+Coaching for Control

Medical Students Changing Chronic Disease Outcomes

Alex Friedman Feinberg School of Medicine MD Candidate, Class of 2014Chicago Area Schweitzer Fellow, 2011-2012

+What do we know…

Diabetes prevalence: overall

Disproportionate burden: AA and Hispanic

Easily modifiable by lifestyle change

+But...

60% of patients with diabetes do not have good control of their

disease!

Knowing = Doing

Saydah, S.H., J. Fradkin, C.C. Cowie. “Poor Control of Risk Factors for Vascular Disease Among Adults with Previously Diagnosed Diabetes.” JAMA2004;291:335 – 342.

+“Difficult Patients”

+Peter Griffin

Overweight (BMI of… )

Diabetes

“Diet? Exercise? You mean driving through the fast-food restaurant doesn’t count?

Pills? I actually have to take them?

+

You are his doctor… what do you do?

+Get angry?

+Smile and say the same things, knowing nothing will change?

+What if it were even more COMPLICATED:

Peter couldn’t afford his medication?

Did not know what foods were healthy?

Had no safe place to exercise?

Did not understand why taking care of his Diabetes was important?

Did not trust his doctor would take care of him?

Had to worry about having enough to eat, not just eating the right things?

+Facing difficult patients

Image of patient and doctor

Image of patient with insurmountable walls

Patients facing barriers

+Coaching for Control Observations

Behavior change is difficult, especially for underserved patients who face greater barriers to care.

Idea

First year medical students have the time, compassion, and enthusiasm to encourage and counsel patients.

Students want and need to learn how to effectively promote behavior change

Support

Schweitzer Fellowship

PCC Austin

MSSRP

+Research Medical Students

Meaningful Service Skill Building 2-4 hours/week

Patients Motivational support Personal connection Bimonthly calls + group visits

Providers Education!

+YOU and Health Coaching

8 hours of training Basic diabetes knowledge Complication prevention Motivational Interviewing Program Tools

Orientation Meet your patient Initial Evaluation

Bimonthly phone calls (20-60 minutes)

3 in person group sessions (3 hours/month)

Bimonthly training (1 hour/week)

+Why ME?

Learn about the most rapidly growing chronic illness

Practice behavior modification not covered in our curriculum

Learn about determinants of health first hand

Establish strong bonds with a cohort of your peers

Provide an irreplaceable service for patients

Become a more valuable asset for patients you work with now, and will see in the future.

+What now? Reply online

Applications will be due Sept. 1

No experience is necessary; only enthusiasm and dedication!

Questions? Alex Friedman Mary-Friedman@fsm.northwestern.edu 803-479-7653