More than any disease I can think of, diabetes is tedious, relentless and frustrating. It does not go into remission, take vacations, or get cured. And of course, ignoring the disease increases the likelihood of negative consequences, which can lead to a life full of morbidity and early mortality.
It is within that context that I believe diabetes requires more support daily, weekly and monthly than any other disease on the planet! There are a limited amount of resources available from a time perspective, as well as a cost perspective, making constant follow-up and support a challenge. So what can we, as diabetes educators, offer the patient on an ongoing basis? The research does suggest that there is better blood glucose control over time with continual professional support.
We can offer frequent visits (monthly rather than quarterly or yearly), where a practitioner can charge for the visit to help booster support, but the coverage for that is fixed and usually the amount does not support weekly visits. We can ask patients to fax in blood sugar, food and exercise reports for review, but that is not reimbursable at this time. So, it is back to hours of individual counseling with no paycheck. Telemedicine might be paid in the future, but no one knows the frequency or the duration of the chargeable moments.
Since most of us are in this field because we are passionate about helping patients achieve their goals and stay healthy, what can we do?
Support groups offer an option. They do not require paperwork, and can be overseen by a variety of providers in your facility. It’s a “place” where patients can share success (and failure), seek support and ideas from others, and have some guidance of the discussion by a qualified health care provider, so the conversations don’t go too far astray from truth.
The location can change, from a medical setting to a park bench. Our facility recently began a support group for women with type 1 diabetes. We met last month at a local favorite restaurant. The weather was terrible, but we had a nice group, enjoyed conversation and clarified some points about carbohydrate counting during dinner. We shared our thoughts and even had a bit of a competition guessing how many carbohydrates were in every dish we ordered.
Recently, I was able to secure an evening (at no charge) at a local health club. We plan to work out together, and then relax in the hot tub with stories. We have the biggest crowd signed up ever! The number of folks that show up varies, but if it is always a place I (as the group leader) enjoy being, it’s easy to go and not feel “put out” by longer hours. It still takes some of my time, I’m still volunteering my hours, but if I am headed to a location I like, it sure is easy to go!!! And patients really feel “supported.”
What type of support network have you created for your patients? Do you feel burdened by it, or does it make your day? How do you avoid burn out? Does your facility cover your costs, or are you extending your unpaid time? Would love to have your input!!!!