Primary Care Diabetes Fellowship Programs: Developing National Standards

Author:

Shubrook Jay H.1ORCID,Ramirez Beatriz Francesca2,Healy Amber M.34,Salzberg Lenard5,Ahmed Sumera1,Feinberg Howard1,Schutta Mark6,Schwartz Frank L.7,Low Wang Cecilia C.8

Affiliation:

1. Touro University California College of Osteopathic Medicine, Vallejo, CA

2. East Carolina University Brody School of Medicine, Greenville, NC

3. Ohio University Heritage College of Osteopathic Medicine, Athens, OH

4. Ohio Health Physician Group Heritage College Diabetes and Endocrinology, Athens, OH

5. Duke Southern Regional Area Health Education Center, Fayetteville, NC

6. University of Pennsylvania, Philadelphia, PA

7. West Virginia University/Camden Clark Medical Center, Parkersburg, WV

8. University of Colorado, Aurora, CO

Abstract

The rapid and constant increase in the number of people living with diabetes has outstripped the capacity of specialists to fully address this chronic disease alone. Furthermore, although most people with diabetes are treated in the primary care setting, most primary care providers feel under-prepared and under-resourced to fully address the needs of their patients with diabetes. Addressing this care gap will require a multifaceted approach centering on primary care training in diabetes and its complications. One-year diabetology fellowship programs are well situated to provide this training. Previous research has shown that the higher the diabetes-specific volume of patients seeing a primary care physician was, the better the quality outcomes were across six quality indicators (eye examinations, LDL cholesterol testing, A1C testing, prescriptions for ACE inhibitors or angiotensin receptor blockers, prescriptions for statins, and emergency department visits for hypoglycemia or hyperglycemia). Primary care diabetes fellowships have existed for many years, but the number of fellowships and fellowship positions has recently grown dramatically. This article proposes a standardized curriculum for such programs and makes the case for increasing their number in the United States.

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference17 articles.

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2. The clinical endocrinology workforce: current status and future projections of supply and demand;Vigersky;J Clin Endocrinol Metab,2014

3. Diabetes technologies: we are all in this together;Oser;Clin Diabetes,2020

4. Population-based geographic access to endocrinologists in the United States, 2012;Lu;BMC Health Serv Res,2015

5. Agency for Health Care Research and Quality. Medical expenditure panel survey. Available from https://www.ahrq.gov/research/data/meps/index.html. Accessed 10 August 2020

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