Advocating for Patients

Rep. Peter Welch (D-VT) recently held a press conference at Community Health Centers of Burlington to unveil legislation he authored that will provide relief from soaring insulin prices for patients with diabetes. Joining him were Dr. Joel Schnure, Professor of Medicine and Director of the Division of Endocrinology and Diabetes, and two Vermont patients with diabetes.

Welch PresserConnie Woodworth, who has type 2 diabetes, talked about the health problems she has faced because her insurance company would not cover the insulin formulation her doctor prescribed and instead forced her to use its preferred insulin.  “From the begining it was not working, but because they require a first fail l was on it for six months. Finally, after an ER visit and increased health problems, l was allowed to switch. I am now taking even more medication and under the care of a cardiologist."

Elia Spates Marquis, who has type 1 diabetes and requires daily insulin, spoke to the multiple dramatic price increases for her treatment.  ”The insulin that I take now costs over $2015.00 out of pocket per month, yes…out of pocket! The rise that I have seen in this price in the last 22 years is astronomical.  Stop and think about how you would manage your finances if you were paying over $1200 per month in insurance premiums and paying an additional $2000 per month for a medication that is literally keeping you alive."

Dr. Schnure supported these patients’ statements and confirmed that many patients cannot afford their full doses of insulin.  “So they skip doses or take half the dose and suddenly their diabetes is totally out of control.  We deal with this almost every single day."

Welch's legislation would allow patients, pharmacists, and wholesalers to import lower-cost insulin from Canada and other countries.  The FDA would certify all foreign exporters of insulin, the insulin would be eligible for insurance coverage, and patients will still need a prescription to obtain it.

Primary Care Update 2019Jennifer Kelly, DO, Associate Professor of Medicine in the Division of Endocrinology and Diabetes, was the course director for this CME program. The program was designed to keep primary care physicians, nurses, nurse practitioners, physician assistants and other health professionals abreast of best practices in outpatient care of thyroid-related medical issues, and was attended by primary care providers from Vermont, New Hampshire, Maine, and upstate New York.  Invited faculty and their presentations were:

  • Joel Schnure, MD, Professor of Medicine and Chief, Division of Endocrinology, LCOM (below) - Hyperthyroidism
  • Matthew Gilbert, DO, Associate Professor, Division of Endocrinology, LCOM - Thyroid Nodules
  • Muriel Nathan, MD, PhD, Professor, Division of Endocrinology, LCOM - Hypothyroidism
  • Juan Pablo Perdomo Rodriguez, MD, Assistant Professor, Division of Endocrinology, LCOM - Interesting Thyroid Cases
Thyroid 2019_Schnure

Advisory Council for the Diabetes Self-Management Education Program at UVMMC

Since 1998, the American Diabetes Association (ADA) has recognized the Adult Diabetes Self-Management Education Program provided by the Division of Endocrinology and Diabetes at LCOM/UVM MC.  The National Standards for Diabetes Self-Management Education and Support require that recognized programs establish an Advisory Council to provide ongoing input from stakeholders and diabetes experts to promote program quality and enhance participant utilization.

Our Advisory Council holds its annual meeting in November, usually around World Diabetes Day.  The meeting provides valuable input to our diabetes education team.

Telemedicine Initiative with NMC

TelemedicineThe outpatient clinic at the Division of Endocrinology and Diabetes and Northwestern Medical Center (NMC) in St. Albans, Vermont have created a virtual video conferencing set up for use by patients with diabetes. Patients are first seen in the endocrine clinic for a new patient visit, and subsequent visits are via a telemedicine appointment.  Leading this initiative on the UVM MC side are Joel Schnure, MD, Professor of Medicine and Director of the division, and Kaitlyn Barrett, DO, second year Endocrinology Fellow (pictured during a telemedicine patient visit).

In rural areas, the distance that patients with chronic illnesses must travel increases the likelihood for missed appointments and negatively impacts effective, long-term care. This telemedicine initiative allows providers and patients the ability to interact virtually for diabetes follow up appointments, blood sugar and laboratory review, and medication adjustment.

News from the Department of Medicine