The healthcare professionals formerly known as “diabetes educators” will henceforth be referred to as “Diabetes Care and Education Specialists” (DCES).
This was the biggest news coming out of the mid-August 2019 annual meeting of the American Association of Diabetes Educators (AADE), the professional org that may be changing its name soon as well to fit with this rebranding effort.
It’s all part of something called Project Vision, AADE’s multi-year plan to define and refresh the roles, capabilities and care priorities of its roughly 14,000 members nationwide. This effort dates back to at least two years ago, when the organization realized that something had to be done to address the tides of change in diabetes education.
Yes, We Said “Rebranding”
The announcement of the new job title by current AADE President Karen Kemmis on the first day of the #AADE19 conference was met with some enthusiasm, and also a good deal of confusion: Will there be a change to the credentialing process of becoming a Certified Diabetes Educator (CDE)? Will the new title bring expanded responsibilities? And how inclusive will it be of those in diabetes education roles who do not have the CDE certification?
We sought answers to all those burning questions in our Q&A below.
But first, it’s important to know that this move is basically “new packaging” for the existing multi-faceted work that educators already do with patients, Kemmis says.
“If you say ‘I’m a diabetes educator’ now, it sounds like you just teach a few classes… or just tell patients to count carbs and exercise a certain number of minutes per week. This better describes what we’re able to provide: medication management, psychosocial assistance, working with PWDs (people with diabetes) collaboratively on their health goals, and recommending interventions when needed.”
Also, the term “educator” doesn’t invoke the same respect and authority as “specialist” in medical circles, Kemmis adds. She notes that some AADE members have already told her how much more proud they will be to identify themselves as a “Diabetes Care and Education Specialist.”
“(Our work) is not one-and-done, it’s not linear. It’s an ongoing cycle of care, and that’s better represented by the term ‘specialist,’” Kemmis says, adding that this could potentially help convince skeptical physicians and payers of the need for ongoing patient contact with these DCES experts.
They expect a positive reaction from the patient side, too, Kemmis says. “’Educator’ sounds like I tell them what to do… that’s less appealing.”
In contrast, the term “specialist” may help many PWDs be more aware of the training and expertise these folks have in behavioral health, nutrition, exercise physiology, and new diabetes technologies. The hope is to help offset widespread “underutilization” – when patients get referred but don’t come in for appointments.
The new title should also help the general public better understand that they provide both ongoing care as well as education.
The final important audience for this new language is young people entering the field. “Millennials are not as into ‘certifications’… We want to attract a younger generation into the profession, and have them understand the importance and scope of the work,” Kemmis says.
Q&A on the New Title: “Diabetes Care and Education Specialists”
Now on to the burning logistical questions. Answers below are compiled from information provided by current AADE President Karen Kemmis, AADE CEO Chuck Macfarlane, and in part by Sheryl Traficano, CEO of NCBDE.
DM) Where did this new name come from?
AADE) We conducted extensive research that began in March 2019 and culminated in the name choice by our Board in June. We started with qualitative interviews with a variety of stakeholders – from physicians' groups to pharmacists to the CDC.
The outcome of those interviews then drove a survey that went out to our members and a broad swath of stakeholders including ADA (American Diabetes Association), JDRF, the Endocrine Society, AACE (American Association of Clinical Endocrinologists), nurse practitioners, family physicians, PAs, and more.
We worked with The Brand Consultancy headquarted in Washington, DC, and they did an amazing job synthesizing the results, which showed clearly that the name ‘educator’ didn’t hold weight. In fact, the survey tested a dozen name options including “Diabetes Care Coordinator,” “Diabetes Outcome Manager,” and “Diabetes Health Specialist.” The DCES title is the one that came out on top.
Will the AADE organization be getting a new name as well?
Quite likely. We are looking at that, but it will take some time. Meanwhile, we wanted to share this new career title with our members now, at the annual meeting. In that sense, it was kind of like a soft launch.
How are you getting the word out, in order to establish this new DCES title?
