The above picture was taken when I spoke at the International Diabetes Federation side panel at the World Health Assembly this past May in Geneva. The quote is my perspective as it related to the session:

Access to diabetes medicines and care in underserved populations: patient, health worker, government and multilateral perspectives on policy

Access to care is a major problem around the world. Yet while we may one day solve access to meds and affordability, there’s another type of access almost none of us have. Access to providers who work with us in a way that supports and encourages sustainable self-management. Why is there no innovation on this front?

Today companies are mushrooming everywhere with new multi-purpose drugs, devices, apps and services for diabetes management. Big companies are buying little start-ups, like Roche buying the popular app MySugar last week, to have more data, data, data. Yet, no one is thinking among all this external “hardware,” where is the “heartware” people need – the connection with their provider, the confidence building – to manage their condition?

In other words: Is the quality of interaction between health care providers and people with diabetes manifesting patients who are confident, enthused, skilled and committed to their daily self-care? Mostly, no. Why?

There is no major training for providers in chronic illness. So instead providers are applying what they’ve learned, acute care and attempt to fix our numbers, they are trying to repair what they see as broken in us. While Americans over the age of sixty increasingly live with one or more chronic illnesses, we should be training health professionals a different way of working with this enormous population. And, that treating someone with a chronic illness, requires something else entirely than a condition that will heal.

We know intuitively, and there is scientific evidence, that confirms people act when they feel safe, when they feel trusting. This is actually part of our neurobiology. People take new actions when they feel there’s a chance they’ll be successful, and that’s in part because someone makes them feel that they have their back.

We can throw as many new meds, meters, and apps at people living with diabetes as R&D budgets allow. That’s the easy thing to do. But studies show it doesn’t make all that much difference helping people be more successful managing their diabetes.

However, innovating the patient-provider interaction, that’s what we should be doing to help the millions of people with diabetes who still struggle with their care. That’s what we should be doing to help those doing well, continue to do so. That’s what I’m doing.  When the doctor paid a house call fifty years ago that’s what he was doing.