AACE Sees Difference in Diabetes Care Provided By Physicians vs Nurse Practioners

January 07, 2000

New York (MedscapeWire) Jan 7 — In response to the January 5, 2000, Journal of the American Medical Association article "Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians," American Association of Clinical Endocrinologists (AACE) President Richard A. Dickey, MD, FACP, FACE, noted that the care of patients with endocrine disease such as diabetes is often complex and adherence to well publicized guidelines of managing diabetes is often lacking. This often results in less than desired outcomes and increased risk for complications and rise in cost of care. Patient and physician education, collaboration, and adherence to good practices are vital for achieving good results, including patient satisfaction.

The healthcare practitioner who is interested in and attentive to the patient and who knows and adheres to good practices will achieve the best results, regardless of the disease being treated. In a cost-conscious healthcare environment such as ours, what appear to be similar outcomes, short term and long term, in the equivalent patient satisfaction and comparable costs, regardless of the healthcare provider's training, demands careful study. This experiment comparing primary care by nonphysicians to that of physicians does not provide answers to all the concerns.

AACE has developed and made available guidelines for the diagnosis and treatment of many endocrine disorders, including the recently revised AACE Clinical Practice Guidelines for the Management of Diabetes Mellitus, which were the centerpiece of the 1999 Patient First, AACE diabetes public education initiative. All AACE guidelines are available on its web site at http://www.aace.com. The diabetes guidelines include the AACE System of Intensive Diabetes Self-Management and such a system is advocated under the management of the clinical endocrinologist, the physician best trained to care for the patient with endocrine disease.



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