Education or Indictment?

When I was at the AADE (American Association of Diabetes Educators) conference last month, one of the speakers referred to needing more “sticks” and less “carrots” with regard to people with diabetes. I have to admit I’m not much of a “stick” person, so that statement really didn’t sit well with me.

I’m reading a book called, Last Call, by Daniel Okrent. It’s about Prohibition: what led up to it, what happened while it was in place, and life after it was repealed. The other night I read a part that discussed what was happening with the enforcers of Prohibition. Some wanted to educate people about why being “dry” was better (healthier, safer, cheaper); others just wanted to arrest everyone who was drinking or bootlegging (they were breaking the law, after all).

So how does this relate to diabetes? It dawned on me that one approach is to educate people – teach them how to take care of themselves, what’s going on in their bodies, what their medications do, the benefits of exercise, examples of healthy foods, and so on. That would be a proactive approach, maybe even prevention. On the other hand, we can let it go and wait for people to get sick, experience complications, or end up in the emergency room and then “treat” them. This reactive approach is often accompanied by an attitude of “it was their fault.” Kind of like being arrested and indicted, but in a different way.

I tend to be more of an educator than an indicter. Maybe to a fault. I do not support scare tactics because I don’t like them myself. I had an experience where a physician told me I was going to have to experience my goals posthumously because I would die from diabetes complications before achieving them. At the time I was extremely upset by that. I felt that physician did not recognize the steps I had been taking in managing my health, but just condemned me for what I wasn’t doing. On the other hand, I do have to admit that I went home and started doing a lot more from that day on (to this day). I did not go back to that physician, though.

Then there’s Mike Huckabee. I once heard him give a talk about his experience being diagnosed with type 2 diabetes. He said his physician sat him down and gave him the top ten list of how he was going to die (a slow, painful death) due to his obesity and poor health. He said that it was a very effective approach for him, and he made changes immediately. He went on to lose a lot of weight and manage his diabetes.

I know that everyone is different, and that’s a good thing. I suppose every diabetes professional is unique in their own way too. I try to be the diabetes educator that I would want to work with. I also recognize that my style does not work for everyone else. Those who want to be scared into action might not like working with me. I struggle with how to best combine those approaches. Or is it ok to just be one or the other? I worry that people often don’t realize they can work with someone else if their provider is not a good fit. But sometimes they don’t have that option because of their location or their insurance coverage.

I’m curious how many people out there know what kind of health care professional is most effective for them. Do you?

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