So with the AADE annual conference going on right now, it got me to thinking about diabetes education. Who is qualified to give diabetes education, who shouldn’t be giving diabetes education, and should people who do not have a certification be able to give diabetes education? Well, why wait, let’s get into all three of them now.
Who is qualified to give diabetes education?
Currently, if you are a CDE (Certified Diabetes Educator) you are qualified to give diabetes education. Because you are certified! What if you aren’t certified, does that mean that you are not qualified to give somebody some education about diabetes? I do not think so. I think that there are many things that I can give better education about than even a CDE can. I am not a doctor, nor do I play one on tv, but I am a diabetic, so I may know a thing or two about diabetes. I don’t claim to be a diabetes guru, but if somebody comes to me with a simple diabetes question, I feel that I am qualified to give an answer. There are items, such as diet or very scientific items that I will not give education on. Maybe some advice, but would definitely refer them to somebody who is more certified. I have always felt that I learned more from the diabetes community than I do from a CDE. I look at it as the difference between a class at college or an internship during college. During a class you learn everything in the book, but you don’t actually learn how to apply or adapt to these items in the real world until you actually do them, like during an internship.
Who shouldn’t be qualified to give diabetes education?
Diabetes Douchebags like Dr. Oz and Wendell Fowler. Enough said, moving on.
People without a “Certification”
I am not going to pretend like I know what are the rules and regulations are for this. I do not know the legal, financial, medicare, insurance billing, or accountability factors (if somebody does, please comment). To me, it seems that the knowledge is there for a diabetes educator, they just haven’t taken the test. I once spoke with several CDE’s who were encouraging me to go back to school and become a CDE, but I couldn’t afford it. They joked and said that I probably knew more than most CDE’s, but I don’t know any “technical” terms and would fail the test miserably. So this becomes a very tricky question and one with an answer in a gray area. Do we allow diabetes educators without a certification to give education about insulin and diet without having the backing of an accreditation? Or is the accreditation just a piece of paper with a few signatures?
Now I’ve gotten to the end of this post and now I confused myself and I’m not sure where I stand anymore.
What are your thoughts?
Given the numbers you would think orgs like the AADE would be falling over themselves to recruit more CDEs. It would be great if there were a more realistic career path for us laypeople.
Kathy,
First thanks for the comment. I agree 100% . If the demand is there, then why not look to open up the supply? That also opens the door to un-qualified people, but there needs to be a better way to allow more people to do the diabetes education. Even if it is just a certain focus area that you have rather than an all-in-one CDE.
I thought about going back to school to be a CDE, but money, as well as an aversion to math made out impossible. But I feel like I know a lot already. I’ve actually taught my CDE a thing or two, and she’ll tell you that. But, I think a certification is a good thing. I don’t think random people with no experience should be giving out diabetes care advice. But I do think they should give people like us some credit or a fast track to certification or something.
Cara,
Thanks for commenting. Absolutely. Not just anybody off the street should be able to become an educator, there needs to be some sort of validation of how they can become one. My thought is that there can be different levels of educators. CDE’s give a lot of advice and recommendations and tell you exactly what to set your basal rate at. That is not something that somebody who is not certified should be doing. But somebody can explain what a carb is and how it breaks down, I don’t think you need a certification for something like that? What do you think?
In New Jersey, one is required to be a Registered Nurse before being allowed to continue on to become a Certified Diabetes Educator. That said, I often find myself talking with CDEs in a more collegial manner than a patient manner — and that is because I see general trends they may not, or I may have questions about something I’ve read or how to support one of the other diabetics in my circle of friends and family, more than I have issues (other than the psychological ones of getting back-on-track) with my own care. (I know what I need to do and how to do it, I’m just not doing it.)
That said, while most of us see certification as a method of making sure a minimum level of education has been achieved, it is more often used to restrict the number of people who can enter a given field, raising the salaries of those who have kowtowed to the union (and don’t believe for a minute that professional certification agencies such as the American Bar Association, American Medical Association, American Dentistry Association, American Association of Clinical Endocrinologists, and American Association of Diabetes Educators aren’t labor unions!) and making services of that ilk less accessible to lower socioeconomic classes.
Ok not just anyone can be a CDE. Most are Dietitians or RN. You also have to have so many years of experience (2-5? cant remember at the moment) before you can just take the “test.” But then every few years you have to redo certification to make sure everything is up to date. A lot of diabetic educators aren’t certified because it is such a long process. As long as they are educated in their field and are competent I dont see why they cant practice, considering they need experience first, we have no choice. Im going for my bachelors of science in nursing and am considering becoming a CDE eventually so ive looked this up a time or two.
This is a problem that came up as a discussion point at the second Roche Summit, when the AADE was present. Many of the same arguments were made, about needing to recruit more educators despite all the difficulty in the current certification process. That same issue came up this summer, where the discussion point about a more patient-certified educator might be possible. This is all something that the National Certification Board for Diabetes Educators could address, as well as states that are considering a licensing of these D-Educators… Lilly blogged about this recently over at LillyPad. Whatever the path may be, the point is well-known that CDEs are going the way of the dinosaurs unless they do something.. and really is seems like the AADE should take more of an advocacy role on this if they are truly interested in representing their membership and the future of this profession.