Diabetes
Targeting Top Care In Northern Michigan, diabetes is a very bright blinking dot on the health care radar screen. Roughly 14 percent of Northern Michiganders are afflicted with diabetes, a rate nearly 60 percent higher than the national average. Part of the reason is lifestyle, and part of the reason is cultural: we have a heftier than average population; we have an older than average population; and we have a higher than average Native American population, a group that is susceptible to the disease. But regardless of the reasons, top-notch diabetes treatment training is important for Northern Michigan physicians. Dr. Jill Vollbrecht, an endocrinologist affiliated with Munson Medical Center, saw a need for better dissemination of state-of-the-art diabetes treatment information when she began practicing in Traverse City in 2007. “What I saw was physicians were practicing diabetes medicine in very different ways,” she says. Overall, she felt the care was good, but she felt she could improve diabetes outcomes across the north if she could reach key caregivers—general practitioners in particular—and explain in a clear and nuanced way the standard-ofcare protocols developed by the American Diabetes Association. “As a specialist, all I do some days is diabetes, so what seems easy to me can be difficult for a general
provider. They have to keep up on many, many issues,” she says. Vollbrecht developed what was in essence a diabetes road show designed for general practitioners. She arranged a time to present at a given medical practice so that all the physicians there could hear the information together, and then she would meet with some of the group’s diabetes patients along with the attending physician. A key goal was reinforcing the need to stay fresh on ever-evolving standard of care protocols developed by the American Diabetes Association. To track the effectiveness of the education program, Vollbrecht gathered diabetesrelated data for patients treated by the physicians to whom she presented. The data show that patients who were already meticulous about managing their diabetes showed no significant change. But among patients who had been performing more poorly, there was meaningful improvement even 18 months after the visit. Thus far Vollbrecht has presented to 22 medical practices and is exploring the possibility of using teleconferencing technology to spread the word farther and faster. Vollbrecht wrote up her study, and it was accepted for presentation at the recent annual national conference of the American Diabetes Association, a prestigious invita-
Heart Valves
Advances in Minimally Invasive
TOP: BETH PRICE
Implant Surgery
Dr. Jill Vollbrecht
“As a specialist, all I do some days is diabetes, so what seems easy to me can be difficult for a general provider. They have to keep up on many issues.” tion that included the results being published in the Scientific Sessions Abstract Book, a supplement to the journal Diabetes.
231.935.5000 munsonhealthcare.org
Physicians at McLaren Northern Michigan have recently begun implanting aortic valves in a minimally invasive way directly through the chest wall, without open heart surgery. The procedure is a step forward in catheter technology and a key advance for especially frail patients. We asked Dr. John Talbott, a surgeon with Michigan Heart and Vascular Specialists, to explain the procedure. One of the more common forms of heart disease is aortic stenosis, a condition in which the aortic valve becomes stiffened by the accumulation of calcium on and around the valve tissues. A stiff aortic valve does not open and close adequately, and the blood flow through the valve can be greatly reduced. Of course any heart valve with reduced flow
MyNorth Medical Insider
MI 3