Connections - 01.30.20

Why We Need Specialized Physicians for I/DD

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By Craig Escudé, MD, FAAFP

Educating physicians and other healthcare providers is imperative to improving access to quality healthcare for people with disabilities. Physicians, nurses, dentists, physical and occupational therapists and others receive little, if any, training in the field, however, as more people with disabilities enjoy the benefits of community life, these same people are seeking healthcare from clinicians who have not been trained to meet their needs.

As I travel the country speaking at or attending conferences where there are numerous groups of healthcare providers and supporters of people with I/DD including physicians, direct support professionals, nurses, administrators, case managers and family members, the topic of lack of education of I/DD health issues almost always comes up.  And the sentiment is the same; people with IDD have difficulty finding clinicians who understand their unique health needs.

There is progress being made in this area. Here’s what’s happening:

The American Academy of Developmental Medicine and Dentistry promotes the National Curriculum Initiative in Developmental Medicine, (NCIDM) The goal is to provide training to medical students in the field of developmental medicine—the care of individuals with intellectual/developmental disabilities (I/DD) across the lifespan. Their goal is the have this education in 10% of medical schools by 2021 and 30-100% by 2026. The intent to expand to other disciplines over time.

National board certification in developmental medicine is becoming a reality. IN 2019 the American Board of Developmental Medicine began certifying physicians in the field of adult developmental medicine. The current requirements for application include extensive experience in providing direct care to people with I/DD, experience as a leader in improving health of adults with I/DD, and a background of research, teaching  and advocacy in this field. The process is evolving to include a requirement to pass a Development Medicine Certification Exam in the near future.

The Developmental Disabilities Nursing Association certifies both RNs and LPNs in the field of developmental nursing. Certification in the specialty demonstrates that a nurse possesses specialized knowledge in I/DD nursing, indicating advanced experience, competence, and proficiency beyond that required for basic nursing licensure. Candidates are required to have experience in the field and pass a certification examination to receive the added qualification of Certified Developmental Disabilities Nurse (CDDN) for RNs and Developmental Disabilities Certified (DDC) for LPNs.

Health Risk Screening Recognized Provider in I/DD HealthcareHealth Risk Screening, Inc. offers a Continuing Medical Education accredited  program called Curriculum in IDD Healthcare for physicians and other prescribing clinicians. The web-based program consists of 6 modules that provide straightforward, practical and clinically relevant information about healthcare for people with I/DD. Topics include the top fatal conditions in the field (The Fatal Five), how specific behaviors can point to underlying medical conditions, dual diagnosis, effective communication, avoidance of polypharmacy and much more. The program is accredited to award both physician CME and nursing CEU credits.

The Clinical Pearls in IDD Healthcare was published in 2019 and is quickly becoming a trusted resource for healthcare-related information for anyone who supports people with I/DD. It covers 55 different topics in the field relating the 4 types of support: General Support, Medical Support, Behavioral/Psychological Support and Nutritional Support. Each topic is 1-2 pages long and is written in an easily digestible and accessible format. It can be used to provide helpful clinical information to physicians, to use as in-service training for support staff and as a reference for families and providers of all types who support people with I/DD.

I started practicing medicine in the 1990’s and spent the majority of my clinical career in this field. I am so pleased to see that greater importance is being placed on clinician education in I/DD healthcare. I hope that one day soon, ANYONE can walk into any clinicians office and receive compassionate, competent, capably-delivered healthcare.

Craig Escudé, MD is a board-certified family physician who had worked and taught extensively in the field of I/DD Healthcare and is the president of Health Risk Screening, Inc.