Co-existing with your Doctor?

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Co-existing with your Doctor?


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Old 01-23-2012, 22:50   #1
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Default Co-existing with your Doctor?

Am I the only one who has problems getting along with my doctor? I like my ENT and my Podiatrist, but my GP who is the gatekeeper - I don't like much.

He is really ignorant where diabetes is concerned, especially a person on the modern insulins and/or a insulin pump. Recently I had a heated debate with his office staff regarding diabetes management and I would just like to quit going to him. However Medicare requires that I see a doctor every 3 months (whether I need to or not) or they will not pay for my insulin pump supplies or the insulin I use.

It is really hard to sit in his office and listen to him scolding me for "trying too hard to keep my BG in line". He thinks I'm obsessive for testing more than 3 times a day. My A1C is 6.1 and he thinks that is way too low.

My OH gets upset with me when I talk about getting a new doctor as I seem to have a real knack for choosing the wrong one.

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Old 01-23-2012, 23:05   #2
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I've been known to interview doctors before deciding on one. It's MY health; s/he is my paid consultant. I say replace him.

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Old 01-23-2012, 23:17   #3
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I've been known to interview doctors before deciding on one. It's MY health; s/he is my paid consultant. I say replace him.
What a good idea!

 
 
Old 01-23-2012, 23:17   #4
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I've been known to interview doctors before deciding on one. It's MY health; s/he is my paid consultant. I say replace him.
I'm not the brightest bulb in the lamp, could you give me some idea of what it is like to 'interview' a doctor? What kind of things do you ask the doctor? It has gotten to the point now where I have no confidence in my own ability to choose a doctor. I seem to have fallen through the cracks so to speak and this idea of picking a new doctor is frightening.

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Old 01-23-2012, 23:29   #5
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I'm not the brightest bulb in the lamp, could you give me some idea of what it is like to 'interview' a doctor? What kind of things do you ask the doctor? It has gotten to the point now where I have no confidence in my own ability to choose a doctor. I seem to have fallen through the cracks so to speak and this idea of picking a new doctor is frightening.
I've fired a few doctors (fired = quietly never going back) because we didn't see eye to eye. I'm not asking for complete agreement but treating me like a person worthy of respect instead of a fat moron would be helpful.

I second the request for how you go about interviewing a doctor. Do you call up and say "I want to see the doc and interview them?" What do they charge for the privilege?

At the moment I only see specialists (who don't work with insurance...) because I can't find a good GP. Which I really need to find since I can't really go to my endo when I think I have a sinus infection.

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Old 01-23-2012, 23:38   #6
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I ABSOLUTELY interview the candidates when I need a new doc - thankfully I haven't had to do that for a good many years now, but it started back in the 70s when my gynecologist made the statement in passing that I didn't need any more babies (I had TWO!) I never visited that office again, and as soon as I had an appointment with a new one, I explained exactly why I left the previous one & exactly what I expected of the new one. He said he'd be happy to "suggest" options without visiting his opinions on me, and we got along fine until I no longer needed an ob/gyn.

Years later, everlovin's psychologist retired, & referred us to a psychiatrist to take over the paperwork required by his disability insurance. Everything was forwarded to him from the previous doc, but as soon as we got inside the door, he had a laundry list of tests he insisted were necessary. The diagnosis had already been made, the insurance had been paying for years already, and nothing more was needed except to sign the papers once a year. But this yoyo actually said he refused to take other doctors' word for it, and we could also pay him $100 an hour (back in the 80s) for the privilege of being his patients. We said emphatically "no way in hell", and left considerably faster than we came in. Not even sure he GOT paid for that visit . . .

It's our money, whether we pay insurance premiums or out of pocket, and we damn well deserve courtesy & respect.


(Eek! Can you tell you tripped my trigger?!)




