I see often patients complaining about the advice of doctors. I can see people getting upset about a doctor giving advice to a diabetic who doesn’t seem to have any business giving advice. I read that in the States, doctors in school get only half a day on the subject of diabetes. They mainly learn what they know from their patients.
On the other hand talking with my doctor where I go for 32 years, his frustrations when dealing with new cases of diabetes sounds very real. As you know about 90% of diabetics are type-2 and the rest type-1. Their frustrations comes from non-compliance in particular with the type-2s with the advice given. ( No wonder at about 90%.)
He knows that many patiens going for their HGA 1C try to get a good report by living properly in the month before the test. Of course the test is over 3 months, so it won’t have much impact because of the last month. They often show blood tests with their monitors for which they didn’t use their monitors at all. They don’t know that they cheat themselves! Also the way they eat, they don’t realize that they have to put special attention to the portions taken.
So, listening to both sides, we can see the position that both sides are taking. Bad doctors are a curse on our diabetes patients. Bad behaving diabetics are a curse to the good doctors.
We can only do our very best for ourselves, while trying to help those that will accept help. What is your opinion about this matter?
Many Dr’s simply dont understand T-2 symptoms, causes, and treatments. So many are in the camp that T-2’s simply overeat and have poor will power.
For many of us in the T-2 community we get caught in this carb craving vortex of eating. Add to that we lack a signaling chemical to the brain telling us we need to stop eating. Hence development of drugs like Byetta and Victoza.
I know now looking back I was overeating and couldn’t stop. I was literally starving to death, especially as my blood sugars began to rise.
Having normal blood sugars now is like a god send to me. I will never look down on a overweight T-2 ever again as I know the issues they are dealing with.
Most of us in the T-2 community are treated by family physicians. Many are unwilling to give proper treatment to a chronic condition in a busy clinical practice. 15 minutes with ya, onto the next room. My Dr hardly even looks at my BG log, last time he didnt I was complaining about spikes!
He calls me his star T-2 patient, so yes I am complaint and take this seriously. Puzzling though he doesn’t take my concerns that I bring up very seriously.
I am not sure why anyone would say that doctors in the States get only one half day of information on the subject of diabetes. It is difficult to imagine that any accredited medical school curriculum would not include entire courses on pathophysiology and disease states. It is also difficult to imagine that within these courses there would be only a few hours of instruction about diseases as prevalent as Type 1 and Type 2 diabetes. During the third and fourth years of medical school, students spend hours each week in clinical rotations under the guidance of licensed physicians. Again, what are the odds that during the hundreds of hours of hospital and office time, no patients with diabetes are encountered? Then, the vast majority go on to residencies varying in length from 3-7+ years, which must surely include internal medicine rotations, as well as those with other specialists, depending on the physicians’s chosen specialty. I believe that the article stating that physicians in the US receive only 1/2 day of instruction/experience with diabetes is grossly inaccurate and the writer is grossly ill-informed.
“So, listening to both sides, we can see the position that both sides are taking. Bad doctors are a curse on our diabetes patients. Bad behaving diabetics are a curse to the good doctors.”
This is a subject that I get very opinionated about! I do agree that there are bad patients. But I also wonder are those bad patients really bad patients or are they just un-educated patients? I have a T1 aunt that I would definitely put in the bad patient category. Her doctor would ask her to call in numbers and she made up numbers to give him instead of giving him the actual numbers. If someone is trying to help you, they obviously can’t do that if you are going to make stuff up. I have a T2 neighbor that did the same thing when she was asked to log what she ate for several days.
I also had a T2 aunt that after years of being diabetic was put on one shot of Lantus at night. Prior to that, she was never told she should check her BS. When she was put on Lantus, she was given a meter and told to check her BS first thing in the morning. One day when I stopped to see her, she was bragging what her BS was that morning. I asked her what it was before she ate lunch or dinner. Next time I stopped, she told me she started checking her BS at other times of the day and was surprised how high it was. Unfortunately, a lot of T2s are told they only need to test 1 time a day.
I also think that bad behaving diabetics are a curse to other patients. When I started having trouble with gastroparesis, I turned to doctors for help. Instead of getting help, I was treated like I was causing the problem even though they knew that I had gastroparesis and that made it hard to manage BS. One time while being criticized, I even told a doctor, “tell me what to do and I will do it.” Instead of being offered help, I was met with blank stares.
Although I agree there are bad patients, I do have to wonder if those same patients actually had some meaningful education, would they still be bad patients? I think everyone should be handed a copy of Think Like a Pancreas upon diagnosis and a copy of Using Insulin when prescribed insulin. Maybe the percentage of bad patients would go down drastically!
Your so right Kelly. Education is severely lacking. I have gotten more out of TU than my CDE, nutrionist, and certainly my Dr.
One of the things being a proactive patient is you get weary at times. Sometimes this occurs with your interaction with your Dr too. Right now I am weary of these appointments.
I think diabetics are a source of frustration to doctors. Chronic conditions are difficult for them to deal with, especially one that requires self-management.
Over & over we hear how patients aren’t given adequate tools & information. They’re told they’re doing fine when they’re not, judged & shamed when they don’t meet goals. My doctors barely look at my logs & rely solely on A1c. They’ve been of no assistance in fine tuning doses or providing the education I needed. It takes too much of their time.
At the heart of the problem is the nature of the doctor-patient relationship. Far too often doctors are treated & view themselves as god-like authority figures who can’t be questioned. Patients are treated as non-compliant errant children. No surprise that patients lie wanting authority figure approval &/or fear being judged & labeled. Until it’s a more equitable relationship between patients & doctors, I think there will continue to be frustrations. There will always be patients who think they can cheat & always good & bad doctors, but it would be helpful for both sides to view it as a partnership.
Kim, I’ve read the same about doctors receiving very little training in diabetes. I believe it was on www.bloodsugar101.com. Jenny thoroughly researches the info she presents.
In terms of education, you can look through an example of med school curriculum here. In their second year, the students get about a day on diabetes. That is basically it. You can say that residencies and rotations will fill in their education, but that is a very tainted view of diabetes. My GP actually believes that T1 is only diagnosed in the emergency room, because that is all she saw in here years of residency.
I wish doctors had more education, you would think family and internal medicine would require more, but that is it.
ps. And I admit, I am a difficult and “bad” patient. I ask too many questions and won’t just do what I am told. I am at times “non-compliant” (although I am “adherant”) and generally just a total pain in the *ss.
For many of us in the T-2 community we get caught in this carb craving vortex of eating. Add to that we lack a signaling chemical to the brain telling us we need to stop eating. Hence development of drugs like Byetta and Victoza.
I hadn’t heard of this lacking chemical Pauly. That is interesting and would explain a lot. Is Victoza given by shots also? I’ve tried to get one of our Type 2 Friends on Insulin to get his sugars down but he has a needle phobia. Thanks for mentioning this.
Thanks for mentioning this.