Special circumstances that will alter the frequency of office visits.
Diabetes
All Diabetics require closer monitoring of their overall health status than patients without medical conditions in the general population. This should be done in order to preserve their health, prevent infections, prevent complications and detect complications early for treatment and control. All Diabetics should do home fingerstick glucose monitoring and should bring their meters to the doctors office.
Non-Insulin Dependent Diabetics (NIDDM) who are well controlled with their Glucose and Glycated Hemoglobin Levels (HgbA1C) should be checked a minimum of every 3 months with an annual complete physical exam from the time of their diagnosis onward. If they are not well controlled, glucose and HgbA1C levels outside of goal range, then the office visits should be at least monthly.
Insulin Dependent Diabetics (IDDM) who are well controlled with their Glucose and Glycated Hemoglobin Levels (HgbA1C) should be checked a minimum of every 1 month with an annual complete physical exam from the time of their diagnosis onward.
If they are not well controlled, glucose and HgbA1C levels outside of goal range, then the office visits should be as frequent as required to achieve goal glucose levels and then at least monthly.
At these visits for Diabetes Management the following should be evaluated:
- Glucose reading at every office visit
- Comparison of patient’s own glucose meter with Glucose reading at least twice a year
- HgbA1C reading at least every 3 months
- Urinalysis for proteinuria and microalbuminuria at least twice a year
- Diabetic foot check twice a year
Patients on Polypharmacy
(Polypharmacy means taking multiple medications due to multiple medical conditions)
These patients should be seen once a month on an ongoing basis to check for adverse drug reactions and interactions. To monitor for changes in medical conditions which can more readily be treated and managed as an outpatient if discovered early in the course of the medical problem.
