Diabetes impacts multiple aspects of a patient’s health. Because of intertwining medical conditions, it’s imperative for the patient’s caregivers to work together. The following four pearls may help ensure each patient’s condition is co-managed as effectively as possible.

1. Early communication is key
Veeral Sheth, MD, Director of Scientific Affairs at University Retina and Macula Associates, notes, “Often, patients don’t take diabetes control seriously until something, such as their vision, is affected.” Realizing vision loss is only part of the picture, Dr. Sheth always communicates with each patient’s primary care physician. “After the initial visit, I make certain to send a note to the primary care physician. Everyone involved in the patient’s care should be on board from the beginning; this makes systemic control so much better.”

2. Follow up with the primary care physician
Primary care physicians are the gatekeepers for their patients’ health care, Dr. Sheth explains. “Every patient who comes in with a diabetes related complaint already has a connection to a primary care physician.” When following up with primary care physicians, Dr. Sheth not only faxes notes, but also makes phone calls. He says, “Where there is clear pathology or a concerning issue, I make certain to speak to the primary care physician personally.”

3. Communicate with referring physician
To successfully co-manage a patient requires a team effort between the retina specialist and referring physician, who may be primary care or specialty, such as an endocrinologist. Dr. Sheth discusses the importance of meeting with referring physicians to educate them so they understand which patients should be referred to retina specialists and at what stage of disease. These meetings promote a team approach to patient care and help to keep all caregivers on the same page. An informed referring doctor ultimately benefits the patient.

4. Spending time with the patient initially is a good investment
When first meeting with a new patient, Dr. Sheth blocks out extra time. “The initial patient visit is 30 minutes,” he says. He uses this time to review treatment plans with the patient and the patient’s caregivers, particularly family members or others who will be assisting the patient regularly.

Rather than assigning a staff member with the duty of following up with a patient’s treatment plan, Dr. Sheth himself is the patient’s “point person” in the office. “I’ve found that there is improved follow through when I’m directly involved, versus my staff,” he explains.

Dr. Sheth also says patients need to be empowered regarding their own health. In his office, every patient sees his OCT scan. “In many cases, patients — particularly younger patients — request copies of their scans. They seem to like the instant feedback. I explain the scans to the patients. It’s true that a picture is worth a thousand words.” After the initial visit, subsequent visits go more quickly, lasting about 10 to 15 minutes.

By following these pearls, Dr. Sheth helps improve patient care by keeping all healthcare providers informed about his treatment plan. “I’m connected to my patients’ individual health histories, as well as their interactions with other physicians. Because my patients are aware of this co-management, they feel more secure and confident in my treatment.”