certified diabetic educator (CDE) certification - lucrative or not

[katpac]

certified diabetic educator (CDE) certification - lucrative or not?

My manager approached me today to excitedly inform me that she suggested me when a diabetes rep came in and mentioned her company will provide free CDE training for a provider in our office. I do really like endocrinology but don't want to work in Endo due to the lower salaries (kind of burnt out right now on long hours and low compensation as it is in family med). I'm trying to read between the lines and see if this is something that would actually benefit me or only benefit the hospital and my workplace. I have a very busy patient schedule and family medicine and work long days and already feel quite underpaid. I like many aspects of family medicine but that one is not one of them. I guess I'm a little bit worried that if I do this training I will have an increased workload but really nothing financially to show for that. Has anyone out there done this? Worth it or not? I kind of feel like this would be something for a nurse and not something that will be financially beneficial for a physician assistant's career. Huge thanks in advance to anyone who can offer some advice or perspective on this.

[SocialMedicine]

I would not pay a PA to do in depth diabetes education visits. The CDE's I know are either LPN or RD. To be honest RD's are very good at this probably better than a PA given all the diet modification strategies and education. It would help you in the sense that you would gain some extra teaching points. I wonder how much a CDE really expands on a PA's knowledge base. 

[Guest Paula]

CDEs are RNs, RD, PAs, NP, Pharmacists and a few others qualify to take the CDE exam.  LPNs do not qualify.  The RN and RD CDEs in my office get lots of referrals from me and they manage the insulin dosing, teach carb counting and insulin dosing, teach on the use of pumps, self-monitoring blood sugar testing techniques and strategies to achieve good control, teach on treating what to do during sick days and much, much more.   They relieve my work load a lot as I don't have time for the in-depth teaching needed.  They work under a standing order for patients they are sent and do a great job making insulin adjustments and suggesting medication changes that will help the patients.

 

I considered getting my CDE but after talking to my RN CDE friend she said to not bother because the reimbursement for it is not really there, if at all for her.  The RD can bill out for medical nutrition therapy under some insurance plans, not highly reimbursed.  I do not know if there are any rVUs associated with diabetes education and management.   I am seeing patients anyway and bill for what I do and I need to continue to see patients, not do all the education.  I suppose if your office has rVUs for each visit it might be different. 

 

After 3 years at my old job doing it all, diabetes education, PA, social worker, medical guru, drug counselor, emergency medicine PA, etc., etc,.  on the rez I am so happy to delegate some of this to the team members in my new job in a larger system and medical practice.  It really relieves a lot of stress and burnout to have others shoulder the load and responsibilities with you. 

 

Plus you will need to have 4,000 hours ( or so) of direct diabetes care before taking the test, costs about $250 last time I checked and you have to keep up CEUs and re-certify every 5 or 10 years.  Don't you have enough to do with keeping all your PA CMEs and new 10 year cycle PI/SA CME?  That was another reason why I decided against taking the test.  I had the hours of patient care but there is so much more to the test...than medical knowledge. 

[katpac]

Thanks a lot for the quick and very helpful responses. I will hear the rep out later this week but unless there is significant new information that is in favor of me doing this I will pass. Thanks again! :)

[LKPAC]

I can already do more than a CDE.  In fact, I give orders for a CDE to do my grunt work, ie spending hours teaching diet, insulin injections, blood glucose monitoring, exercise, etc.  For me to do that myself would be a waste of my time, as I would not get reimbursed well.  I can see a dozen patients in that time.  I'm not dissing, as I utilize our hospital's CDE frequently.  I'm just saying...