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Taking Charge of Hormonal Health

Endocrinologists play a crucial role in treating hormone-related diseases, including common conditions like diabetes, thyroid disorders, and osteoporosis. Dr. Caitlin Colling, an endocrinologist based in Boston, Massachusetts, affiliated with Massachusetts General Hospital, and one of the newest members of the DocGo Medical Advisory Board, believes that there is a misconception about her field:

While many associate endocrinology with the treatment of these hormonal conditions, most endocrine care is focused on preventing the onset or progression of such conditions before they significantly impact a person’s quality of life.”

Proactive care, namely prevention, early detection and chronic condition management are essential in reducing the long-term consequences of endocrine diseases. 

Preventing Diabetes Complications with Proactive Care

Among the most prominent conditions treated by endocrinologists is diabetes. The CDC estimates that 38.4 million people have diabetes in the U.S. (11.6% of the population). Diabetes complications, such as damage to the kidneys, heart (heart attack or stroke), eyes and nervous system, develop over years. This extended timeline provides healthcare providers with numerous opportunities to intervene early and prevent more serious developments. “These life-altering, if not life-ending events are largely preventable with proactive care,” emphasizes Dr. Colling.

Early Intervention & Lifestyle Changes

For individuals with pre-diabetes, lifestyle changes involving diet and exercise can significantly delay or even prevent the progression of type 2 diabetes, the most common form of the disease. The earlier a patient is identified as being at risk, the more beneficial and impactful these interventions can be. Importantly though, practitioners must consider the social determinants of health, especially when dealing with populations that lack access to nutritious food, safe housing, or reliable transportation to attend medical appointments.

The challenge lies in providing accessible, realistic information on health and wellness. Conflicting advice about diet and exercise, along with disparities in access to resources, underscores the need to tailor wellness education to each patient’s lifestyle. A one-size-fits-all approach rarely works, particularly for vulnerable populations. However, as society becomes more sedentary, any cultural shift that promotes physical activity can positively influence diabetes prevention.

The Challenge of Access

Most diabetes care is managed in primary care settings due to its prevalence, but the timing of a referral to an endocrinologist can vary. Early warning signs of diabetes, such as increased thirst, urination, and weight loss, often prompt patients to seek care. Fortunately, screening for diabetes is relatively simple, requiring only a blood test. Some patients are referred early, while others may not see a specialist until their disease progresses, depending on the complexity of their care needs.

Unfortunately, one of the greatest challenges in endocrine care is access. Gaps in primary care are well-documented, but these issues are also significant in specialized fields like endocrinology. While screening and diagnosis is simple, accessing follow-up care has traditionally required multiple in-person visits. In reality, many patients with endocrine disorders do not live near endocrinologists, limiting their ability to receive timely care.

The Importance of Virtual Care & Remote Patient Monitoring

This is where virtual care comes into play. Advances in healthcare technology, such as remote patient monitoring, have made it possible to manage much of this care from home. Many aspects of endocrine care, including diagnoses based on blood work or imaging, can be managed remotely using innovative virtual platforms. This capability helps overcome geographic barriers and expands access, especially for patients living in underserved areas. 

By leveraging virtual platforms, healthcare providers can better meet the growing demand for endocrine services. Although some patients face an initial learning curve with these virtual tools, once informed, they can effectively manage their condition remotely. Physicians can use cloud-based platforms to monitor vital signs and blood sugar levels, reducing the need for frequent clinic visits.

The Future of Endocrinology: Overcoming Systemic Barriers

Despite the critical role endocrinologists play in chronic disease management, there is a growing shortage of specialists. This shortage is only worsening, and it’s clear that the current model of endocrine care is not sustainable. Dr. Colling believes that endocrinologists are not able to care for as many patients as they could because the traditional model, which has remained largely unchanged for decades, is outdated. The bottleneck in care is not due to medical expertise but rather the billing and communication practices that slow down care delivery.

Healthcare is full of stakeholders—payors, health systems, governments, patients, and practitioners—who are invested in improving patient outcomes, but they are held back by outdated systems of care delivery and billing.”

Like much of the industry, Dr. Colling feels that care needs to evolve from a system focused on billing and procedural events to one centered on patient outcomes, such as Value-Based Care (VBC).

Despite these challenges, Dr. Colling is optimistic about the future of proactive care and its potential to reshape chronic disease management:

Forward-thinking organizations like DocGo are stepping outside the traditional framework to facilitate innovative solutions to these challenges, and the wider medical community is excited about the potential for change. By embracing new models of care, endocrinology can become more accessible, more proactive, and more effective in the years to come.

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