The Central Role of Primary Care Physicians and Endocrinologists in Treating C-R-M Conditions
Q&A with Mohamed Eid, MD, MPH, MHA, Head of Clinical Development & Medical Affairs, CardioMetabolism & Respiratory Medicine and Cagri Senyucel, MD, Senior Medical Director, Alliance products, Cardio-Renal-Metabolism
Boehringer Ingelheim’s Mohamed Eid recently sat down with one of our colleagues at Eli Lilly and Company, Cagri Senyucel, to discuss opportunities and challenges for healthcare providers who treat cardio-renal-metabolic conditions. Mohamed has 27 years of direct patient care and clinical research experience, and Cagri has 10 years of medical affairs and clinical research experience in helping people living with these devastating, chronic conditions.
In the following conversation, they touch on the unique and critical role primary care physicians and endocrinologists often play alongside other specialists and how the BI-Lilly Alliance is working to improve health outcomes through a holistic treatment approach.
Mohamed Eid: When we talk about treating cardio-renal-metabolic conditions, this may give the impression that the focus is on what specialists who care for the heart, kidney and endocrine systems can do to improve patient outcomes. How can we bring primary care physicians into the conversation so that their role in offering better care for people with one or more of these diseases is visible?
Cagri Senyucel: Based on my experience, primary care physicians are uniquely positioned to diagnose and treat cardio-renal-metabolic conditions, as they may be able to identify risk factors, signs, and symptoms early. They typically see their patients more regularly for routine checkups than specialists do, and they may have more direct and earlier insights into other important parameters, such as obesity, lifestyle and family history. Because of this, I do believe that primary care physicians should be integral part of the dialogue around better care.
Mohamed Eid: That’s certainly a valid point. With this in mind, what’s your thought on the state of collaboration between primary care physicians and the specialists who they refer their patients to?
Cagri Senyucel: The interconnectedness of these systems requires both comprehensive treatment and effective cross-specialty communication – and physicians agree. Our recent survey of 1,000 U.S. healthcare professionals revealed a desire for greater collaboration to improve outcomes in diabetes care. At the same time, providers, including primary care physicians, should feel empowered to treat patients holistically by monitoring their status, adjusting their treatment plan and, yes, collaborating with specialists whenever appropriate. This includes working alongside nurse practitioners, certified diabetes educators and pharmacists, to ensure effective multi-disciplinary care.
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Mohamed Eid: Right. That takes me to my next point. This same survey you mentioned reported that the majority of healthcare professionals, including nurse practitioners, primary care physicians, cardiologists, nephrologists and endocrinologists, agree that it’s the responsibility of all specialists involved in the treatment of type 2 diabetes to prescribe the best treatments available regardless of specialty area. This underscores the importance of a treatment plan that looks at the whole patient, rather than each specific organ or system separately. How do we accelerate the adoption of this approach in routine practice? Cagri Senyucel: Patients cannot afford the time, the cost or the lost health opportunities that come with being referred to specialist after specialist to manage individual cardio-renal-metabolic conditions. And given the substantial overlap in these conditions, they shouldn’t have to. It creates an unnecessary burden for patients. In fact, a person with type 2 diabetes is more likely to have an outpatient encounter with a cardiologist than with an endocrinologist, highlighting the need for a coordinated care approach. As healthcare providers, it’s critical we are knowledgeable about treatment options in different categories but also think holistically about the patient, that we collaborate with each other productively, and that we only send patients off to other specialists when necessary; this can help keep down medical costs and save everyone time at doctors’ offices. Mohamed Eid: I couldn’t agree with you more. As we discussed, primary care physicians have a particular line of sight into their patients’ risk factors and medical histories and can readily monitor for signs and symptoms indicating that heart or kidney disease may be on the horizon. From your perspective, what makes endocrinologists ideally positioned to keep an eye on these associated risks and conditions and to treat people with diabetes holistically? Cagri Senyucel: People who develop type 2 diabetes are often relatively younger at diagnosis than some of the other diseases we’re discussing. The onset of type 2 diabetes is most often in people over 45, but the condition is becoming more common in children and young adults. Endocrinologists have the opportunity to identify and treat the emerging cardio-renal-metabolic conditions at a relatively early stage, and they can take charge to develop a treatment plan that addresses the patient’s needs comprehensively, even before there’s a need to pull in a cardiologist or a nephrologist, for instance. That being said, it is always good to consult the appropriate specialist as early as possible, and as deemed necessary by the treating physician. |
Primary care physicians and endocrinologists are uniquely positioned to diagnose and treat cardio-renal-metabolic conditions.
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With 94% of people living with type 2 diabetes presenting with at least one additional cardiovascular, metabolic or renal condition, endocrinologists have a patient population that especially stands to benefit from this sort of multi-system approach. That’s fitting, because the transformation of treatment in the cardio-renal-metabolic space has recently been accelerated by advances in diabetes medicines that are demonstrating potential benefits for multiple organs, which is groundbreaking for patients living with these conditions. As we discuss in our advisory board meetings, there is still a lot we could gain from increasing awareness about the interconnectedness of these systems and gathering additional evidence to better understand therapies that may benefit them.
Mohamed Eid: It certainly is critical to continue pushing the boundaries of therapeutic innovation, generating meaningful data, increasing awareness, and supporting meaningful education with the overall goal of improving outcomes for patients.
Cagri, thank you for taking the time to speak with me today. With this approach in mind, we can continue to inform and advocate for a holistic approach that best serves healthcare providers and the more than one billion people living with cardio-renal-metabolic conditions worldwide.