Doctor not on board

I’m finally ready, and excited, about moving to a pump for the first time. After meeting with several manufacturer reps and doing lots of online research I’ve decided on the T:slim pump and the Dexcom sensor. My problem is with my Endocrinologist. She is doing her best to push the Medtronic system on me. I could not even get her to sign off on getting started with Dexcom. I feel she thinks if I move forward with Dexcom it takes Medtronic out of the picture. She has been on me for 3 years to move to a pump and now I’m getting major push back.

I’m in technology sales and just can’t get past Medtronic looking like 1980’s technology. I felt like I knew how to use the T:slim pump after handling it for 5 minutes and everything I’ve read online by users is very positive.

Has anyone had this problem? I am not opposed to changing docs.

Thanks in advance.

I just dealt with this less than a week ago. My endo group is %98 medtronics. The doc personally called me to le me know that none of the doctors patients are using the T:Slim pump. Well it’s hard to get approved for a new pump. Every 4 years at minimum and some times longer. So that does not surprise me that the majority don’t have it yet. And once you with one company they offer cheap a upgrade path without need for another insurance approval so most people don’t even look at new ones.
One of the reasons for her denial was they don’t have access to the software, I told her I can print it, show her my numbers on the iPad, email it to her in PDF or excel format. Her choice, but not a good reason to deny me the pump. I also work in IT and knew more about all 4 pumps I researched than the reps did when I met them. She know I did my research.

Simple, they have no reason to deny it, it has approval from the most scrutinizing drug administration in the world, the FDA, and that approval should be enough.

Tandom is going above and beyond now offering my training with my doctor. Working with the office to set up the access they need to view my numbers. And if the software does not work for them (I don’t see why it wouldn’t) I will change my password to a BS password and just give my doctor my login.

So, Tandom will work with your doctor if she is willing, I know Tandom is willing. Or get a new endo. I know getting a new endo first time appointment may take time, so keep in mind any doctor, your family doctor or nurse practitioner can sing off on the prescription until you get in to see your new endo if that’s needed. For me I needed this dome by the end of the year or it would have cost me extra when my deductible resets.

Good luck, I hope it works out for you.

I have used the Medtronic pump for many years,and the corresponding sensor. I was fine with the pump, the the CGM was NOT accurate, so 3 mos. ago I switched to the newest Dexcom sensor and was amazed with how accurate it is! I absolutely love it. When my insurance will approve a new pump, the t slim with the integrated Dexcom will be my choice. (It is not available yet).

I still use my Medtronic pump with the Dexcom, and honestly, I miss the convenience of having it all integrated in one system, but the accuracy of the dexcom is so good, that it’s worth having to devices on me, as unbelievable as that might sound!

If your doctor won’t approve it, get another endocrinologist to write you the prescription, the tandem rep can tell you of a doc in your area that will approve it.

Then after you have it, you can stay with the new doc, or ask your current one to continue following your diabetes.

There is no medical reason for your doc to deny it. It’s probably just new and he doesn’t know much about it.

What state do you live?

I’m in Lexington, SC. Thanks for all the feedback from everyone. I’m going to talk with her again this coming week again. I did tell her last week I was very comfortable being her first patient with the t:slim since I felt very good about the product. I do like the idea of getting another doc to sign off on the CMN and moving forward with another endo if she can’t come on board.

On a side note, my Tandem rep said my endo office will not give him an opportunity to even meet with him.

I got a new Dr. because he wanted me to continue with shots and not do a pump. He said they were too “high maintenance”. My new Dr. immediately recommended Dexcom and gave me about 7 brochures and told me all the pumps were good, but one would suit me the best according to my lifestyle. I picked the T-slim and have not regretted it yet. I’ve only had it three weeks but it amazes me at how simple it is to use, stylish so when I take it out at a restaurant or in public it doesn’t draw attention, and the touch screen saves thousands of “scrolling” minutes. I would say find a Dr. that supports YOUR individual needs. Also, Tandem has had phenomenal service and customer support so far. I love these two pieces of technology together! Also to note, I use the Animas brand Inset infusion sets with my T-Slim. Super comfortable and easy to use.

Wade,

I would ask your doctor outright if Medtronic is offering incentives to her for referring patients to their pump. Nuf said.

For any patient uncomfortable with their physician's care for ANY reason, I recommend making a switch if possible. This disease is too difficult to control without a fully supportive team.

I'm in the same boat, but I love my doctor and I don't want to ■■■■ him off. He is concerned that Tandem will fail like 14 other pump companies have.

