Old Medical Records

My least favorite former endo would listen to me for a few fleeting seconds, then tell me I was diabetic because I was fat and seemingly randomly change my medications while ignoring my carefully written out questions. Then he would spend the remaining time dictating his notes, back to me, while I spoke over his shoulder correcting him. He explicitly ignored all my comments. OMFG!! At least I knew what was happening.

And you are right, dietary choices make a big difference, and it isn't always a "non compliant" patient but it takes a good professional to carefully see through what is happening.

She didn't know to test you further. Her understanding of T2 DM was limited to what her professors in school had taught her. I can say this because I have sat through hours and hours of MD continuing education sessions with my husband MD. Physicians seldom have gotten adequate training in diabetes Type 2.
Let's all remember that patients were pulling information together in 1990-2005 regarding carbs and setting ratios because they had hands on experience with meters. Patients were getting far ahead of physicians' continuing education. Endos were even having difficulty seeing what patients could do because not all their patients could do it. And they believed nutritionists when they said you had to have 40-60% carbs in the diet. I remember dealing with the pumps of the 80s. They weren't the pumps of today.
The research of the 80s was all about compliance but not about the underlying processes. She was just doing what she had seen her teachers do. She didn't know to test, and she didn't know to ask questions of real centers that were getting good results as meters came along and patients started taking matters into their own hands. Believe it or not, patients led the way then and they're leading the way now.

Even if this statement is only used as a diagnosis code, it's easy to take is personally. It can make you feel like they don't think you are doing enough or well enough.

The GOOD news, she might have stopped practicing medicine >8 D !?!?!

They earn OUR trust...

I kind of hope so. ;)

Exactly. This trust goes out the window when I'm treated like that. & then to find out she mis-diagnosed me. That's the icing on the cake.

Patients, especially the motivated ones, do lead the way in day to day diabetes management. It is the rare doctor that has the inclination or time to ask his successful patient how s/he does it. I’m sure that every endocrinologist has at least one patient in their practice that excels in BG control. While they make the effort to go to expensive and time-consuming continuing education, have they ever thought about doing an extensive, in-depth interview, of their successful patients?

I have over 200,000 hours of living with and studying T1D but have only detected mild interest, at best, from medical practitioners in what I actually do to get the results I get.

The current buzzword in medical circles is “patient-centered.” I wonder what clinicians think this means?

Too true.

Terry, this is a great point. It would really benefit everyone if this was common practice.

I am late to the "game" here, but I think that the OPs (jriccardi's) experience of having her doctor blame her when it was the doctor who misdiagnosed jriccardi and gave her the wrong treatment is sadly very typical for people with adult-onset Type 1 diabetes. Lots of people will say that it is not important what the diagnosis is, what is important is the treatment. But sadly most doctors will just blame the patient instead of seeking and providing appropriate treatment (and how about the irony of being labeled as "non-compliant T2 DM" when you don't even have Type 2 diabetes).

Good points, Terry. Oddly enough, I have had the experience where my GP asks me LOTS of questions about wearing a pump, using a CGM, world travel with diabetes, etc. She is trying to get at how I have achieved the consistent A1cs and control. We have had quite in-depth conversations. My endo also gets advice from me to provide to her other traveling patients, since I have successfully traveled all over the world with diabetes including some very remote locations (Bhutan, for example). I think I am probably just very lucky to have the doctors I have.

I think I must have been lucky with my doctors at dx. When I woke up in the hospital, they knew I had diabetes (the coma and DKA were kind of clues there) and despite the fact I was 31, the first thing the endo told me was that they were going to check which type I was. They did a c-peptide, and that coupled with the DKA was enough than my first endo correctly diagnosed me as T1.
When he closed his practice and I went to my new endo, the first thing she did was do a GAD antibody test--just to make sure. She told me that if I was not T1, they were going to get aggressive about getting me off insulin (which is a whole 'nother kettle of worms). It was suffeciently conclusive that she told me I'd never have a doctor question my type again.
I'm not sure I believe her, but at least I have the "proof" from the start.

I recently had a related experience. My doctor's office implimented the new ERecords, and my husband signed both of us up. The lab tech showed me how to find my test results online, and a week after my last set of tests, I went to the website. The test results weren't there, but my doctor's damning opinion of me was"NONCOMPIANT PATIENT," because I decided not to accept her recommendation that I start on statins.

All of a sudden, I realized I could no longer trust this woman.

I work in a dentist's office, and he has a very different attitude about what gets written in patient records. Basically: stick to the facts. Say: "Refused statins," never mind the judgemental comments. Remember that anything in a medical record can be seen by the patient or a court. If physicians think they are protecting themselves from malpractice with this sort of comment, now that they are being rquired to use electronic recordkeeping, they will begin to see that these comments have far-reaching effects.

I have decided that I will continue to use her for her DEA number, I no longer feel I can trust her.