What will change for us during this recession?

The first thought must go to our patients: As more people will be likely to lose their jobs, and small companies will be inclined to offer fewer benefits, fewer people will have health insurance. Even if the new government institutes “universal healthcare”, it will take a while to take effect. The average patient with diabetes is taking 9 medications, some of them brand-name. Drug prices probably will not change much, so fewer people will be able to afford the medications prescribed, and many will start rationing their test strips. There is plenty of research indicating that, as out-of-pocket expenses for patients rise, medication compliance declines and ER visits increase. Data from previous recessions indicates that, in bad economic times, health care further suffers because patients feel that they simply cannot leave their job for a doctor visit in times of crisis, or they might lose it. Finally, with decreasing income and increasing stress, more patients are likely to turn to “comfort food”, which is not only high-cal, high-carb, but also considerably cheaper and easier to store and prepare than fresh produce. It is even feasible to assume that the number of patients with diabetes will grow, as more people will unknowingly slip from pre-diabetes to actual diabetes.

What does this mean for your practice?

Fewer patients will be able to afford to see their doctor, be it because their finances do not permit it or because they make the choice not to invest the time to take care of themselves. I see diabetes at the bottom of priorities for many patients: Like hypertension, it is a deceptive, indolent disease, with catastrophic results when neglected over time. In a society that demands “fixing” problems, urgencies take priority over chronic troubles.

Hospitals will also be affected by the economy, as fewer patients will be able to afford the care. Public support, be it via Medicaid or direct subsidies, will decrease, and philanthropy will decline. At academic centers, researchers will compete for smaller pots of funding. Finally, as industry adjusts to the new economic realities, there will be fewer resources for diabetes research and educational campaigns.

Bottom line: The economic crisis affects all of us, and it hits patients with diabetes especially hard. I expect to see fewer patients in the office, and more patients clogging the already crowded ER.

What do you think? How do you think the recession will affect the diabetes community? Do you think it could even present an opportunity? Weigh in on our etalk! Join in on an array of eTalk Topics taking place on PRESENT Diabetes right now. Or create one of your own.

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