Abstract
Purpose of Review
Diabetes is a complex and costly chronic disease that is growing at an alarming rate. In the USA, we have a shortage of physicians who are experts in the care of patients with diabetes, traditionally endocrinologists. Therefore, the majority of patients with diabetes are managed by primary care physicians. With the rapid evolution in new diabetes medications and technologies, primary care physicians would benefit from additional focused and intensive training to manage the many aspects of this disease. Diabetes fellowships designed specifically for primary care physicians is one solution to rapidly expand a well-trained workforce in the management of patients with diabetes.
Recent Findings
There are currently two successful diabetes fellowship programs that meet this need for creating more expert diabetes clinicians and researchers outside of traditional endocrinology fellowships. We review the structure of these programs including funding and curriculum as well as the outcomes of the graduates.
Summary
The growth of the diabetes epidemic has outpaced current resources for readily accessible expert diabetes clinical care. Diabetes fellowships aimed for primary care physicians are a successful strategy to train diabetes-focused physicians. Expansion of these programs should be encouraged and support to grow the cadre of clinicians with expertise in diabetes care and improve patient access and outcomes.
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References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
• Center for Disease Control and Promotion: Diabetes: National and State Data. Available at: https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf Accessed 8/04/17. Data on the current prevalence and expected growth of diabetes in the United States.
Barker LE, Kirtland KA, Gregg EW, Geiss LS, Thompson TJ. Geographic distribution of diagnosed diabetes in the United States: a diabetes belt. Am J Prev Med. 2011;40(4):434–9.
•• The Lewin Group: A White Paper: Endocrine Clinical Workforce: Supply and Demand Projections. Accessed at:. A commissioned study by The Endocrine Society on the Endocrinology Workforce and the analysis of the current and projected shortage of endocrinologists.
Agency for Health Care Research and Quality: Medical Expenditure Panel Survey. Available at: https://www.ahrq.gov/research/data/meps/index.html. Accessed May 29, 2017.
Ostbye T, et al. Is there time for management of chronic diseases in primary care? Ann Fam Med. 2005;3:209–14. https://doi.org/10.1370/afm.310.
Casagrande SS, et al. The prevalence of meeting A1c, blood pressure, and LDL goals among people with diabetes 1988-2010. Diabetes Care. 2013;3698:2271–9.
•• Vigersky, et al. The clinical endocrinology workforce: current status and future projections of supply and demand. JCEM. 2014;99(9):3112–21. The current and projected shortage of endocrinologists based on the Lewin Group White paper.
•• Pelley E, et al. Female physicians and the future of endocrinology. JCEM. 2016;101(1):16–22. Prediction that female physicians will dominate endocrinology in the future and have different work life and career objectives that could affect the workforce for endocrine disorders.
Brigham and Women’s Hospital. Primary care physicians play vital role in caring for diabetes patients. ScienceDaily. ScienceDaily, 11 December 2012. <www.sciencedaily.com/releases/2012/12/121211130314.htm>.).
Accessed online at: http://www.healthline.com/diabetesmine/meet-dr- whitehouse-historical-endo- extraordinaire#1.
Fred Whitehouse, MD: personal communication to RJT.
•• Tanenberg RJ, Cummings DM, Springer-Dreyfus K, Newton CA, Lewis MJ. Primary care fellowship in diabetes: an innovative program in post graduate diabetes education: teaching and learning in medicine. Int J. 2009;21(4):334–43. Describes the 1-year diabetes fellowship program at East Carolina University that can be replicated to increase the training of diabetes care specialists.
• Centers for Disease Control and Prevention. County Data. Available at: https://www.cdc.gov/diabetes/atlas/countydata/atlas.html Accessed June 1, 2017. Data on the prevalence of diabetes by county level in various regions of the United States.
Acknowledgments
We would also like to acknowledge Frank L. Schwartz, M.D., for founding the diabetes fellowship program at OUHCOM and his continued involvement in the program.
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Conflict of Interest
Robert J. Tanenberg, Shivajirao Patil, Doyle M. Cummings, and Archana R. Sadhu declare that they have no conflict of interest.
Amber M. Healy reports that Ohio University Heritage College of Osteopathic Medicine pays part of her salary.
Jay H. Shubrook reports that he has received fees from the American Diabetes Association for being a speaker (Diabetes is Primary), from Novo Nordisk and Lilly for being a consultant, and from Medicine Matters Diabetes of Springer Nature for being on the International AD Board.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
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This article is part of the Topical Collection on Health Care Delivery Systems and Implementation in Diabetes
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Sadhu, A.R., Healy, A.M., Patil, S.P. et al. The Time Is Now: Diabetes Fellowships in the United States. Curr Diab Rep 17, 108 (2017). https://doi.org/10.1007/s11892-017-0936-6
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DOI: https://doi.org/10.1007/s11892-017-0936-6