In part 2 of this Exclusive Interview, Nancy D’Hondt talks with Diabetes in Control Publisher Steve Freed about the hurdles of educating the patients with diabetes and how to include it in health care delivery.
Nancy J. D’Hondt RPh, CDE, FAADE is an ICU pharmacist in the St. John Health System in Detroit.
Transcript of this video segment:
Freed: So, education is a key component of type 2 diabetes. I always believe that without the education a person is doomed for failure no matter what drugs you give them including insulin, if he really doesn’t understand the benefits in physical activity and nutrition, and everything. And I always say that the physician doesn’t always have the time. We all know that. They can’t get paid for it. But I personally feel that it’s their responsibility to get the patient educated however that may be. One of their jobs is to make sure that they follow up with that patient and make sure that they are getting educated. So, the physician needs to have the places available and the cost and whatever to the patient so that he actually signs the patient up before they walk out of the office. And I really think that’s what physicians need to be. So, if education works why is it that what I just said isn’t happening? Why aren’t physicians getting their patients educated? Because I talk to type 2s all the time, nobody mentions education, pretty much, on a majority of time.
D’Hondt: I think education is a scary word. And I think that we’re, as an association, we’re looking at starting to change that dynamic. It’s about self-management. It’s about helping build the skill sets. Where we interpret it as education for the patient, it’s learnings; learning how to manage, learning what to do, learning how to deal with the daily routine of diabetes. It’s overwhelming. There’s a lot to know. There’s a lot of medications. You have to know how to take them. You have to know what to eat, what not to eat, how it will affect your blood glucose. It’s all about numbers. What are your blood pressure numbers? What are your lipid values? And I think that giving them the skills to understand, our understanding what their needs are, and then giving them the skill set, they’ll be able to manage on their own. They see a health care provider 0.07, I think, percent of the time in a year and they spend the rest of the time by themselves. So, giving them the skill sets to self-manage while they’re not in the presence of the health care provider as well as delivering the contact points that they’ll have in that time alone: peer support groups, technologies, access to an educator; those are all things that are important to helping to build those skills and give them the confidence to better manage their chronic disease. It’s not going to go away.
Freed: And so, there’s been a number of times where I got community to participate and open up the library and invited people to come, and learn about how to prevent diabetes, how to treat diabetes. And they put it in the newspapers and they put it on the cable channels, and three people show up in a community of 100,000, 200,000 people. And that’s one of the issues is that if you tell a patient to get educated, that’s where it ends. They really don’t act upon it. So, what is AADE [American Association of Diabetes Educators] — and that’s where it needs to come from — what are they doing about it?
D’Hondt: So, we’re actually looking at integrating the educator — and that term may be changing as we move forward to be more in line with what we think we should be doing — but integrating care and self-management care, and those skill set and teachings into the fabric of health care delivery. So, as we look at population health and value based care, we’re not looking at a service and you silo the services. You go here for your dental appointment. You go here if you have heart disease. You go here for your education. We think that those things should be coordinated and the care should be across the continuum and access points should be continually being reached by the patient and given to the patient. And that the educator will be ingrained in that fabric of the health care team. So, everyone — it won’t be about access. It’ll be about the delivery points.