With more than 25 affiliates around the country, the Joslin Center was looking to establish a presence in the Southeastern United States. Recognizing the growing need for diabetes care in our region, Joslin officials decided to join the Alabama healthcare community and have established the Joslin Diabetes Center Affiliate at Brookwood Medical Center in Homewood. Diabetes specialists Michael Rowland, MD, and Robert Chadband, MD, moved their practice from St. Vincent's Hospital to Brookwood to manage the new clinic.
"When I started training in diabetes care, the Joslin Center was the first place I heard about," Rowland says. "Knowing its reputation, I saw joining Joslin Center as an opportunity to do something to help this area."
Joslin was founded in Boston more than 100 years ago by Elliott P. Joslin, MD, a pioneer in diabetes treatment. He believed that patients should be educated about diabetes so they could take charge of their disease. Joslin Center still embraces those principles today. The Joslin Center philosophy of lifestyle modification embodies treatment, education, and research.
One of the advantages of being affiliated with Boston's Joslin Center is the monitoring and scrutinizing of patient plans and educational programs in affiliated clinics. "Because we are affiliated with Joslin Center, we are required to provide certain things in our office," Rowland says. "We already have a diabetes educator and a dietician in our clinic, and we have access to Joslin's diabetes specialists all over the country."
Rowland says the clinic follows quality care guidelines set by Joslin Center, and the physicians receive a scorecard that reflects their level of performance and the areas in which they need to improve. "I've been in private practice for 18 years and have always thought I did a good job. Now I have to prove it," he says. "I see it as a challenge and a help to me as I care for patients."
Rowland embraces the patient education philosophy that Eliott Joslin imparted so many years ago. "I came to Birmingham to practice in 1992 and have seen a lot of people impacted by diabetes. Obesity and sedentary lifestyles are the biggest issues," he says. "The hardest struggle is not just eating a good diet but getting the patient out and moving. A 20-year-old can exercise more easily than a 75-year-old, so we have to adjust our treatment accordingly."
The Joslin Center also recognizes that one size does not fit all in diabetes therapy, Rowland says. The therapy the doctors provide in the new clinic will become even more specific to patients with the planned addition of other specialists, like an exercise therapist. The clinic already offers a diabetes support group and a diabetic insulin pump program. The clinic is developing an outreach program to target regional health care professionals, medical students, doctors in training, nurses and nursing students. In addition to local patients, the clinic also is getting referrals for patients from Florida, Mississippi, Tennessee and Georgia.
Rowland says they are striving now to reach primary care physicians around the region to educate them on what the Joslin Diabetes Center Affiliate clinic offers. "We realize we can't see all diabetes patients in the region. We should only see the most difficult cases and let the primary care physicians take care of the routine ones. We want to work with primary care doctors to do that and to let them know we are here to help," he says.
Referred patients typically are seen quickly, Rowland adds, and they try to see doctor-to-doctor referrals the same day or next day. "We want to work with the doctors, and it is not our intention to take their patients," he says. "Some doctors just want us to get the patient's sugar under control and once we do that we send them back to the primary physician for continuing care. In some cases, the physician turns the patient over to us for diabetic care and they continue to manage the other areas of the patient's care."
Rowland says that because of the ancillary resources available through the Joslin Center, they are able to employ a more aggressive treatment approach for patients. In the past, he typically saw a patient every three months. Now, with more available resources in the office, the doctors can see a patient more often, which can mean faster treatment results.
Rowland is excited about what the Joslin Center affiliation will mean to the local health care community. "The Joslin Center brings a truly comprehensive diabetes care center to Alabama. It's been tried before but because of what the Joslin Center makes available, Brookwood Medical Center has made a commitment to this clinic," he says. "The funding and support staff is here, and all this will allow us to provide top-notch care for diabetes patients. It's an all-inclusive, one-stop- clinic for diabetes care."