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Practices Bring in Diabetes Educators With Great Results

Posted: Thursday, November 02, 2006

Having a diabetes educator in your physician's office practice can have dramatic results in improving diabetes control.

When a diabetic patient needs to see a diabetes educator, convenient access can boost compliance and help improve health outcomes.

That's the experience of Dr. Francis X. Solano Jr. and his primary care colleagues, who refer patients with newly diagnosed or uncontrolled diabetes to a certified diabetes educator—and the educator sees patients on-site.

With the educator right there in the office on designated days, most patients follow through and receive the prescribed diabetes self-management education (DSME). As a result, they have improved their health outcomes, Dr. Solano said in an interview.

He has data to prove it. “Having a diabetes educator in-house showed us the value of what we can do with our outliers and our new diabetics,” he said. “Some 65% of our patients now have an A1c less than 7, and only 8% have an A1c greater than 9. When we started [the project], at least 20% of our patients were above 9.”

Dr. Solano's practice is one of six primary care practices in Community Medicine Inc. (a group of 65 practices owned and managed by the University of Pittsburgh Medical Center) that are participating in a project aimed at integrating DSME directly into primary care offices, where it can be most easily accessed.

Physicians “need to think outside the box and look at what kinds of relationships they can develop with hospital program leaders,” said Linda M. Siminerio, R.N., Ph.D., C.D.E., director of the University of Pittsburgh's Diabetes Institute and senior vice president of the International Diabetes Federation.

“There are all kinds of clever ways you could do it outside the [traditional] system” of education occurring in hospitals, clinics, and endocrinologists' offices, she said.

Dr. Jennifer Mayfield, a family physician from Seattle who commented on the project at the meeting, said that such problems are common and that primary care physicians all over need help.

“I don't think insurers understand how difficult it is for us to do the education—we don't have the training and the expertise,” Dr. Mayfield said. “And insurers don't appreciate the fact that many patients won't go across town.”

Source: Diabetes In Control: Internal Medicine Volume 39, Issue 20, Page 1,4 (15 October 2006)