About Us

Telemedicine for Rural Diabetes Care LLC

Telemedicine for Rural Diabetes Care

We are an organization devoted to making it easy for retired endocrinologists to get involved during retirement to solve the challenge faced by rural, underserved communities with diabetic patients.

❝It is medicine without the misery – no travelling, filling out endless forms, following someone else’s rigid regulations, chasing payment, and continually trying to squeeze more patients into strengthening appointment times.❞

Dr Richard Santen

Dr. Richard Santen, Professor Emeritus in the Division of Endocrinology at the University of Virginia, has accomplished much in his career which has involved care of patients, teaching, research, mentorship and administration. He has held several academic positions including Chief of the Division of Endocrinology and Vice Chair of Medicine at the Penn State School of Medicine and Chair of Medicine at Wayne State University. He recently served as the President of the 18,500 member Endocrine Society. Upon retirement he has wanted to share his clinical expertise with providers in rural, underserved areas.

Dr Richard Santen, Program Director

He has received numerous awards from professional societies including the highest award of the Endocrine Society for lifetime achievement. As a retirement plan, he decided to utilize his expertise to help manage patients with diabetes in rural, underserved areas using telemedicine. A six year program has been successful in improving the level of control of glucose in his patients. He has developed a template to instruct other retired endocrinologists how to work with Federally Qualified Health Centers as consultants to improve the care of patients.

Key Reasons to Participate

The need:

Patients with diabetes living in rural underserved areas frequently experience less than adequate health outcomes, a problem exacerbated by insufficient availability of endocrinologists.

The solution:

Encourage retired endocrinologists to return to practice (“reboot”) part-time and use telemedicine to evaluate and treat these patients.

Retirement:

Every year, endocrinologists decide to retire when they reach a certain age but they usually are still in their prime and capable of managing patients.

Opportunity:

Many retired doctors are eager to offer their services and are looking for ways to reach out and help. The opportunity is to consult at one of the 1400 Federally Qualified Health Centers in the United States and take advantage of the variety of clinic resources.

Telemedicine:

Endocrinologists can take care of patients several miles away using telemedicine to initially evaluate and then follow patients.

Reduced hassle:

The Community Health Center staff handle many tasks including electronic medical record data entry; ordering prescriptions, laboratory tests and imaging studies; and calling patients when urgent issues arise.

Time management:

Retired endocrinologists reentering practice can decide how much time they would like to spend: as little as 5 hours a week or as many as 20; but only the amount desired.

Getting started:

A navigator helps to guide one through all the steps needed to begin interacting with the Federally Qualified Health Centers.

Success:

Dr Santen’s six-year experience has demonstrated the success of this process.

“It is medicine without the misery – no travelling, filling out endless forms, following someone else’s rigid regulations, chasing payments, and continually trying to squeeze more patients into strengthening appointment times.”

References:

1. Intensive, telemedicine-based, self-management program for rural, underserved patients with diabetes mellitus: Re-entry of retired endocrinologists into practice. Santen R J, Nass R, Cunningham C, Horton C, Yue W Journal of Telemedicine & Telecare. 29(2):153-161, 2023 Feb

2. Meal Replacement in Conjunction with an Integrated, Technology-Driven Strategy for Treatment of Patients with Diabetes in Rural, Underserved Areas: A Pilot Study

Richard J Santen, Cindy Cunningham, Carla Horton, Ralf Ness and Wei Yue. Trends Telemed E-Health 4(1):1-8, 2023

3. Need for navigators for care of patients with diabetes in rural, underserved areas

Richard J Santen, Trends Telemed E-Health 3(3) 1-3, 2022

4. Back to work: a solution to the shortfall in diabetes care in the USA

Richard J Santen, Health and Medicine, Research Features.com

5. Challenges to care of patients with diabetes in rural, underserved areas

Richard J Santen, Open Access Government October 5, 2023

6. ‘Re-booting’ after retirement: novel approach using telemedicine to solve the work – force gap in diabetes management

Richard J Santen, Maturitas 133:68-69, 2020

News Posts / Articles

Back to work. A solution to the shortfall in diabetes care in the USA

In the United States there is a shortage of endocrinologists to treat and advise patients with diabetes mellitus.

Challenges to care of patients with diabetes in rural, underserved areas

Patients with diabetes mellitus in rural communities face major impediments in achieving and maintaining control of glucose levels and preventing complications; patients in these areas endure their healthcare being medically underserved and financially challenging.

Podcasts

Patients Come First

Blogs

Underserved Diabetes

Professor Richard J. Santen, MD from the University of Virginia, explains the need for retired endocrinologists returning to work to manage patients with diabetes in America’s rural underserved areas, including a comment on telemedicine

Road map

Getting Started

Contact Dr Richard Santen at [email protected] to direct you to the navigator to guide you through each step of the process

You need to look up the list of Federally Qualified Community Health Centers and select 1 to 5 that are in your state. To find the state by state list click on:
https://data.hrsa.gov/data/reports/datagrid?gridName=FQHCs

Dr Santen will then contact the CEOs of each and determine if there is a need for Endocrinology consultants. He will also determine the willingness to provide sufficient consultant fees to pay for medical malpractice, renewal of license, dictating software etc. He will also devise a plan, setting up a contract. The consultant ongoing reimbursement is estimated to be about $500 per month and covers all set up costs. Dr Santen’s consultant contract provides a template for this arrangement.

Follow the navigator’s directions for obtaining the necessary insurance and equipment needed including:

Malpractice insurance
Renewal of medical license
Setting up of LLC (Limited Liability Corporation)
High resolution TV camera
Home computer
Scanner
ZOOM software
Encrypted e-mail from FQCHC
Dragon one dictation software
Adequate broadband internet service
Cell phone service for patient calls

Setup an employment contract and you are ready to start