At this year’s annual meeting of the Alabama Academy of Family Physicians, faculty of the College of Community Health Sciences provided presentations to family medicine physicians about quality diabetes care, and to medical students preparing to apply to residencies.
The meeting, held June 22-25 in Sandestin, Florida, allowed family medicine physicians from throughout the state to connect, earn continuing medical education credit and learn more about representing family medicine in the legislative, regulatory and public arenas.
Quality care for diabetics
Quality care measures for diabetic patients generally include blood sugar screening, retinal eye exams and nephropathy monitoring. “But there’s more that we want to do for our diabetic patients,” said Dr. Jared Ellis, associate professor of family medicine at CCHS. “It makes a difference to provide quality care.”
To make quality care a reality, “we need to rethink health-care delivery,” Ellis said in his presentation, “Improving quality care delivery for diabetic patients.” Care, he said, needs to be evidence-based and pro-active, not reactive. Patients should be cared for by a team of health-care providers, and reimbursement models need to be driven by quality, not volume of services provided. And, “we need to teach our patients to take better care of themselves and to be more engaged in their care,” Ellis said.
He shared with the audience steps he has taken to further improve the care he provides diabetic patients, which includes screening for blood sugar levels, checking blood pressure, urine and lipid panels, providing foot exams, referring patients for retinal eye exams, and encouraging patients to take aspirin, get flu and pneumonia vaccines and, if they were smokers, to stop.
Ellis focused on three quality care measures that he felt he could improve – retinal eye exams, foot exams and recommending flu shots. Instead of referring patients for eye exams, he now has his office make appointments for patients, and he makes sure to receive an eye exam report afterward. He helped create a template and prompt for foot exams in his practice’s electronic medical record. And he now documents when patients take him up on his recommendation to get a flu shot, and when they don’t.
In addition, Ellis huddles with nurses before patient visits to conduct chart reviews and to order pre-visit lab tests. “It saves 10 minutes on patient visits,” he said.
Ellis said after a second assessment, there was improvement in all of his quality-care measures. “I got 100 percent on everything,” he said.
Interviewing for residency
Across Alabama, family medicine residencies accept a total of only 55 medical school graduates per year.
“There’s lots of competition for spots,” Dr. Richard Friend, director of UA’s Family Medicine Residency, a three-year program that provides specialty training for physicians, told an audience of more than 50 medical students who will soon apply to residencies.
When medical school graduates apply for residency positions, they use the Electronic Residency Application System, or ERAS, which is a system that collects common information from all graduates. Friend urged those in the audience to “spend a lot of time on your application. It’s the first snapshot we get of you, and we pay attention to every detail.”
He said the application allows students to showcase their strengths, and explain their weaknesses.
Of the several thousand applications the UA Family Medicine Residency receives, 150 applicants are interviewed. “When we get you into an interview, we start assessing you right away,” Friend said. “Be prepared. Learn about the program. Read about the people who will interview you and learn their roles in the program.”