Physicians' perceptions that they were unable to help patients overcome these barriers resulted in high levels of frustration. According to the study, this response was consistent among physicians in all four areas of the country included in the study. The frustration arose from a perceived inability to address patients' motivation for maintaining good health, patients' resistance to treatment recommendations and a belief that the barriers faced by patients are outside of physicians' control.

Specifically, the study noted that none of the physician participants identified their own action or inaction in providing care as barriers to good control, but instead often felt that "nothing I do will change anything." As a result, the study recommends training physicians and other health care providers in effective strategies that will allow them to work collaboratively with patients to address the barriers. At the system-level, the study recommends that more team-based strategies be developed, with health plan partners included in those teams to address payment reform for physicians. Physicians noted that spending more time with diabetes patients is not cost-effective and that there is a lack of reimbursement from health insurers for time spent counseling patients.

The research included physician participants who provide care to adult diabetic patients at translational research centers participating in the Translating Research into Action for Diabetes (TRIAD) study. TRIAD is a ten-year project funded by the Centers for Disease Control and Prevention (CDC) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to understand and influence the quality of care for patients with diabetes in managed care settings.

The study can be found online at: jabfm/cgi/content/abstract/23/2/171.

Source UMDNJ-Robert Wood Johnson Medical School