I have been with the same endo. for 10 years now. Over the past 3 years I have had repeated problems with his nurse returning my phone calls.
Some background: I really like my endo. He isn't a warm & fuzzy person, but he is responsive, encouraging and supportive. He has very little personality, which normally bugs me, but I've learned to work with him and together we've managed my diabetes quite well. He is always telling me that I'm a model patient and he wishes all his diabetes patients were as committed to their management as I am, etc.
The problem is his staff. Whenever I phone his office with a question/concern/need I never get a return phone call. In fact, in the past 2 yrs or so, I typically need to make several calls which eventually lead to me asking for the office manager and then finally I get the help I'm looking for. I should say that I RARELY call my doctor. I started using an insulin pump last year and I needed some assistance that first week and it was like pulling teeth to reach someone in the office. I was so frustrated I ended up in tears because I didn't have a full grasp of the pump and no one to guide me during my "time of need". I mentioned my problem with return phone calls to my endo and he was quick to apologize and said he would look into it. However, this week I got more of the same. I was in to visit him on Tuesday for a standard check up during which we discussed Symlin. I came home and researched the drug some more and decided I want to give it a try. First thing this morning I phoned his office and left a message with his nurse that I wanted to try the Symlin and that I needed a return call to discuss it (they have an automated message that says they will return your call the same day. I left my message at 8:30 a.m.). I never received a return call, but did receive a call from my pharmacy saying my prescription for Symlin was available for pick up. I am so upset. First, I cannot believe I would be given a prescription like Symlin with no instruction on how to use it. Second, I asked for a return call.
I'm at a loss, I don't know what else to do. The idea of switching endo's disturbs me, but I really cannot continue on this path. Do I try one last time to complain to office management and my endo.? Should I put it in writing? Help!
Definitely put it in writing. Do you know if your endo is part of a group/corporation/hospital or is he on his own. You can make a complaint to the HR department if he is part of a group, but also, stopping into the office isn’t a bad idea. Ask to speak to the office manager and explain your issues again. There is no excuse for a staff member not to return your call. If the problem persists, looking into making a complaint with your local medical board. This is usually reserved for issues with doctors but I think all medical personnel should be covered. A letter addressed to your endo may also be in order just to cover your bases.
I’ve worked in medical offices for years, and in my experience, the squeaky wheel gets the grease, so keep at them, eventually they will do what you ask, if for no other reason than to “quiet you”. I’m sorry you are dealing with this. For some reason, some medical personnel just think they are above it. Put up a fuss, you deserve it!!!
I would definitely put it into writing - to both the endo and the office manager. It is sad that a decentg endo doesn’t have the decent support staff to go along with it. I would also think that if he started you on Symilin, that the CDE at the least would have called you to discuss dosing etc, if not the endo. If you don’t get the response you would like, then you may have to find another endo with better supporting staff.
Different doctors have different strategies towards their patients. Some doctors are very proactive in education, training and that sort of thing, actually employing CDEs on their staff to provide the sort of support you need. But other doctors, just want to do the doctor stuff, write the prescription and move you out the door.
Let me make a suggestion. If you like this doctor except for these issues, why don’t you get a referral to a local diabetes center with broad staff of CDEs, RNs and such to be there every day when you need them? I stay in close touch with my local center. I know that if I ever had a question, I could just call them up. They have insulin pumping classes and the offer individual instruction. And it is covered by my insurance. Just a thought.
ps. And my endo’s staff has never been particularly helpful to me, and he has a CDE on staff.
I work in the medical transcription field and a lot of our clients - doctors offices - do not have very good staff in their offices. The doctors employ part-time labor so they don;t have to offer their staff benefits, and they tend to employ staff that have no “real” qualifications because it is cheaper. Sometimes I wonder how the girls in the doctors offices manage to keep their jobs. I get very frustrated with the staff in doctors offices who are totally computer ILLiterate…are rude on the phone and give ill-advise. They keep you on “hold” for hours, and never really assist you - because you know more than they do.
Yes it is very frustrating…
Sheila
My Dr is great too but his office staff leaves alot to be desired. Often I am not even greeted at the front counter and I am looked at as a burden. I will challenge the staff and say “Are you mad me?” or “Why are you so grumpy today?”
This seems to kinda snap them out of their altered state. The staff I deal with has very poor work flow management. I see some surfing the internet, talking about American Idol, and just a general lack of interest in being there. Having worked in an office environment for a number of years I would bet only one or two of them do the bulk of the work and the rest you could do without.
As to your issue with your medication there is no excuse for that. I would put it in writing and complain to the Dr . If he/she has an office administrator they are likely not doing their job overseeing the nurses and staff. The fish rots from the head down as the saying goes. Your complaint would set in motion hopefully a change in behavior with that person to start monitoring the staff closer.
BSC gives great advice too for using your local CDE Team as a resource. I wont talk to his nurses because their attitudes are so bad however the CDE staff at the local center is wonderful
Strange isnt it, so many of these clinics have these shining mission statements but nobody bothers to read or follow them.
This a good post as I am sure it has happened to others too.
