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Provider Success Story – Tracy Towers: Controlling Diabetes in the South Bronx

Tracy Towers Medical PC, a small independent practice in the South Bronx, has successfully implemented techniques to help their patients with diabetes control their A1C levels. The practice is led by Dr. Chaula Patel, who has been a physician for over 18 years and has been working at Tracy Towers for 11 years.

Dr. Patel is one of the top performing NYC REACH providers in the South Bronx – with less than 13% of her patients with diabetes in poor control (based on A1C level > 9%). She is currently performing above the average for the South Bronx and New York City. According to analysis from the New York City Hemoglobin A1C Registry, nearly 20% of people with diabetes in the South Bronx are in poor control. In New York City, 17% of people with diabetes are in poor control.

“It is important to know how much a patient is eating, and what they are eating on an average day. Food is an addiction; it is hard for people to separate what they are eating from what they should be eating,”

Dr. Patel has made controlling A1C levels and maintaining a healthy BMI a critical strategy for Tracy Towers Medical. All providers at Tracy Towers Medical have been trained to be able to independently work with patients with high A1C levels . Dr. Patel has been able to maximize her efforts of communicating lifestyle changes to her patients through modifications to workflow changes within the practice; she equips her staff with the tools to help patients make lifestyle changes needed to combat diabetes. Additionally, she joins her physician assistants when meeting with certain patients to stress the importance of healthy eating and exercising. Dr. Patel dedicates extra time during her appointments to counsel patients on improving eating habits, identifying key issues and determining a plan of action together with the patient. Plans of action focus on diet and exercise, and are based on the patient’s A1C level, BMI, and the patient’s commitment to change. “It is important to know how much a patient is eating, and what they are eating on an average day. Food is an addiction; it is hard for people to separate what they are eating from what they should be eating,” advises Dr. Patel.

Tracy Towers Medical faces many challenges in helping their patients lower their A1C levels. Dr. Patel leverages multiple resources aligned with the Chronic Care Model of disease to help equip her patients with the best tools to control their diabetes. “It’s still very difficult to manage [A1C levels], I struggle every day.” Dr. Patel continues. “I plan to continue to leverage the information available to me to continue helping patients”.

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