I just received a letter that my Dr. is leaving town and I have a chance to make a huge decision. I have had 3 different endo’s in my 17 yrs as a T1 and frankly, they have not been much help. I am not sad to see the one I have now leave. The only reason I kept her was because she was the only one within 75 miles of me and I needed her to sign my scrips. Other than that she was quite useless. Now I have the choice to travel 75 miles to my old Dr. ( if he is taking patients) or stay with a nurse assistant that says she can treat diabetes and thyroid( which I also have)with the guidance of a internal Dr. I have a primary Dr too. He could just write my scripts. What should I do? I need to decide by next month. How valuable has your Dr been for you? As of now I do not have any complications to be treated and wonder if a Endo. would be the one to treat me or would I be passed on to another specialist.
i’ve had many more endo’s than that and none of them really wanted to work with my lifestyle - it always felt like a dictatorship and a lot of “can’t do’s.” in general, i don’t have a positive view on the medical community as far as diabetes treatment goes. i’ll admit i’m a difficult patient because my questions are very specific and highly technical in nature, but if i can’t ask my doctor who is suppose to answer these questions right? i don’t even have an endo now and my sugars and a1c’s have never been better. i only go see one when i stumble into a question i can’t find a credible answer to.
i would go with the nurse assistant if you absolutely need to be medically supervised, but even if you want to see your old doctor, driving 75 miles once every few months isn’t such a bad thing right? - you could make a trip out of it right?
hopefully that kind of helps or at least brings some perspective :]
I had an amazing doctor/np team during my teens at a Philadelphia Children’s Hospital branch. They were respectful (high on my list of qualifications), knowledgable, and flexible. During my teens I was going through constant adjustments, growth spurts and the like. I’d change my insulin regiment pretty constantly- that team helped me learn how to self-manage better than any doctor/np I’d had before.
After I moved from PA I was faced with a dilemma similar to yours. I was at school for 3 years in Savannah, GA and knew I would be moving elsewhere after graduation. I managed to get prescriptions from a NP who was absolutely terrible, disrespectful, unprofessional, etc. I put up with her nonsense for a few years, while trying to find a better endo fit in Atlanta. I went through 2 other endo’s in Atlanta before I finally found a doctor who was a) respectful, b) super helpful, and c) who’s wife had been diagnosed with both type 1 and thyroiditis (same as me) when she was 27.
Now that I’m not making any drastic changes to my regiment, more just maintaining, I find that even though I have a good endo I could most likely maintain the same if I didn’t. The real question is, is there someone you can see who will listen to you when things change? If the NP is good and the internal dr. is familiar with diabetes complications, this seems like a good bet. If you didn’t like your old doctor, no sense traveling 80 miles when you can get similar care closer.
By and large I’m a “do it myself” kind of guy, but it’s really nice to know that if anything goes wrong I have a doctor that I trust and get along with, and one who is familiar with me outside of emergency situations. Unfortunately I had to change insurance, so my doc is no longer covered :. I plan to pay out of pocket for a visit or two a year, just so I don’t have to go doctor hunting again.
Best of luck to you, I hope you find someone fantastic 
I think I would go with thr NA if you think she knows more than the Dr.
I started my T1 care 25 years ago under the care of an internist who was not very knowledgeable with diabetes. I’ve since had two different endos, both excellent and very knowledgeable, as well as going through a period of time where I had no insurance coverage and little care at all.
Here’s what I found personally. As long as everything is going ok, any competent MD who can write prescriptions seems to do fine. Heck, as a knowledgeable diabetic who is responsible for the application of diabetes care 100% of the time, your care depends mostly on you anyway. Preferrably, you already have a team (nutritionist, nurse practitioner, opthamalogist, etc.) for your diabetes care and your endo is just one part of that team. If any complications arise, however, you want to be under the care of a somebody that knows how to handle those complications or knows when to turn you over to someone who does.
Most inportantly, you wnat to be under the care of somebody who knows where and how to look for complictions and head them off. I recently had microalbuminuria which would have gone undetected if I didn;t have an endo, or somebody, knowledgeable enough to look for those early signs of kidney problems. 6 months and lisinopril later and my latest labs show everything is back to normal. I give all the credit in the world to my endo.
Just my 2 cts. =)
Thanks for the 2cts. I agree that we basically take care of ourselves. I have to give my current endo credit for keeping up with blood work. She tested me for low vitamin D without me knowing about it and turned out that I was very deficient. What I don’t care for is she had a very heavy accent and i have a hard time understanding her. Also, the second time i went for a visit, i had forgotten some paperwork and she made the comment " I was wasting HER time"!! I was the one paying out of pocket for her “time” grrr! That stayed with me, although the next time she had a different attitude, so I just figured she was having a bad day.
I would love to have a diabetic team. It just isn’t available to me. Insurance wont cover many things. I have to be hospitalized 2 times in a year for them to cover a $350.00 lesson from a dietitian. How crazy is that! Well I took things into my own care and am now trying Dr. Bernsteines low carb diabetic diet. 4th week and so far so good. I cant wait to see my new a1c. My endo never suggested anything about diet or exercise.She was always changing my pump settings. Extremely frustrating because soon after she made the changes, I had to switch them around on my own again. I enjoy this site so much because of all of the help I’m getting. It is good to know you are getting good care.
Well thanks for the suggestions, i still have to weigh some ideas before my decision.
The last time I had a NA, she was so good that I only saw the Dr when the insurance co. made me. If she is still there, that would be a consideration. Thanks