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If Your Diabetes Is Out of Control, Go See Your Family Doc Every 2wks!: Thoughts on current medical literature & news as it pertains to optimizing our health. October 2, 2011
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Alvin B. Lin, MD, PLLC About the Author
Alvin B. Lin, MD, PLLC

Provided by My 2 Cents

I try to call a spade a spade.  I've pointed out colleagues who perform colonoscopies too frequently and place unnecessary coronary stents.  I've also pointed out areas for savings in our insurance system and in our government (stop paying benefits to the deceased! andreign in legislatures' ability to plump up their retirement benefits in ways that you & I can't do).  Earlier this month, two authors concluded that primary care physicians in the United States, including family physicians like myself, are paid too much relative to other countries and are thus driving up the cost of healthcare (conveniently, the reporters underplayed the point that primary care in the States is way underpaid relative to specialty care in comparison to those other countries- but that's another battle for another time). 

So just how do I jack up the cost of healthcare?  By seeing more patients!  Really?  At $40-50 per visit? Even at $100/visit, I'd be seeing patients 24/7 in order to approximate the cost of just one (unnecessary) procedure running into the tens of thousands of dollars.  Can you tell I'm not very happy about how we've moved away from prevention and towards treatment after the fact?  Don't get me wrong.  I love being a family physician.  I've truly been blessed with this opportunity such that I wouldn't trade this profession for any other.  I just don't care for our dysfunctional sickcare system.

But I digress.  What I wanted to point out is a study published this week in Archives of Internal Medicinewhereby patients with diabetes who are seen more frequently (every 1-2wks) have their cardiovascular risk factors brought under control much more quickly than those seen every 3-6mo.  The authors arrived at their conclusion after evaluating patient charts for over 26,000 patients w/poorly controlled diabetes, dyslipidemia & hypertension followed for 9 years.  The patients seen most frequently were able to reach goal blood pressure, cholesterol & hemoglobin A1c in weeks-to-months as opposed to months-to-years. 

So, would you rather pay your family physician $40-50 per visit for a few weeks-to-months to get your health optimized or would you rather pay a specialist to emergently place a stent in your heart or bypass an artery for $50,000.  Which brings up that healthcare conundrum once more:  quick, great, inexpensive - which two adjectives do you want to describe your healthcare because you can't have all three at the same time (at least not w/our current system) unless you put in the effort like a Biggest Loser.

Dr. LinAfter 17 years in Northern California, I headed south where I graduated with a Bachelor of Science in Biology from the University of California, Riverside, in 1984 and promptly entered the private sector.  A glutton for punishment, I returned for post-baccalaureate studies in Computer Science in 1987 after which I earned my Doctor of Medicine in 1991 from the Bowman Gray School of Medicine at Wake Forest University.  Love called & romance blossomed, so I returned to the San Francisco Bay Area where I completed my Family Medicine residency at Merrithew Memorial Hospital at the University of California, Davis School of Medicine in 1994.
After 3 years wandering around the country as a locum tenens physician and collecting a dozen state licenses along the way, I was feeling rather masochistic once more.  So I applied for subspecialty training, completing my Fellowship in Geriatrics at the Brody School of Medicine at East Carolina University in 1998. I joined the faculty as an Assistant Clinical Professor in the Department of Family Medicine and was appointed Director of the Ambulatory Geriatric Center in Greenville, NC. In 2003, I was recruited by Cenegenics Medical Institute to build it into the ubiquitous presence it is today in your airline inflight magazines. After 7 years as an employed physician, I left to return to my family medicine & geriatric roots by developing a small private practice which this website represents.
I have served as a Clinical Assistant Professor in the Department of Family and Community Medicine at the University of Nevada, School of Medicine since 2004 and recently became an Adjunct Assistant Professor of Family Medicine & Geriatrics at the Touro University Nevada College of Medicine.  Along the way, I have written many articles, given many presentations, and made myself available to both patients and colleagues.  I plan to continue more of the same (but without the middle-man!).  For more information, go to and

The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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