I'm on Omnipod and having problems with failures. Plus I'm hoping t:slim is cheaper?

hate the idea of tubing, though

Scott, in the long run which is the cheapest option and by how much? Am on Omnipod but if I get laid off next year during the acquisition, I don't want to be paying for a pump every 3 days. Thanks!

Nicole, I've heard that the new Medtronic sensors are MUCH better. I'm a Dexcom user, but wanted to let you know. And it is integrated in the new suspended insulin pump

Well I remember when omni pod came out also, and they didn’t fail. But omni had something the patients wanted, and so does t:slim. I think they will be around for a while, well I’m banking on it since I purchased one. They now own the patterns from the Cosmo and are partnered with dexcom, also working on a dual pump as well.

The way I see it because they have something people want I don’t think they will fail, at worst they may get bought out by one of the major players for the technology.

My doctor has analyzed the FDA data and it is still not as accurate, and has many of the same features that annoyed me about the Medtronic sensor before: calibration required every 12 hours and only when the BG is stable. The suspend option doesn’t work and the graph won’t display if you don’t enter a calibration.



The sensor itself is nearly the same, and they were VERY uncomfortable before.



They do not last 1 full week, like the Dexcom does.



Just to list a few that my doc mentioned.



I am in love with my Dexcom. I am excited to see it integrated with the tandem brand in the next year or so.

"I would ask your doctor outright if Medtronic is offering incentives to her for referring patients to their pump. Nuf said."
The doc's refusal to sign off on Dexcom is also suspicious evidence that she is a med-bot. The Tslim passed FDA standards and at this point, its pros and cons are well-known on the DOC. In any case, it should never be about the doctor or the insurance company. It is about the PWD who has to live with the disease.

I introduced the T-slim to our endo (pediatric) for the first time last year after I stumbled upon it online. She did some research, and gave us the A-Ok to give it a try. Since then, she is promoting it equally along with Medtronic, Animas, and Omnipod. We have had zero issues with the T-slim and my son (age 12) has been using it one full year. It's sleek design/touch screen make it very appealing for anyone (especially a boy his age.) I highly recommend it and I am sure Dexcom/Tandem will end up with an "all-in-one" device soon. My son also wears the Dexcom.

We had a few issues with Medtronic (it was far from perfect) and I can't assure you the T-Slim will be perfect either but so far we are very pleased.

I switched to tslim from the Ping in the spring at the urging of my doctor because the Animas reports are terrible to read. I have no experience with Medtronic but I've heard the reports are nice. Tslim reports are web-based and VERY convenient and easy to interpret. Dexcom is also easy to read so it'll be nice when the 2 systems merge.

Wade, I have just changed doctors over this issue. This has been a very difficult decision for me because I have been with the same doctor for almost 20 years, and he has a reputation as one of the best diabetologists at a leading hospital in St. Louis. But their office is organized almost exclusively around Medtronic and I had so much difficulty w that cgm that I stopped using it. Still, I was pressured to stay with medtronic supplies.

I just moved to a diabetes group that offers a variety of pumps and cgms, where I was able to inspect and compare products, and consult the diabetes educator sitting beside me, who is well versed in all the leading gadgetry. You said so well that you just couldn't get past Medtronic looking like 1980's. That is how I am seeing my old doctor's office compared to the new.

The difference between Medtronic cgm and Dexcom is night and day. I haven't decided definitely on the t-slim, may wait until it communicates with the cgm, but when I decide to leave Medtronic's pump, the t-slim will be the one I change to.

Good luck with your decisions. And thank you so much for your post.

"...my endo office will not give him an opportunity to even meet with him." Wow, stunning. There is something really wrong with this picture.

She does have access to the software if she has a browser. You just give her your log in information and she can see everything you've uploaded and she can coordinate the dates she wants to see and print whichever report she wants. She can even download the information in csv.

It sounds like this is a doctor's office that doesn't want a disruption to their assembly line. I would be wondering if I fit on that assembly line any more.

To see if your doc is receiving kickbacks go to http://projects.propublica.org/docdollars/
and enter his/her name.

I went through the same thing with my first pump -- when I said I wanted the omnipod and my doc didn't have anyone on that. But after I insisted I was only interested in the tubeless pumping he was more open... I was his first patient and the entire office had to learn all the software but they did it! Yr. later I switched to t-slim :) I was sold on being on a pump -- not sold on the omni.

Your doctor has to ultimately do what you want - it is your health - be persistent... but pleasant :)
Good Luck
Holly