Comments on: Prescribing insulin for diabetes, do endocrinologists have a financial incentive to do so? http://www.kevinmd.com/blog/2009/01/prescribing-insulin-for-diabetes-do.html medical blog Mon, 23 Nov 2009 01:35:28 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Family Doc http://www.kevinmd.com/blog/2009/01/prescribing-insulin-for-diabetes-do.html/comment-page-1#comment-107647 Family Doc Wed, 15 Jul 2009 13:20:06 +0000 http://clients.emmense.com/kevinmd/2009/01/prescribing-insulin-for-diabetes-do-endocrinologists-have-a-financial-incentive-to-do-so.html#comment-107647 The few diabetics I have sent to endocrinology (because their diabetes proved very difficult to control, they had multiple endocrine issues or they seemed to have "type 1 1/2" diabetes) have seen an NP who hasn't provided any insight or changed management in any meaningful way. As for the newer oral agents, studies show they lower A1C by 0.5 to 1 at best. For my uncontrolled diabetics, that's simply not sufficient, so not including those agents in the guidelines seems appropriate. The few diabetics I have sent to endocrinology (because their diabetes proved very difficult to control, they had multiple endocrine issues or they seemed to have “type 1 1/2″ diabetes) have seen an NP who hasn’t provided any insight or changed management in any meaningful way.

As for the newer oral agents, studies show they lower A1C by 0.5 to 1 at best. For my uncontrolled diabetics, that’s simply not sufficient, so not including those agents in the guidelines seems appropriate.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/prescribing-insulin-for-diabetes-do.html/comment-page-1#comment-99818 Anonymous Tue, 30 Jun 2009 12:33:48 +0000 http://clients.emmense.com/kevinmd/2009/01/prescribing-insulin-for-diabetes-do-endocrinologists-have-a-financial-incentive-to-do-so.html#comment-99818 Anonymous one: You have concisely, and perhaps unintentionally, summarized the inherent conflict of interest in the sickness based medicine model (that includes physicians, hospitals, and pharmaceutical companies.) If the very question of conscious or unconscious incentives is met with moral indignation, then rational debate is precluded. Anonymous one:
You have concisely, and perhaps unintentionally, summarized the inherent conflict of interest in the sickness based medicine model (that includes physicians, hospitals, and pharmaceutical companies.) If the very question of conscious or unconscious incentives is met with moral indignation, then rational debate is precluded.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/01/prescribing-insulin-for-diabetes-do.html/comment-page-1#comment-89073 Anonymous Tue, 06 Jan 2009 15:22:00 +0000 http://clients.emmense.com/kevinmd/2009/01/prescribing-insulin-for-diabetes-do-endocrinologists-have-a-financial-incentive-to-do-so.html#comment-89073 if one follows that line of thought, all doctors have financial incentive to keep their patients sick. in fact, it may make more sense to keep young patients sicker since they have better paying insurance and decades during which they can continue to pay. it's only when your insurance becomes medicare that it starts to make sense to get patients healthy so they don't clog up the physicians schedule.<br/>hopefully that's not what is being implied by bloggers. if one follows that line of thought, all doctors have financial incentive to keep their patients sick. in fact, it may make more sense to keep young patients sicker since they have better paying insurance and decades during which they can continue to pay. it’s only when your insurance becomes medicare that it starts to make sense to get patients healthy so they don’t clog up the physicians schedule.
hopefully that’s not what is being implied by bloggers.

]]>