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Old 01-23-2012, 23:45   #7
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IMHO some doctors treat patients who are on Medicare like the person who has committed welfare fraud. I know Medicare does not reimburse very well, but I didn't write the rules and I'm just trying to manage a difficult condition. It is sad when the patient knows more about the disease management (diabetes) than the Doctor.

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Old 01-23-2012, 23:53   #8
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I have occasionally asked for a consultation visit for a new/possible doctor. Then I take the appointment time and ask questions. I want to know what his/her (usually her) experience with _______ has been and how many patients she has with ________.

In the past it was "does the doctor know ANYTHING" about gluten intolerance and food sensitivities. I would ask "have you diagnosed anyone with Celiac?" A "no" answer would be a red flag for me.

Now, with diabetes, I would ask how many diabetic T2 patients and what is their usual treatment plan (is it one-size fits all, or does the dr. encourage the person to take on the responsibility for controlling it). I'd want to know if they have any patients who are getting good control, and what their stand is on low-carb eating for controlling D.

I would be looking for "one-size-fits-all" and adherence to ADA guidelines. These two issues would be a "no go" for this doctor.

My current dr. dx'd my D, but is not on board with low-carb. Since I don't really need her for anything except scripts for testing strips, I have not had any problems - and she lets me do my own thing, even though I don't think she agrees 100%. Another important thing for me is that she has Celiac patients and understand the impact of gluten on health. So I'm keeping her for now.

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Old 01-23-2012, 23:58   #9
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Originally Posted by Strawberry View Post
It is sad when the patient knows more about the disease management (diabetes) than the Doctor.
GPs and internists know a little about a lot of things (or should), but not a lot about any one thing, unless they have patients with that thing. It's more the attitude than the knowledge. As an intelligent and curious, and determined diabetic, I should know more than the doctor because I live with this.

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Old 01-24-2012, 00:02   #10
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I called and said I needed to change doctors, and Dr. X had been recommended to me, and I'd like to meet with him briefly to see if it was a good fit, and they could charge me if they wanted, but I didn't want to fill out all their paperwork to become a patient yet because I was still weighing my options.

If I were doing it now, I'd start by asking questions of the office staff when I called to make the appointment:
  • Do you accept my insurance?
  • How do you handle your billing?
  • Whom do I see when Dr. X is off?
  • At which hospital(s) does Dr. X have privileges?
  • If I were hospitalized, would Dr. X oversee my case or would I be under the care of a hospitalist?
  • Will you fax prescriptions to my mail order pharmacy or will I have to mail them in myself?
  • Do you have your own lab or one that's preferred?
  • What's the procedure for getting lab results?
  • And other stuff like that.

When I met with the doc, I'd tell her I asked for this appointment because I'm trying to find a doctor who shares my belief that I'm ultimately responsible for my own health and the role of the doctor is consultant:
  • If she seems to agree with that, I'd ask her how she sees it working in practice. How will she feel about taking appointment time to discuss things I've read so I can become more educated? How easy or hard is it to reach her by phone? What does she want from a patient-partner?
  • If she balks at being a consultant, rather than God and guru, I'd ask why. I'd want to make sure she understood what I was saying so I'd know we really do have a fundamental disagreement. If so, I'd thank her for her time and get the heck out of there.

I might also go over some of the answers to the questions I asked of the office staff, especially the ones about whom I see if she is out and using a hospitalist, which is something I'm wary about.

Now I think I'll call my daughter and ask her if anyone has ever done this to her, and what she'd think if they did. I did it without thinking much about it; it just seemed reasonable to me.

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A1c
11/2011: 8.8 | 03/2012: 5.6 | 08/2012: 5.9 | 09/2013: 6.0 | 03/2014: 6.2 | 03/2015: 6.2 | 02/2016: 6.9 | 01/2017: 6.8 | 05/2017: 7.1 | 09/2017: 6.8 | 01/2018: 6.5

Diabetes meds
Metformin 1000mg BID

Diet
Low-ish carb (~90-150g per day)
Low-ish calorie (<1800 kcals per day)

Exercise
I really should exercise.
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