Encounters by patients with Type 2 diabetes are complex and demanding: an observational study

Michael L. Parchman, MD, MPH , and colleagues

Background During most patient visits, doctors have “competing demands,” that is, multiple health conditions and preventive measures that demand their attention. Because of limited time, doctors often prioritize those demands and deal only with the most urgent problems. This study looks at whether competing demands in the primary care doctor visit affect the delivery of medical care for diabetes.

What This Study Found Needed diabetes services are less likely to occur during visits for the competing demand of acute illness. When fewer diabetes services are delivered, follow-up visits are scheduled sooner. More diabetes care is given when visits are longer.

Implications

• Competing demands during visits with patients who have type 2 diabetes can interfere with delivering needed diabetes services. In spite of this, primary care practices often make use of the acute illn
• Changes in the primary care practice setting could improve the quality of diabetes care. New models of care are needed, such as group visits, as well as information technology that allows for manageme