Detroit practice makes diabetic screening a priority

Perry Olson (right) reviews a patient chart with Amy Connolly, physician assistant.

Stout Family Medicine in Detroit keeps track of between 600 and 700 diabetic patients. The practice's high success rate in getting its diabetic patients to undergo required tests can be attributed to a strict protocol established by Perry Olson, a physician assistant and majority owner of the practice. The protocol includes identification, careful tracking and patient education.

Perry Olson and Lisa Rudd, patient

The first step is to identify the diabetic patients and the screening tests they need. "We use a form on our chart that outlines which procedures are needed for every diagnosis," says Olson. The practice also uses a diabetic registry that includes the name of and information for every diabetic patient in the practice. The registry helps the office track required tests. Olson explains that the registry is required of any practice that wants to be certified as a patient-centered medical home. Stout Family Medicine uses a registry provided by Olympia Medical Services, the practice's physician hospital organization.

A procedure log has proven helpful in tracking patients, adds Olson, noting the practice sees about 10 diabetic patients daily. "Every time a procedure is ordered by one of the providers, it gets put into the log. The log is then reviewed weekly by any of the three providers here. If we don't have results back from the specialists, we contact the specialist and the patient. Then the patient is rescheduled," Olson explains. "Once we started doing the procedure log, we could see exactly when and if the patient had the appropriate tests without having to pull the chart," he added.

One of the challenges in an inner-city practice is transportation. "I would love to bring an ophthalmologist into the office, but I don't have the space," says Olson. Instead, Olson says he looks for specialists that have office hours that accommodate patients with evening and weekend hours.

Other challenges sometimes include patient compliance and financial concerns. "A lot of times, our patients don't go for follow-up testing the first time. They realize that they may have a larger copayment seeing a specialist. But once I've called them to explain the risk of not doing the tests, they usually respond well," says Olson. "It all boils down to education."

Several times a year, Stout Family Medicine sends its diabetic patients to special classes at Botsford Hospital. There are also handouts about diabetes in the office. "Any newly diagnosed diabetic patient leaves with a basketful of information to review," says Olson.

Because he has a background in exercise physiology, Olson usually educates patients on diet and weight loss. "We also do an obesity registry," he adds. Olson says that he sees a correlation between patients with obesity and those with diabetes. "An obesity diagnosis makes it more difficult to control the diabetes," he says, "so you have to treat that at the same time."