ENDOCRINOLOGY SCOPE OF CARE
Endocrinology services encompass the ambulatory clinics as well as the inpatient setting. Patients are referred for care from any inpatient or outpatient service of the John H. Stroger Jr. Hospital of Cook County Hospitals and the entire Cook County Health & Hospitals System.
Special Endocrine Clinics in Fantus Ambulatory Center provides subspecialty endocrine assessment and management as follows:
1.Complex Patients Clinic
2.Endocrine Follow-up Clinic
3.Thyroid Biopsy Clinic
4.New Patients Clinic
5.Dynamic Testing Clinic
6.Radioactive Iodine Treatment Clinic
7.Combined Endocrine Surgical Clinic
8.Podiatry Screening Clinic
Subspecialty care includes the evaluation, diagnosis, treatment, patient education, and overall management of the patient's endocrine conditions. Administration of radioactive iodine for patients with Graves' Disease and thyroid cancer is done in collaboration with the Nuclear Medicine Division. Fine needle aspiration biopsy of the thyroid is a low risk procedure performed monitored by the division for indication, contraindication, and major adversities. Dynamic endocrine tests include infusion studies (ACTH stimulation, TRH stimulation, glucose suppression) that are performed to diagnose and clarify endocrine conditions.
Thyroid Cancer Program
This program provides comprehensive care including radioactive iodine therapy for patients with
thyroid cancer. Approximately 250 patients are enrolled with a very negligible rate of attrition. The
center is an excellent example for longitudinal care for patients with thyroid cancer and is reflected in the quality of life experienced by this group. Interdisciplinary approach among endocrine surgeons, pathologists, nuclear medicine specialists and endocrinologists confers strength to this program.
Endocrine Consultative Services
The Division provides consultative services to hospitalized patients who pose difficulties in diagnosis and management for primary care providers. Emergency consultation for diabetes and endocrine emergencies are provided by the Division on a 24-hour basis. Elective consult rounds are conducted Monday through Friday.
DIABETES SCOPE OF CARE - THE NETWORK DIABETES PROGRAM (NDP)
The Network Diabetes Program (NDP): The NDP is a is comprehensive diabetes program and was developed as a part of the CCBHS Division of Endocrinology and Diabetes which is also affiliated with Rush University and has a combined endocrinology fellowship program.
Services of the NDP encompass three (3) acute care hospitals and thirty (30) ambulatory sites for an estimated population of 30,000 patients with diabetes. The basis of the program is multidisciplinary diabetes teams operating in several sites throughout the Cook County area. The teams consist of Endocrinologists and/or primary care physicians; Certified Diabetes Educators (CDEs) including dietitians, nurse practitioners, and clinical pharmacists; clinical psychologists and social workers. The diabetes teams provide patient education and management in conjunction with the primary care physicians. The teams also serve as a diabetes resource for health care providers.
The four current NDP sites include Fantus Clinic, Near South Clinics, South Suburban Clinics, and the Western Hub 4 clinics serving mainly the Hispanic population. Clinical psychologists, psychology externs and a social worker, with specialties in individual and group counseling and stress management, provide the behavioral and social support for the Diabetes Program. The NDP staff is involved (as part of "Bridges to Health" project) in developing diabetes education skills for Latino peer mentors "Promotores". Five diabetes Promotores trained in NDP serve already in other County Clinics.
The NDP Center in Fantus Clinic is an American Diabetes Association (ADA) Recognized Diabetes Education Program. Additionally, as part of quality improvement, the four NDP teams participated 2002-2003 in the Chicago Regional Diabetes Collaborative (Dr. Fogelfeld, the medical director of the NDP, was the Co-Chairman of the Collaborative), which implemented the "Chronic Care Model" components. The NDP is also involved in many clinical research projects in the area of diabetes. For example, the outcomes of care of diabetes in CCBHS and NDP will be presented this year in 5 abstracts in the annual scientific meeting of the American Diabetes Association. The NDP has been a
site for several master theses in the course of "Masters in Clinic Research" by Rush University as well as dissertations for clinical psychologists.
The NDP, in its fourth year, has managed more than 7,000 single patients for almost 20,000 visits. All the patients' data are recorded in a detailed computerized database which tracks longitudinal parameters of diabetes control, laboratory and medication data, and self-management information (glucose monitoring, adherence to medications, nutrition management and exercise) as well as psychosocial concerns.
The NDP serves as a professional resource for the clinical providers (physicians and non-physicians) across the CCBHS sites. Currently, structured programs of multidisciplinary management of diabetes are taking place and involve physicians, physician assistants, nurses, nurse practitioners, residents and students.
The Division of Endocrinology is responsible for the entire diabetes program. In addition to the NDP, diabetes services include a multidisciplinary Diabetes Clinic provided five days (5) a week. The Diabetes Clinic, staffed by endocrinologists, manages patients with difficult and uncontrolled diabetes. Patients with unstable diabetes arriving to emergency care sites are provided immediate access to diabetes care. Such treatment includes medical management via oral and injectable medication for diabetes and nutrition counseling.
A new multi-year program for detection and management of pre-diabetes/metabolic syndrome is currently being launched by NDP in conjunction with primary care sites of ACHN. The principles and resources needed for such an extensive program are being delineated. The clinical space needed for one of the components of this program, the "Lifestyle School", has been recently identified and secured in the Fantus Clinics.
The Division provides intensive education in clinical endocrinology to medical students, medicine, family practice podiatry and ophthalmology (in planning phase) during their monthly rotations. Medicine residents participate on an elective basis in a yearlong continuity outpatient endocrine clinic. Combined Fellowship Program with Division of Endocrinology Rush-Presbyterian Medical School provides clinical and research training to 4 fellows.
Research activities focus on outcomes of care in diabetes, clinical research in thyroid cancer, molecular pathogenesis of thyroid cancer and diabetes drug studies as follows. Please click here to view a list of current research activities.
For a list of Publications and Abstracts please click here.