Resources

Podcasts / Blogs

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

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.

Intensive, telemedicine-based, self-management program for rural, underserved patients with diabetes mellitus: Re-entry of retired endocrinologists into practice

Endocrinology workforce data demonstrate a substantial gap in the number of practicing endocrinologists, a phenomenon particularly affecting patients with diabetes in rural, financially challenged, underserved areas.

Need for Navigators for Care of Patients with Diabetes in Rural, Underserved Areas

This opinion piece will provide the background and rationale why navigators are needed for the care of patients with diabetes living in rural, underserved areas and who are utilizing telehealth and its requisite technology. My experience with 280 rurally-based patients with diabetes over the last five years has uncovered multiple problems with utilization of technology.

Out of Practice: Why Retirement Doesn’t Always Mean You Stop Seeing Patients

When Endocrine Society past-president Richard J. Santen, MD, achieved “emeritus” status at the University of Virginia in Charlottesville, he was far from being done with practicing medicine. That’s when he decided to continue seeing patients throughout southwest Virginia from the comfort of his home and with help from telehealth technology and the Federally Funded Community Health Centers program.

Read full version (Part1, Part2, Part3)

Re-Entry of Retired Endocrinologists into Practice: Role of Telemedicine for Patients with Diabetes Mellitus in Rural, Financially Challenged, Underserved Areas

A large workforce gap in endocrinologists taking care of patients with diabetes mellitus exists and is particularly problematic in financially challenged, underserved, rural areas.

Maturitas

“Re-booting” after retirement: Novel approach using telemedicine to solve the work-force gap in diabetes management. Telemedicine is a rapidly growing, internet-based technology which enables physicians to practice medicine from their professional offices, homes, portable devices or personal computers

‘Rebooting’ retired endocrinologists to provide vital diabetes care

A large shortage of practicing endocrinologists in the US severely compromises the care of patients with diabetes mellitus. Dr Richard Santen at the University of Virginia School of Medicine, US, is encouraging fellow retired endocrinologists to step in to help, especially in financially challenged rural areas without access to comprehensive healthcare.

Managing patients with diabetes in rural underserved areas

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

Rural, medically-underserved, financially-challenged geographical areas lack endocrinologists to provide consultation and management of patients with uncontrolled diabetes.

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

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