All this talk about “Health 2.0” and the “power of the healthcare consumer” only makes sense if we patients really do have choices. And lots of us still feel that we don’t. We’re either stuck with whatever our insurance provider dictates, or we don’t have the time/money/resources to really drive our own medical treatment.
While the financial aspect remains a painful hurdle, there’s lots of help on the way with respect to getting patients the information they need to make informed choices. (One of my favorite resources here are those almost comically simple Humana healthcare videos.) And one of the most important choices we patients make is proactively choosing a doctor — or rather, that’s what we should be doing instead of than just sticking with whatever physician happens to be in close proximity or is assigned to you by some health plan. When it comes to managing diabetes, you’re not going to get anything out of time spent with a doctor who doesn’t “click” for you.
I think Fellow D-blogger Scott Strumello is wise in encouraging us to “fire” our doctor if we don’t like him or her — but what happens after that? How do you find someone new who’s any better? Or what can you do to make sure you don’t have to fire your doctor in the first place? Allison Blass, who works with lots of Health 2.0 providers, tipped me off to an extremely useful resource here: a new free eBook from Vitals.com, a web site for searching and rating doctors.
(Click on the image for the download link.)
I looked it over and am impressed with the amount of useful information in these 29 pages. There are definitions of physician types: Do you know the difference between a Hepatologist and a Hemotologist? Or between a “Concierge Doctor” and a Hospitalist? They suggest ways to evaluate a doctor’s credentials: specialty certifications, Senior Doctors vs. “Residents,” etc. And they walk you through prioritizing the things that might matter to you most in a doctor-patient relationship: what’s the average wait time for an appointment? Do you care about his or her age / ethnicity / religion? What type of “bedside manner” do you prefer?
It’s definitely worth 10 minutes to read through this book and give the “Dr. Right” issue some thought. I’m betting that most of us never spent more than 10 or 15 minutes identifying the doctor(s) we now see!
For my part, I was referred to my first endocrinologist by the hospital where I was diagnosed. At the time, I was an emotional basket case, and that doctor turned out to be a big tease. I dreaded going in to see him knowing he was going to try to be funny and “yank my chain” over little things. Definitely not a style that worked for me. I’m on Endo #4 now and very happy. If you haven’t shopped around, this online booklet should prove a nice guide to getting started.
This is a disease of SELF-management. Most endocrinologists have no clue what it’s like to deal with this day in and day out; all of the advice I’ve received from my doctor has been nothing more than common sense. He offers such gems as “don’t drink juice, drink Crystal Light.” What exactly does an endocrinologist do for type 1 diabetics? I am not sure.
Also, I say this as a future physician myself: if a doctor does something that bothers you or pisses you off, tell him/her. I’d want to know. Doctors need to be sensitive to their patients’ situations. And if you choose to end the doctor/patient relationship, tell the doctor why you’re leaving their practice.
I am struggling to find a new endo and it’s not for lack of trying. I just moved from New York to Napa and there are exactly THREE choices in the area. One is semi-retired, one is not far from retiring, the third is almost oustide of the valley. I’ve been told I should travel to Marin or San Francisco – which I don’t mind doing for a great doctor. But it’s been years since I’ve had to look for a new endo and I am frustrated how long it has taken (i’ve been here 4 months now) and don’t know where to go from here.
@Lauren
“This is a disease of SELF-management. Most endocrinologists have no clue what it’s like to deal with this day in and day out; all of the advice I’ve received from my doctor has been nothing more than common sense. He offers such gems as “don’t drink juice, drink Crystal Light.” What exactly does an endocrinologist do for type 1 diabetics? I am not sure.”
I would agree with everything you’ve said. I’ve felt this way about almost all doctors I’ve dealt with over the last 28 years. I do have a pretty good doctor now, but he still doesn’t understand most of the things that we as diabetics go through. With the holidays coming up, and wine and champagne being prevalent, he would say, “Just don’t partake in those activities”, which of course makes sense, but there is no understanding of social pressures…granted, I’m prone to a bit of drinking, but there is no offering of a solution to “ok, but what if I do…”, it is mostly met with scorn, which feels like (but is not said), “well, it is bad for your eyes, liver, kidneys, health”, rather than what I believe should be said “moderation…no more than two, and watch your blood sugars”.
“Also, I say this as a future physician myself: if a doctor does something that bothers you or pisses you off, tell him/her. I’d want to know. Doctors need to be sensitive to their patients’ situations. And if you choose to end the doctor/patient relationship, tell the doctor why you’re leaving their practice.”
I think you will make an excellent physician, but I would encourage you to focus on diabetes and endocrinology! I have always wanted a physician who would understand exactly what it is that we, as diabetics, go through, whether Type I or Type II! You would do us all, including yourself, a great service!
Thank you for your input!!!
Mike C
I have found that shopping around is definitely the thing to do. My company changed insurance plans and the dr. I was seeing for the last 11 years was not in network. Leading to very high deductible and 60/40 coverage. I asked my dr. if he suggest some to try from their list. However docs are not supposed to do that. I choose one, I saw him for a whole year and each visit lasted if I was lucky 10 minutes. He’d review my logs that were down loaded including from my pump. He’d basically in the year made one change to my bolus rates and that was it. My logs, showed huge swings. No tests were done other than A1c, eventhough I requested them. I changed to a doc that someone at church recommended. When I saw her, they did a finger stick for A1c and that was it. She asked me a few questions and asked if I had any for her. I said yes, “Do you treat diabetes individually or look at the whole picture (everything in the body) and she responded that endos treat the disease and your general practitioner treats the whole body. I made a follow up appt for 6 months. Went home and told my husband I didn’t think I could find someone in network that would allow me to meet my goals. To die with all my body parts, my sight and not be on dialysis. I felt my health had already deteriorated since I last saw Dr. Rosen and that if I wanted to have a decent quality of life and stay out of the hospital I needed to return to Dr. Rosen. I have and the quality of care is excellent. He cares about you as a human being and does not like to see anyone looking sick. I have just now gotten the pendulum to stop swinging. But I have had close contact with Dr. Rosen and he always studies all your logs.downloads and makes changes based on them. He works closely with my other providers, and always makes sure that what no matter what is transpiring your diabetes and his office let me work out a payment plan with them.