Many, many thanks to all of you for your input. I’ve been frustrated by I also don’t want to make waves (because I like the people and know they are busy) but most of all… I hate getting worked up about stuff like this. So here’s the latest:
I phoned my doctor’s office and asked for the office manager, but she was out so I was given the nurse supervisor. I explained to her my ongoing issues with getting return calls and explained how I was given a prescription for Symlin with no doctor’s instructions for how to administer it, etc. She was very apologetic and said that my endo’s nurse was out of the office also but that it’s no excuse and she discovered a few errors that were made in handling my call. My endo have dictated all the info for me but no one every phoned me to give me his instructions. I explained that I’ve been with my Dr. really like him and his staff but that I really can’t tolerate the problems I have with getting help when needed. I further explained that there are emergency situations that require an immediate response from endos (once I was out-of-town and lost my insulin and needed a prescription phoned in - again, couldn’t get a return phone call). She completely agreed and said that while it’s no excuse, my endos nurse is completely overwhelmed and they really need to consider adding additional staff to free her up some because they “need to be able to treat their patients and handle their needs”. YES!
So, in the meantime, I was given the name and direct phone # to my endos scheduler and I spoke with her and she said that I can call her anytime and she’ll “take care of me”. She arranged for me to go to the office the day we spoke and got me samples of the Symlin and supplies, prescriptions and directions for using it. AND she grabbed my endo as he was in between seeing patients and had him speak with me about starting the Symlin.
So, do you think I should follow up with a letter to the office manager about my experience, my gratitude to those who worked things out for me that day but expressing a hope that communication will improve so that I can remain a patient with their office?
Well, it is clear from your post that you like your doctor and don’t want to change. On the other hand despite all the assurances you were given and the “hope” that you might have for a letter to bring a sea of change, it is unlikely. Send the letter, they really should correct their behavior. But, consider augmenting your team with a local diabetes center with additional staff. Why not have a deep “bench?”
Do you keep a log of when you call, who you called for and times/dates? I write things down, it’s a left over from my legal days. It sounds like the office has a chronic issue, and you need to be direct with your doctor. The office and nursing staff is a huge part of the doctor’s office experience, and if they are unable or unwilling to be cooperative, find a new doc. But be up-front with your doctor.
I had a similar issue years ago with my first endo. He was alright and most of his staff was good too. But he had a nurse practitioner I couldn’t stand. She started lecturing me about diabetic pregnancies one day, when I had my then 6 week old with me. I finally stopped her and asked if she experienced a diabetic pregnancy. No, was her answer. I have, so please leave my room. I told my doc I never wanted her in my room again, nor involved in my care. He said he couldn’t promise this, as she was helping him. I told him I’d find another doctor if he couldn’t abide by my wishes. So I left. I wrote him a letter and told him why I was leaving. I never heard back from him.
They work for you. If you don’t get cooperation, be open with the doc as to why you are leaving, here’s my list of phone calls, etc. which were never returned, and then leave. There is no reason to endure this kind of treatment from your doctor’s office. They should be helping you. You are one of the reasons they are employed!
A follow up is always a good idea, to make sure you express what you expect from them. What would they be saying to you if you were non compliant with their wishes? That’s what they are, non compliant!
Before reading you whole post. My first suggestion was going to be to talk to the office manager. It’s usually the only/main way I get what I need from a practice. Maybe you should do this each time. They’re generally very busy. If she has to keep tracking things down and returning your calls. It may prompt her to make some personnel changes or at least shape them up. I have also, during a visit, made mention of it to my Dr.
Sometimes things change for a while only. But it’s the squeaky wheel that get’s oiled. Be a squeaky wheel. To have a good Dr. I’ll put up with staff stuff. But I don’t suffer in silence.
Having read through these posts, I think you’ve handled this well and should follow up with a letter confirming the promises made to you and thanking specific people for their help.
But I also agree that you should ‘deepen’ your team. Doctor’s office are always stretched thin and when we’re being ignored it’s easy to think that’s all there is to it - we’re being ignored - rather than that the doctor is helping someone else.
If you can find a CDE or diabetes education center, I think it would be a great asset to you and reduce a lot of frustration. They could be the first place you call for some questions.
Another strategy that might reduce frustration is to try to write down your questions before hand to reduce the number of follow up calls. I know it’s not possible to write down everything and that some questions won’t arise until your visit, but it might cut back on the follow up calls.
I am very close to the CDE’s and doctor at our diabetes center. That is where I was initially diagnosed during my first pregnancy 12 years ago. They cared for me through both pregnancies and I made long-lasting friendships there. Sadly, the doctor there was no longer taking patients except for the newly diagnosed and pregnant type 1’s. She is a remarkable woman and taught me so much and really made me understand tight control and good management (and she gave me her home tel.#). They always tell me to call on them if i need them but I know how busy and overwhelmed they can be so I don’t. But I think that I am going to expand my team (as some of you have suggested) and bring them into my rotation. Do some of you see CDE’s and nutritionists regularly (like every 6 mos or annually)? I currently do not. Just my endo every 4 months.
There are not a huge number of endos in my area - let’s face it, there isn’t a lot of money to be made for doctors in diabetes mgmt. So I really am committed to making things work where I am. I’m not a door mat but I believe in being reasonable and expect help and assistance and efficiency in my care. I will squeak but in a respectful and reasonable way. Now, put me on the phone with Medtronic’s billing dept and I will lose my patience and get ugly quicker than you can say “go”.
Thanks again, folks. I love the good advice that rolls in on these forums.