At the conference, we held a big meeting with all the stakeholders involved in the research to share the results, and all the feedback was extremely positive – so we know they’re on board. That meeting also included Thom Scher of Beyond Type 1, as a patient-facing group.
We’ll be sending out a packet to our members and holding a webinar for them soon.
And we plan to issue press releases and other materials. But we’d like to announce it broadly along with the new name of the organization when that happens.
The Big Question: Does this change the career path for people working in diabetes education?
No. It’s really just a repositioning of the specialty – the requirements will remain the same. The new language is meant to illustrate that we are part of the integrated care team, handling not only the education piece but clinical components as well.
Who Qualifies Now as a “Diabetes Educator”?
For those unfamiliar, it’s important to understand that being a Certified Diabetes Educator (CDE), is not a stand-alone profession: it is a certification that one gets on top of already being established as registered nurse, dietitian, doctor, pharmacist, or other licensed health professional.
To get the CDE certification, these professionals need to accumulate a total of 1,000 practice hours working with diabetes patients to qualify to sit for the comprehensive exam, overseen by the National Certification Board for Diabetes Educators (NCDBE).
However, not all ‘diabetes educators’ have gone through the process of getting that CDE certification. In fact, AADE CEO Chuck Macfarlane says a full 50% of the org’s members do not have the certification, but are qualified to call themselves diabetes educators based on training in clinical nursing, pharmacy, dietetics, physical therapy, social work, etc., and their work with diabetes patients on a regular basis.
For more detail, see CERTIFIED DIABETES EDUCATORS: WHAT YOU SHOULD KNOW
Will existing CDEs (Certified Diabetes Educators) need to retest, or earn a new credential?
No, the CDE credentialing process will remain the same, and continue to be governed and administered by NCBDE. The only changes to the exam itself are ongoing updates to keep the content current.
NCBDE continually solicits feedback on its exam questions to test their validity, and a more comprehensive review of the exam that was formerly conducted every 5 years will now be bumped up to a two-year cycle.
How is NCBDE reacting to the new job title? Will they be getting a new name as well?
NCDBE's leadership is very supportive of the new title, which they see as "a positive reflection of what we feel our CDEs have been doing for many years, while providing expanded opportunities to place themselves in important roles to ensure a continuing movement that supports quality person-centered care."
Note that NCBDE and the CDE program are separate and independent from AADE. The NCBDE Board is now considering renaming the credential to reflect this update.
They're hoping to make a decision shortly regarding changing the name of the certification designation from 'Certified Diabetes Educator' (CDE) to something akin to 'Certified Diabetes Care and Education Specialist' (CDCES)' -- in other words, adding an additional "C" before DCES. (More medical alphabet soup!)
Because the CDE program is accredited by a third-party organization called the National Commission for Certifying Agencies (NCCA), that entity will need to sign off on any name change before it can happen.
What about efforts to include different levels of certification, for community educators and others?
The Career Path Certificate that AADE announced in 2015 will also not change. That established ‘Professional Level’ recognition programs to embrace lay health workers, community health workers, peer counselors and others.
Also the BC-ADM (Board Certified-Advanced Diabetes Management) credential that AADE offers, which is a level above CDE, focusing more on overall care coordination, will not change. That credential requires Master’s level competency in a variety of specialties – advanced nursing, pharmacy, dietetics, etc.
But the new DCES name and positioning may open the door for us to create new certificates or badges that any member could earn to show expertise in things like CGM, mental health effects of diabetes, and so on. We’ll be exploring that.
Finally, just to clarify: If people are still earning a ‘CDE’ credential, how will the new DCES title be used?
It’s a vision for umbrella clarification. “Diabetes Care and Education Specialist” becomes the overarching title for everyone working in this field. Some will have the CDE certification, the BC-ADM certification, or one of our Professional Level designations.
Overall, the CDE moniker has a lot of recognition and good will. This is a name change only, aimed at being more attractive to healthcare partners, new clinicians, and patients alike – and being more central to the diabetes care team.