Dr. Anne Peters’ Top Ten Actionable Tips

Dr. Anne Peters of the University of South California shares her experience as a health care provider and the top ten tips that she has learned while working in the field of diabetes. All patients – and other health care providers – should read her advice and make their meetings happier, healthier, and more productive. For more ideas on talking to your health care provider, please read our patient guide at diaTribe.org/patientguide.

For more about Dr. Peters, please read our diaTribe dialogue with her as well as our learning curve about her work at the Roybal Diabetes Management Center.

1. Talk about your biggest obstacles, fears, and concerns. Talk to your health care provider about your goals. Often the responses differ between the patient and health care provider. As a provider, I am looking for better glycemic control, but my patients may want something else. If so, then my goals and their desires can be interrelated so targets are reached.

2. Talk about your adherence with medication, even if your health care provider thinks they already know. People often surprise me with their honesty and sometimes their common sense (e.g. skipping a dose of Bydureon when they travel because the half life is so long, reducing the statin dose to every other day to reduce muscle pain, etc). If you are not at target and adherence is low then you should discuss ways to improve with your health care provider.

3. Providers should try hard not to scold. Sometimes health care providers tell people the same things over and over and they don't change, such as "test more often", "bring in your meter", "exercise", "eat better", "take your pills", etc. If someone continues to stick to less successful habits, then as a health provider I have not communicated the need for the habit well enough. My endocrine fellows in our type 1 diabetes clinic are amazingly good at getting people to improve self-care behaviors by providing all sorts of options of when to test, how to log, etc. These are very creative, and we need to make patients feel acknowledged.

4. The diabetes "puzzle" is large and complex. Even if glucose targets aren't reachable, we should praise patients for achieving LDL cholesterol and blood pressure targets. Sometimes using a statin effectively may be more helpful than blood glucose lowering.

5. Providers should encourage family members to come to visits (if you want this to happen).

6. Be sure to go home with one goal that has been mutually set with your health care provider. Make sure you agree on one achievable goal. Both patients and providers should write it in down in their notes so you can follow-up next time.

7. Providers should make refilling prescriptions easy.

8. Providers should always be accessible – diabetes is a tough disease to manage and far harder to manage alone.

9. Providers should never forget that patients who have had diabetes for a while know more about their diabetes; the provider likely knows more about diabetes overall but each patient knows their own experience with the disease best.

10. Encourage, encourage, encourage. Providers should try to be positive in nearly every situation. Conversely, they should be honest if there are true negatives to discuss. Even at the end of life there are ways to comfort and reduce suffering for patients. Thus, providers should always encourage and suggest creative methods with which to confront any situation.