Has there been any research done on the functioning of diabetes teams? I am unhappy with the team we have now for my 5 year old daughter, and would like to know what to look for. What makes a team work well? efficiently? There are many choices in our area, and I am looking for the best possible care for her.

The two most important criteria on which to judge a team are on completeness and accessability. A team should have in addition to a physician, a nurse educator, a dietitian and a medical social worker and all of them need to be familiar with the problems of diabetes in young children. The clinic also needs to be able to carry out simple laboratory studies such as a blood A1c and to have access to a few more complex items such as various antibody tests.

There are no established criteria for all of this; but it is also assumed that they have ready inpatient backup and the ability to arrange consultations in other fields besides diabetes. It commends a team if you know that they are also involved in some form of related clinical research because that indicates a concern for what may be new. The second most important quality is that all members of the team should be reasonably accessible on the telephone or by fax during normal working hours and that there should be a physician or a nurse available on the telephone around the clock seven days a week. These are costly services to supply and third party carriers are often reluctant to bear the complete burden so that there may be times when you have to tolerate some delays. This issue of telephone availability has repeatedly been shown to improve care.

And finally it is important that you and your daughter personally like the team.

DOB
Additional comments from Dr. Jill Weissberg-Benchell:

I’d imagine that the best way to find a good team is to schedule meetings with them to interview them. It might take a bit of your time, but it will likely be the best way to determine if you feel comfortable with them, if they are attentive and good at listening to your concerns, and if you think they are knowledgeable. It may also help for you to write down all of the reasons you did not like the other team to be sure you look for these issues as you interview others.

JWB
Additional comments from Dr. Tessa G. Lebinger:

I’d imagine that the best way to find a good team is to schedule meetings with them to interview them. It might take a bit of your time, but it will likely be the best way to determine if you feel comfortable with them, if they are attentive and good at listening to your concerns, and if you think they are knowledgeable. It may also help for you to write down all of the reasons you did not like the other team to be sure you look for these issues as you interview others.

TGL