(Sort of an addendum to my last post)
With the shifting focus to official recognition that successful diabetes management lies in the hands of the patient rather than the medical provider, there’s a whole lot of flurry of late about “behavioral issues.”
William Polonsky, author of Diabetes Burnout and founder of the new Behavioral Diabetes
Institute (and also a really nice guy!)
ADA Conference, Dr. Polonsky was kind enough to give me a moment to ask him
about this phenomenon.
Being the only disease that is managed more by
the patient than by the doctor?” I asked (thinking myself quite clever).
cancer? And heart disease? Patients have to be
diligent about testing their blood pressure, and about their diet –
avoiding salt, for example. Actually, we’re
breaking ground here for other diseases by focusing on the behavioral side.”
“compliant” versus “non-compliant” patients turned inside-out. No matter what drugs and treatment plans are
available, they will only work if the patient
takes charge and uses them proactively.
countless clinical studies attempting to gauge
the success of medical therapies. For example, if you send a bunch of patients off with capsules they’re supposed to
swallow and a meal plan to follow, and then
measure their blood pressure levels (or whatever’s being studied) weeks or months later, how do you really know anything for
sure? Did they really follow instructions? They
may say so, but everybody likes to get an “A,” right?
they’re closely monitored tend to overachieve for
the period while they’re in the limelight. This well-documented occurrence is called the Hawthorne Effect.
patients aren’t just abstract “subjects” at which
doctors can throw new drugs and devices. Rather, they are the key people who
will make the medicine work. Like
so many “new” concepts in medical science, common sense is finally coming to the surface here: patients’ behavior matters
at least as much as the treatments