Finding your Niche: Making an impact in diabetes care

When Rick Siemens first started practising pharmacy in 1996 in a small community in Northern Alberta, he met patients with diabetes who didn’t know or understand what they could be doing to keep their blood sugar levels in check. “When you work in community practice you pick up gaps in care, and I realized this is where I could be making real impact with my patients,” he said. “Family doctors can’t be experts at everything, so they really appreciate when you can help them.” Today, Siemens is known across the country as a diabetes expert, and works almost exclusively as a clinical (non-dispensing) pharmacist at London Drugs, where a vast majority of patients have diabetes and/or seek his assistance in implementing cardiovascular risk reduction strategies. Aligning with Diabetes Canada guidelines, he monitors blood sugars and A1C levels, prescribes medication, helps develop exercise goals and focuses on cardiovascular care for people with diabetes. “Much of what I do is develop care plans for these patients, writing letters to their doctors with my recommendation and providing up to 12 follow-up visits per year that are covered by the provincial drug plan,” he said, crediting his employer of 20 years for allowing him the time and resources to build his practice. “Being able to prescribe and order labs has certainly made it easier to get involved in the patient’s entire diabetes care plan too.” Read: Finding your Niche: Relief pharmacy offers variety, flexibility His practice keeps evolving along with guidelines in diabetes. Patients require different care as their disease progresses. “Even 30 years later, there is still so much to do in diabetes,” he said. “It’s lucrative, too, as these patients are loyal and appreciative of the expertise I give them.” His advice to those wanting to get involved in diabetes care is to “start low and go slow.” It could be just about helping patients hit their blood sugar targets better, he said. “As you become comfortable, you’ll inevitably end up doing more.” Over in Ontario, pharmacist Shelley Diamond, found her diabetes niche initially by developing educational programs for pharmacists at Shoppers Drug Mart to help patients with chronic diseases. “We started with asthma clinic days at the pharmacy and then the program evolved to include other health disease areas, such as children and women’s health and then eventually diabetes,” she said. “One of my responsibilities was to develop an online study program for pharmacists wanting to become certified diabetes providers.” Seeing the positive impact these programs had in helping patients manage their diseases better and recognizing the lack of support for people living with diabetes, Diamond co-founded a website— Diabetes Care Community—as a resource specifically for Canadians, featuring engaging, objective and credible information as well as self-management resources. It includes topics ranging from diabetes management, prevention and monitoring, to how to incorporate a healthier lifestyle, including diabetes-friendly recipes. Started in 2011 and sill growing, the site has become a go-to information resource for those living with prediabetes and diabetes, as well as their caregivers. “We know there are quite a few healthcare professionals coming to the site and referring their patients,” she said. A diabetes patient counselling system specifically designed for use by pharmacists is currently in development. Read: Finding your Niche: Going to the pharma side When she’ not working on the website, Diamond consults on diabetes topics as both as an expert speaker and columnist. “There is so much opportunity and such a great need to help people with diabetes. Whether it’s lifestyle suggestions or making sure patients are on the right medications, pharmacists can make a real difference.” How can I specialize? While it’s not mandatory to become a certified diabetes educator (CDE) to work with diabetes patients, pharmacists who have completed certification say it gave them a good base understanding of the disease and more recognition among other healthcare providers. Once certified a CDE can rewrite the certification exam every five years or complete an education profile showing that they have done significant learning in the area of diabetes. The Canadian Diabetes Educator Certification Board provides information about the certification and examination process as well as answers to other frequently asked questions.

Finding your Niche: Making an impact in diabetes care

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