In a recent episode of The Hard Things About Healthcare, we spoke with Dr. Qudsia Hussain, a board-certified endocrinologist dedicated to improving diabetes care. With a background in public health and extensive clinical experience, Dr. Hussain shared her insights into the complexities of modern diabetes management, from the overwhelming demand for endocrinologists to the challenges posed by new technology and administrative burdens.
From Science Enthusiast to Diabetes Advocate
Dr. Hussain’s journey into endocrinology started with a childhood love for science and a fascination with the human body. This passion led her to pursue a master’s in public health, where she encountered the staggering prevalence of chronic conditions like diabetes and obesity. Realizing the systemic gaps in preventative care, she chose to focus on treating patients with chronic diseases as a way to drive meaningful change.
Today, she finds immense reward in building long-term relationships with her patients, helping them navigate the ups and downs of diabetes management, and improving their overall quality of life.
The Growing Burden of Diabetes in the U.S.
Diabetes has become one of the most pressing public health challenges in the United States. According to the CDC, over 37 million Americans have diabetes, and an additional 96 million have prediabetes. These numbers highlight an urgent need for specialized care, but access to endocrinologists remains limited due to long wait times and the increasing demand for appointments.
Dr. Hussain pointed out the challenges this creates in balancing new patient visits with continuity of care for existing patients. The growing awareness of conditions like prediabetes has led to more individuals seeking help earlier, which is a positive trend, but it also places additional strain on an already stretched specialty.
Leveraging Technology Without Losing the Human Touch
Advancements in diabetes technology, such as continuous glucose monitors (CGMs) and insulin pumps, have revolutionized care. These tools provide real-time data that enable more precise and personalized treatment plans. However, managing this influx of information can be daunting for both patients and clinicians.
“A typical visit for me with a patient who has diabetes is integrating continuous glucose monitor data with insulin pump data with lab values that include the A1C, which is the diabetes marker, cholesterol, kidney function, electrolytes, and then the vitals... all of that information plus trying to be present and listening to the patient in a 20, less than a 20-minute visit and doing that 20 times over," said Dr. Hussain.
The key, Dr. Hussain explained, is to balance the data with the personal aspects of care. Understanding a patient’s life circumstances—whether they’re dealing with stress, starting college, or training for a marathon—can be just as critical as analyzing blood sugar trends. Maintaining this “humanness” is vital to successful diabetes management.
"We've come a long way... from finger sticks to these continuous glucose monitors that tell you your blood sugar all the time. And so we've come a long way, and that data is great for patients, it's great for providers, but there's something to be said about the humanness of diabetes care,” she said.
Empowering Patients Through Education
Education is the cornerstone of effective diabetes care, particularly in an era of advanced technology. Many patients find themselves overwhelmed by the constant stream of data provided by CGMs and other devices. Dr. Hussain emphasized the importance of helping patients understand their disease and the tools they use: What does an A1C mean? When is a blood sugar reading alarming? What should they do when they see a spike or drop?
She also noted that creating a nonjudgmental environment is crucial to patient engagement. By framing data as a tool for improvement rather than a source of shame, Dr. Hussain helps her patients feel supported and empowered to take an active role in their care.
"I always make it very clear, like, this is not a judgment zone and there is no, you know, I am not judging you. This is just objective data we're using to sort of help you," said Dr. Hussain.
Administrative Hurdles: The Hidden Cost of Care
While patient care is the most visible part of an endocrinologist’s work, the behind-the-scenes tasks—documentation, insurance approvals, and prior authorizations—consume an enormous amount of time. Dr. Hussain shared that the average endocrinologist spends 14 to 15 hours a week on documentation alone. This includes pulling lab results, updating medication lists, integrating device data, and ensuring accurate billing for reimbursement.
Navigating insurance requirements is another significant challenge. Prior authorizations for medications or devices often require extensive paperwork and follow-up. Even when a specific treatment is clearly in a patient’s best interest, insurance companies may deny coverage, forcing clinicians to appeal or find alternative solutions. These administrative barriers not only delay care but also add stress to an already demanding workload. "You have someone saying, 'No, I think this one's better, and this is because we're gonna cover this one.' Or, 'You haven't gone up on the dose of the medication, so that must mean it's not working, so now we're rejecting it.' It's a lot of back and forth," she said.
The Reward: Changing Lives Through Better Care
Despite the challenges, Dr. Hussain finds huge satisfaction in helping her patients achieve better outcomes. She shared how rewarding it is to see improvements in her patients’ A1C levels, cholesterol, and overall health, knowing that the collaborative efforts between doctor and patient have made a tangible difference.
"When I see them in follow-up and their A1C is going down and they feel better and their cholesterol is better and their blood pressure is better, that to me is just really, really rewarding," she said.
For her, the ultimate goal is not just managing diabetes but preventing complications before they occur. Preventative care, she explained, is critical yet often overlooked in the U.S. healthcare system, which tends to focus more on treating acute issues than on addressing the root causes of chronic conditions.
Looking Ahead: A Call for Systemic Change
Dr. Hussain’s work highlights both the opportunities and challenges in modern diabetes care. Technology has provided powerful tools, but these must be paired with education and empathy to be effective. Systemic reforms, such as reducing administrative burdens and increasing access to preventative care, are essential to improving outcomes on a broader scale.
As diabetes rates continue to climb, the insights and dedication of clinicians like Dr. Hussain will be key to meeting this growing need. By combining innovation with a patient-centered approach, there is hope for a future where managing diabetes is less burdensome—for both patients and providers.
For more insights into the challenges and opportunities shaping healthcare, subscribe to The Hard Things About Healthcare and stay tuned for future episodes featuring leading professionals like Dr. Hussain.
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