Not quite sure what you're asking Annecy. Do you mean which one do we see?
I only utilize an endo. All of my records indicate he's my "PCP" (even that's not really what he is or does) b/c I don't have one a real PCP.
What I actually mean is that my endo SEEMS to feel that I am bringing up issues or questions that should be discussed with my CDE/PCP (I see all 3). For example, I'm now curious about the vitamin D connection to Type I & am wondering about my levels. I don't want to take up more of her time than I should by asking her to act as my PCP or CDE.
I see an endo and a PCP who is an internist but they are both in the same clinic. My endo actually recommended the doc for my PCP.
I used to only see my endo (have been seeing him for 20 years now) but his patient load increased to the point where it made more sense for me to have a true PCP that I could get in more quickly to see for non-diabetes related ailments. Both docs communicate well with each other and since they are in the same clinic they both see my complete file and test results so it works well for me. The CDE is another story...I don't find those visits very helpful unless she's just collecting data to give to the endo. My CDE is also in the same clinic and basically just assists my endo. She's a nice lady just doesn't have much to add that helps me.
Once again I see that "your results may vary" thing. My CDE is THE best medical provider I've ever had. Thanks for your feedback.
I've actually discussed Vitamin D levels with my endo, PCP and my cardiologist. My endo isn't a big believer but my cardiologist is so my cardio does the testing for that in my case. My endo's comment was "oh yeah, he's a big believer in Vitamin D" but he doesn't have a problem with me taking it. I figure if there's a chance something so simple can help me, then why not.
I used to feel like I was taking too much of my endo's time, but I got over it. I ask what I want to ask and I tend to ask the same question to all of them to see how the responses compare. I figure that's what they are paid to do and I need the information.
I'm replying within the context of some of the previous replies. I too have a PCP, Endo, And CDE all within the same clinic. I once asked my PCP whose job it was to keep the "big picture" of my health in focus. That involves, arthritis, cardiac, physical therapy, orthopedic, oncology and other various miscellaneous issues. He said that is his job. I try to use people for all issues within the same "system". That works pretty well. The CDE has become a friend and training partner as well as my CDE and is very helpful.
Your PCP or Primary Care Physician is correct when he said that it was his job to keep track of the big picture.
Some Endos are only concerned with the management of your diabetes and others want to treat your whole body (not many though).
Your PCP is suppose to mange all of your health care aspects and why he may not be treating a particular illness/disease/condition because it was best that a specialist treats you he still coordinates all the health care data about the particular illness/disease/condition along with any others you might be seeing a specialist for including anything that the PCP might also be treating you for including routine exams etc.
Your PCP is the doctor that should be advising you when you would best served by seeing a specialist.
For the most part your PCP is the only doctor that not only has the big picture but really cares about a the big picture.
An area of concern is that now days most health insurance plans let you bypass your PCP and go directly to a specialist, in fact you do not even have to choice a PCP in a lot of plans now. I have worked within the health insurance industry for over 35 years and I am not sure why the health insurance industry is headed in this direction but I believe that the thinking is that most PCPs will send you to a specialist for most health conditions anyway so if the patient has a sinus infection then let them got straight to the ENT, this would save time and money plus the fact that there is a storage of PCPs in certain areas of the country. This is OK for people who are smart enough to manage and coorinate their own health care on a high level and have a full understanding of coordination of multiple issues but I believe that even when you go to a specialist directly you should inform your PCP about the visit(s) and even though as mention you may no longer be required to have a PCP have one anyway, after all you should be going for routine exams and such.
With that being said you must keep in mind that all health care providers are different and some Endos will act and treat you as if they are your PCP however most do not have the time or interest.
Also again, due to shortages of PCPs and certain specialists the situation might be different in you local area. Where I live (Florida) there is such a major shortage of Endos that you might have to wait over 6 months, even over 9 months for you first appointment or you can go to that specialist that no one likes or trusts and then it turns into a bigger nightmare when your insurance company changes their provider list or you have to change insurance companies and choice a new Endo, I am in that process right not - not fun - my first choice of a good endo is no longer excepting new diabetes patients, he recommended his new partner which I only had to wait 1 month for my first appointment which is pretty good but then you have to ask yourself why is the new doctor able to see you so fast - LOL
Everybody's insights/info give me much to think about. Thanks for replying.