HAVE A “NEW DIAGNOSIS” CONVERSATION
When a patient is diagnosed with type 2 diabetes, the first conversation you have with them is a chance to build their confidence in their ability to manage their condition.
- Assess their knowledge. Use motivational interviewing skills, such as open-ended questions and reflective listening, to find out what they know about diabetes, and tailor the conversation to their needs.
- Emphasize the seriousness of their condition. Be frank about the risk of complications. Tell patients they may not feel any different when their blood sugar is high, but treatment adherence is key to keeping their condition in check.
- Handle the conversation with care. A new diagnosis can evoke lots of emotions. While you need to be honest about their disease, avoid being harsh, negative, or too casual.
- Encourage them to take an active role. Emphasize their ability to positively impact their health by making behavioral changes, such as increasing physical activity, improving diet, monitoring blood sugar, and adhering to the treatment plan.
Source:
- 1.Larson J. From shock to action: navigating the first diabetes discussion with patients. Medscape Medical News. May 14, 2025. https://www.medscape.com/viewarticle/shock-action-navigating-first-diabetes-discussion-patients-2025a1000bpz
TRANSLATE CLINICAL SPEAK FOR TECHNOLOGY LEADERS
A few years ago, I interviewed for a job at a start-up tech company and was shocked to find that the team didn’t know about a basic reality of primary care practice — empanelment. As a result, they didn’t value the size of my prior panel or understand why I had listed it on my resume. As I’ve interacted with more start-up founders and tech companies, I’ve found most do not have enough clinical expertise around the table when making decisions.
Family physicians are well positioned to teach tech leaders and bridge the knowledge gap between medicine and technology. What makes us unique is our fluency in “doctor.”1 We’re already translators in other spaces, helping patients, insurers, staff, and specialists communicate, so learning to speak “tech” and translating “doctor” for others is within our skills. Whether you have a side hustle with a tech company or just serve as an EHR beta tester, helping to create better health technology is important work.
Reference(s)
- 1.Matt Sakumoto, MD: Efficient Eddie, AI, and scribes. One Click At a Time podcast. Sept. 10, 2024.
ASK FPM: NEGOTIATING ADMINISTRATIVE TIME
My new employment contract does not specify the amount of dedicated administrative time I will have. How should I approach this?
An employment agreement should contain enough information that the physician’s duties and schedule are clear. Employers often leave scheduling provisions vague to allow for flexibility. However, the employer’s expectations may not align with yours, so you must seek clarification. If your contract says you must devote 100% of your time to patient care, inquire how many hours in the work-week you will be expected to devote to administrative tasks related to patient care. According to the 2023 American Academy of Family Physicians (AAFP) Practice Profile survey, members report an average workweek of 59.6 hours, with 31.3 hours of direct patient care, 11.6 hours of EHR entry, and 16.7 hours of other non-clinical tasks. When negotiating, be clear about your schedule expectations and confirm that the written agreement is in line with any conversations you’ve had. Sometimes, employers are unwilling to make changes to written contracts, and physicians rely on verbal assurances. As you assess your contract, you must decide what you are willing to live with and what would justify walking away from the job opportunity.1
To help physicians assess employers’ offerings around administrative time, the AAFP has added relevant questions to the 2025 Career Benchmark Dashboard survey at https://www.aafp.org/worth. Take the survey by Dec. 15 to contribute to an updated dashboard coming January 2026.
Reference(s)
- 1.Adler EL. A family physician guide to employment contracts. AAFP. Accessed July 25, 2025. https://www.aafp.org/dam/AAFP/documents/practice_management/restricted/physician-contract-guide.pdf
GOT A PEARL?
Practice Pearls presents advice on practice operations and patient care submitted by readers or drawn from the literature. Send your best pearl (up to 250 words) to fpmedit@aafp.org. Send comments to fpmedit@aafp.org, or add your comments to the article online.
