You’re right @Sam19. Neither we nor doctors operate in a vacuum. I go to an endo every three months partly because Medicare requires me to to qualify for pump supply coverage. But I also know that doctors’ knowledge exceeds mine in a more comprehensive way. What bothers me about them is that they don’t know what they don’t know. Many of them seem to believe that they know how to dose insulin.
Over the years, they only made vague and sketchy suggestions about short term control and they never followed up with me after the fact. Like a phone cal asking, “How did that basal-rate change I suggested work out?” Now I’m enough of a realist to know that the modern endocrinologist does not have the time or the energy to provide this custom care. It was only when I decided to take the initiative and figure it out did I have any real long-term success.
When CDEs started showing up in the '90s, I thought that perhaps they could spend some time with me and follow problems through to at least a temporary solution. That didn’t work out either. I found their skill-set in dosing insulin as too text-book and unable to flex. One big exception was when I consulted with CDE Gary Scheiner. I made solid long-term gains under his care. But I had to listen to some sniping remarks from my endo when I mentioned this success.
In fact, for many people, trying to implement insulin treatment changes is like getting moment to moment advice on how to drive a car or ride a bike. Until you take it on as your responsibility and give it a fling then you never learn enough to independently succeed at the skill. That includes risking to make mistakes, the ultimate teacher.
I’ll never again have the deep unexamined respect that I once felt for doctors. But that’s OK. They know enough to be useful but it’s pretty much on your shoulders to tease the useful from the BS they sometimes offer. They’re just human beings like you and me. That’s good enough.