Let me start by stating that I’m generally a fan of the healthcare industry [full disclosure: I work for a company in the healthcare industry]. This industry is full of people who dedicate their careers – as well as their personal lives – to developing, testing, selling, and prescribing therapies and devices that improve the lives of millions of people who would otherwise have little-to-no hope managing or treating a medical condition. Like many industries, it’s not all roses. We all know about the challenges (especially in the United States) around insulin prices, the gaming of the patent system, and the sometimes-ruthless pricing that is patient-unfriendly.
With that said, I’m going to focus on a significant issue that I’ve not only experienced myself, but have seen evidence of broadly, across the world: healthcare providers and organizations doing a super sub-optimal job of communicating with people with diabetes. There’s a pretty good reason for this: 1.5 million new cases of diabetes are diagnosed every year in America alone.
In other words, to healthcare providers, diabetics are a never-ending freight train of insulin disorders, which means we’re all treated about as importantly as just one of the anonymous cars you see on a train as it rolls by a train crossing.
Due to the scale of the insulin disorders in our population, physicians (note: I’m talking in general here; there certainly are exceptions, and I’ve been lucky enough to experience the exception as well as the norm) see diabetics as cookie-cutter cases. So much so that it wasn’t until the 1990s that doctors realized that adults could even contract type 1 diabetes (formally medically referred to juvenile-onset diabetes). Talk about cookie-cutter diagnosis – adults who had an autoimmune disease were being treated for a metabolic condition! But, if we’re being realistic, doctors don’t have much choice – their job is to see and treat as many people as they can. So of course they rely on pre-defined “cookie-cutter” diagnostic templates when they can to drive efficiency into the system. Any decent operational strategist would advise the same – spend as little time on repeatable tasks and spend the most time on the valuable tasks that improve outcomes.
Because each type of diabetes is broadly seen as defined and quantifiable, the healthcare industry uses the following cookie-cutter templates: Got type 1? Here’s insulin (if you can afford it). Got type 2? Lay off the beer, pasta and bread, and here’s your prescription for metformin and perhaps a secondary oral prescription. Wham, bam, thank you, ma’am!
This certainly improves efficiency, but like every efficiency-driven system, quality tends to suffer. Worse, the autopilot nature of template-based prescriptions leaves many diabetics with an incomplete understanding of what exactly is going on, why it’s happening, and how patients can best mitigate this insulin disorder’s long-term effects on health.
Which leads us to the next obvious question: can you trust your doctor? Check out the next chapter to see what the Type A Diabetic Manifesto has to say about this.