People with type 2 diabetes often find visits with their physicians frustrating. Dr. Jeffrey Mechanick, MD, FACE, FACP, Secretary of the American Association of Clinical Endocrinologists (AACE), observes, “Many times when patients come to the doctor, the first thing that they say is really what’s on their mind–that’s their top priority. But oftentimes physicians don’t address that at all. Instead, they move on to what’s on their own agenda.”
It’s one symptom of the difficulties that sometimes arise in the communication between physicians and type 2 patients. To address the glitches that hobble those conversations, the American Association of Clinical Endocrinologists, along with AstraZeneca and Bristol-Myers Squibb, developed “The Type 2 Talk,” a new website for both patients and physicians.
The website (located at http://www.thetype2talk.com/home/), through a melange of suggestions for doctors and patients and downloadable tools for patients, attempts to help patients with type 2 diabetes and their physicians develop a deeper mutual understanding that leads to satisfactory conversations and more successful treatment.
As things stand now, the website reports, “doctors interrupt patients 18 seconds after they begin describing their problem.” Furthermore, “Immediately after their visit, patients only accurately remembered 50% of what their doctors just told them.”
In a series of notes apparently directed at physicians, the website also reveals that “satisfaction, recall, and compliance are all related to the amount and type of information doctors provide patients….A doctor’s warmth and friendliness are important to the relationship between doctor and patient….The emotional quality of the doctor-patient relationship is a key determinant of patient satisfaction with treatment.”
Dr. Mechanick says, “When patients come to their doctor for a routine appointment, they have their own agenda of things they want to accomplish, even if that agenda can’t be articulated. It might be a fear, it might that their blood sugars are out of control, or it might be a question of whether they can have a certain kind of cereal. Doctors also have their own agenda, particularly with electronic health records and all of the standards of care. So doctors need to go through a checklist, making sure the eyes are fine, the kidneys are fine, checking the CV risk, reviewing the medications and the fingersticks, making sure the A1C is okay.”
Dr. Mechanick adds, “You can already, just by hearing me describe this, see that there is an intrinsic tension. The Type 2 Talk website and its activities intend to address this, so that physicians have a better understanding of what patients require for the visit to be successful. And patients themselves have a better understanding of what their physician’s agenda is when they go through this routine encounter. It’s not a website just for patients or just for physicians. It’s about communication.”
One notation on the website suggests, “Doctors, try using empathy to help validate your patients’ emotional experiences.” Dr. Mechanick notes, “Patients are intimidated by physicians being on the pedestal and in the ivory tower, and physicians need to be aware of that.” For his part, he says, “For instance, I don’t even wear a white coat anymore. When the patient is sitting up on the exam table, I’m sitting on a chair with the computer so that the computer screen is not between the patient and me, and I’m sitting a little bit lower. One of the things I do in my own practice is try to break down those barriers that have been held over from maybe a generation ago. There’s always room for more humanism to be infused into the system….The website is only scratching the surface of the topic, but as more attention is paid to communication and behavioral medicine, hopefully we can improve outcome.”
Dr. Mechanick concludes, “The onus is on the doctor to make sure that every visit is a positive experience, so when the patients leave, they feel that something has been done constructively.”
The website does not advocate any particular drug or product. As Dr. Mechanick says, “It’s not about whether you should use a certain medicine. It’s really just about communication and how to ask questions, and tools can be downloaded from the website to make that communication easier.”
Novo Nordisk has announced the U.S. launch of NovoTwist®, a needle designed for use with several of the company’s pre-filled drug delivery devices, including the Levemir® FlexPen®, NovoLog® FlexPen®, and Victoza® pen.
The needle, which comes in 32G (5mm) and 30G (8mm) versions, is the first single-twist needle cleared for use in the United States. Its fitting allows users to “just twist” when attaching it to compatible pens. An audible and tactile “click” confirms that the needle has been attached.
NovoTwist needles may require a prescription in some states. For more information on the product, go to www.novonordisk-us.com.