Patients first see a resident, who gives them a complete workup. Then they are introduced to the diabetes specialist, who follows up with them on a regular basis. Bonding comes through the specialist being sort of the captain of the ship. He or she then empowers the dietitian or nurse educator to teach the patient about diet, home blood glucose monitoring, and other aspects of diabetes care. During the first visit, the patient also goes to the laboratory and the pharmacy, and for the next 2 days, he or she attends nurse or dietitian clinics.
We give patients very quick follow-up because it is important for them to see whether the treatment is working. If it isn’t, adherence drops. We quickly determine whether the treatment is working, and we can design a program just for the individual patient. This makes the patients feel that they are partners in the team, helping to create the plan.
Most of our patients get intensified care initially, and that’s what creates the partnering and bonding. We know that we can reasonably expect them to continue to do what we’ve asked them to do until the next visit.