My mom and I were chatting last night at dinner about what the perfect Endocrinologist office would have and how they would treat their patients. After the stress I've had recently with doctors, it was nice to imagine how it would have gone smoothly.
What would your perfect appointment consist of? Would all your doctors work together in one building? Would they ask you what you want to improve instead of telling you what you need to fix?
I'd love to hear your ideas!
I switched endocrinologists late last year because I moved across the city, and so far the three appointments I have had with him ARE my perfect appointment. He is pretty much on time (sometimes five minutes late, but my old endocrinologist used to be 20-30 minutes late every time), I go in and appointments are 45-60 minutes! My previous endocrinologist had 10-minute appointments! The doctor goes over my pump records in detail and we talk, and then he checked my blood pressure and weight and goes over blood test results, and then he asks me if there are any issues besides diabetes that I have questions about. So far it is great! The ONE gripe I have about him is he asks me at every appointment why I'm not willing to take cholesterol medication, and I wish he would just accept "no" as an answer (or at least "check in" less frequently, like maybe asking once a year if I'd changed my mind).
I am looking for a new GP (I can't find one so for now am officially still seeing my old one) and can only hope that I find one as good as my endocrinologist! My current GP has 10-minute appointments which is not great if you have more than one "issue" to bring up. I do wish all of my doctors communicated more. I'm currently seeing my GP, endocrinologist, ophthalmologist, allergist, and cardiologist, and actually each of these doctors aside from the endocrinologist is primarily for issues NOT related to diabetes, and I don't think any of them really communicate, although they do exchange records (at least some of them do). My current GP does seem good at keeping tabs on what all the other doctors are doing, though, so I hope when I find a new one he's just as good at that.
My GP is great and really is your friend. But his skills are not directed towards diabetes and the Doctor's average visit in Canada is 10 minutes every 3 months. So it is very frustrating. I found that to get real help I had to go private and pay by the hour.
An announcement that my A1c just came back at 4.6% and that I no longer have diabetes.
But seriously, a perfect appointment would be one where my endo listened to me and worked quickly and competently to deal with the health issues that I bring to my appointment. Doctors are all to happy to run a test, find something wrong and "fix" it, but when you come in the door with a complaint, you don't always get their attention.
- I want a proper diabetes diagnosis
- I want to know why I cannot properly control my fasting blood sugars
- I want to know why I have chronic fatigue
Since the answer to all these seem "hard," for a number of years all I've had is doctors play around with the problem and then just "give up." It is like their feeling is that unless it is going to kill me, it will either go away or get worse and then they can figure it out.
Unless the endocrinologist has actual experience fixing real BG control problems and is willing to get down into the "weeds" and look at and truly analyze all the data (insulin, cgm statistics and trends, fingerstick data), then I wish s/he would simply recognize and respect that I am the BG-control expert in the room!
My perfect Endo is the one I have. I still go to my Pediatric office although I'm 21, because
1. they haven't kicked me out yet, :) and
2. Everything is taken care of in one appointment.
My endo doesn't force me to get the pump or anything like that since I'm still on MDI. He understood completely when I explained how I had a rough semester at school and that's why my A1C wasn't as good as normal, and he believes/trusts me that I know how to take care of myself. Although my A1C has always been in the 7's, he is fine with that number, and I'm fine with it. He and I both know that I'm doing the best I can, and he's just happy that I don't have a higher A1C, like many of his other patients I've come to realize. He makes suggestions for improvement, but not requirements. My visits are normally pretty short, because I don't have anything major to talk about.
In one visit to my Endo though, normally once every 4ish months (give or take a few), I also visit a couple of nurses, a nutritionalist,and sometimes a social worker (not so much now that I'm older, but they just like to chat with me about random stuff). My office people all really enjoy it when I come in, because I talk with them, about not just Diabetes, but about my travels and I normally don't have any major issues that need to be addressed.
Thanks Brian! I strongly agree with you. I find that doctors are great at fixing large problems but struggle with helping you improve your quality of life. I hope you are able to figure things out soon. I've had to do a lot of research on my own to figure it out. Something that I found works well for me is eating a Paleo diet. If you're interested I can share some great links with you.
Wow that's really interesting that you can get free appointments but you pay for higher quality ones. Is your private doctor a diabetic? I have noticed that sometimes they understand you more when they are.
Your endo asks you if you have any other issues besides diabetes???? That is awesome! I feel as though my doctor doesn't care about anything other than my blood sugars. I'm so glad you found a great doc! Good luck finding a GP. Thanks for your response.
Haha Terry, AMEN! This was an awesome answer, I most definitely agree.
Yeah, the first time I figured he was only doing it because I didn't have a GP, but he's asked at all three of my appointments. He's also willing to fill prescriptions for things not related to diabetes if I am already taking them and need a refill for some reason.
Wow Marsha, I want your Doctor! That really does sound perfect to me too. I had to leave my pediatric endo when I got of age and since then I've been struggling to find one that I click with. 7's are great congratulations!
I've never seen a social worker for my diabetes, what do they do? Address emotional health? I'd love to know because I'm interested in working in the medical field when I graduate. Thanks so much for your response!
That has to be so helpful and time saving! There should be more endo's out there like that.
Yeah, at my Dr. Office, they like to have a social worker meeting once a year. My last one was in December, and the Social Worker was like, I've never met you before...just tell me about yourself. It had apparently been 4 years since my last social work meeting.
The social worker just wanted to make sure that emotionally I was okay with my Diabetes, handling everything, if there were any problems at home, or school, or even with any other family members. They are more prevalent I felt when I was younger, but not around in High School much for meetings, but I feel that is when they should be most prevalent.
That's really neat! My current office offers nothing like that. I am so surprised to hear that a social worker does that. I wish that was offered or even required at my office. I think high school is such an important time emotionally and it would definitely be helpful to talk to someone about it. I also think that the first year of college it would have been helpful too.
Yeah. I did enjoy meeting her this past December, just because she just said, tell me about yourself. So I did, and I could explain more of the issues I've had conquering my Junior Year of college (My hardest Yet!) She totally understood that it was a hard year, and I think she also just enjoyed hearing about my experiences and outlook on life. It was a quick visit, so I didn't mind it being added to my busy schedule. :)
My appointments wayyy back when were always about 3-4 Hours meeting with everyone. Now that I'm in college, and the Endo is only in the office on Tuesdays (of course my busiest day)..I could get in and out of my various appointments (with normally 4 different people) within an hour and a half!
A Doctor that is a T1 Diabetic would be a dream come true. Most Doctors have no idea of the emotional side of living with diabetes. Our body chemistry is much more than our BG. Our health depends so much on diet and nutrients. Treating symptoms with drugs is not what I call a health system. It's a medication industry.
That's an incredible A1c. Well done. I've read your comments over several years and see that you are dedicated to controlling your diabetes. A true role model for other T2's.
That was an awesome answer! That actually describes my own doc...her first question to me when I arrive is "what can we do for you?" She already has all of the information from labs because I get them done before the visit. I feel very fortunate with my doc in that she sees after my whole me not just the D me.