Poor glucose control is often attributed to clinical inertia: the recognition of a problem by the physician, but failing to act.
This study of 211 primary care encounters between adult patients with type 2 diabetes and their physicians finds the concept of clinical inertia does not adequately characterize the complexity of the primary care encounter; it is really competing demands (patient concerns) that can cause physicians not to act.
As the number of patient concerns increased, the likelihood of a change in medication decreased, independent of the length of the encounter. The researchers suggest that while the comprehensiveness of care provided by primary care physicians to patients with chronic illness is a strength of primary care, it also is a balancing act that requires prioritization and goal setting by both the patient and the physician during the patient visit.
Competing Demands or Clinical Inertia: The Case of Elevated Glycosylated HemoglobinBy Michael L. Parchman, M.D., M.P.H., et al