Dr's and Diabetes

By jsd2005 Latest Reply 2009-03-17 23:53:29 -0500
Started 2009-03-11 04:00:50 -0500

Why is it that most primary care physicians seem to take diabetes so lightly? There are so many discussions on this site about this very thing. These Dr's have so much knowledge, but dealing with things to and so superficially that what they do just doesn't seem to make sense.

Which leads me to suggest that in cases like this your only option is to see a specialist. Maybe it's a conspiracy (I am not a negative person!) designed to get us to do just that, see a specialist. It wouldn't be so bad, if they would just tell us to do this in the first place. The problem is that most are so full of themselves that they don't want to admit that they have been dealing with sore throats, virus's and other more minor issues that they can't or won't admit the truth to us. that they are just not up-to-date on some issues anymore. Like diabetes.

First of all, they want us to keep coming back. It comes down to money again…There are many out there who cannot qualify for insurance,
many also have limited insurance and there is an incredible amount of public aid patients now-a-days that most offices compensate by over scheduling appointment, so they can bring in as much as they can for the day. This also explains the inability of these Dr's to spend much time with one individual. Since, the office nurse is extremely busy with phone calls, maybe they need to hire another office nurse just to actually see patients prior to and following the Dr's exam to complete what the Dr. couldn't.

I mention money being a factor and I do believe it is (this is my pessimism presenting itself here!) Look back at office visit prices. Less than five years ago the office visit price in my area went from 28.00 to 32.00. It has steadily and rapidly increased ever since. It is now 82.00 for an office visit at a primary care physician's office. I can see my specialist for 62.00. Doesn't make sense does it? You can draw your own conclusions here.

Anyway, I would suggest that anyone with major health issues find a specialist or more than one specialist who can meet your needs.
We all need to feel comfortable and trusting and respectful of the physicians we are dealing with.
Don't ever be afraid to ask questions. Make a list
and prepare for your visit prior to the visit. Read or use the internet to get as much information you can about your ailment. This will tell the Dr. you are serious about your health and he may spend more time with you. Demand his time and attention while he is with you. Otherwise, he will hurry and rush off, leaving you confused and frustrated. When you call for the appointment ask or let registration know you are hoping for a little additional time as you have questions for the Dr. They will make a note of this and maybe a lot fifteen more minutes or so.

I wish everyone luck and at least we know we have this forum to ask questions and get answers.

6 replies

2009-03-17 23:53:29 -0500 Report

Ya know, sometimes specialists don't even know what their talking about! So if you trust your doctor, a specialist is only a money pit for you to throw your hard earned money into!

MeiMei 2009-03-13 14:52:20 -0500 Report

I understand where you are coming from. I have insurance so money is not an issue. When I lived in California I was a patient at Scripps Institute and found the health care 1st rate. But since I moved to Missouri ( I pronounce it Misery-because that is what it is), I have had trouble with doctors (or physician assistants) not knowing what they are talking about. And I am a nurse-practitioner. I had one PA who did not know what a carb unit was and proceeded to tell me that what I was doing was too complicated and that he could simplify it. Needless to say I did not go back, even to see the internist he was associated with. I do believe that most Family Practice docs are having problems with malpractice issues, but the best way to avoid this is to communicate with the patient. If you don't know what to do then refer—that was always what I did.

Sarguillo 2009-03-13 14:08:05 -0500 Report

I like the way my doc handles this. I am lucky to have Kaiser as my insurance. I go for my visit, Then me and my doc exchange emails back and forth. I havent been in to see him in over 3 months now. He schedules lab work, was adjusting my meds, all the doc stuff through email. And all my emails become part of my medical history. He has since then turned me over to a diabetic nurse who is now running my treatment. He still reviews my records and still sends me emails in regards to my test results but I dont see much of him anymore. I knwo he is there is I need to see him or need advice and or a consult. I consider him my safty net.

LadyDi - 26259Miller
LadyDi - 26259Miller 2009-03-11 08:25:58 -0500 Report

What you say is so very true in many cases - probably too many. I've been fortunate over the years to have good internists/primary doctors that did care and were knowledgeable about diabetes - were able to help me control it. Last year my internist felt I needed to see an endocrinologist, so directed me to do that (no referral needed). That endo is wonderful and is helping me a lot. I also have been fortunate enough to have doctors who were willing to talk and answer questions and not cause me to feel hurried, for which I am very thankful. I do think that (most) doctors are more willing to discuss your diabetes when you appear to be serious about about controlling it and it is evident that you are attempting to read and learn. Being prepared by having your questions ready, too, makes them more likely to listen to you.

I think it's important to remember that the doctors are there to serve you - you are their "customer". Occasionally you just have to step up and insist on the time and answers you need and deserve. If you still feel you're being short-changed and you're not able to trust that doctor, move on until you find one that does meet your needs.

rbergman 2009-03-11 08:15:45 -0500 Report

While you bring up very valid points, not all PCP are this way thank goodness. I am lucky to have one that takes as much time as I need for the appointment, whether for myself or one of my children, she has 2 nurses on staff and a receptionist that is awesome as well. Though she does treat MY diabetes, she sends me to other doctors for other issues, such as the dermatologist I have to go see next week for my leg condition. As for my daughter's diabetes she does NOT treat hers, she referred us to a Ped Endo because Laura's issues are not just diabetes but also thyroid and addison's (kidney related).
Just last week after my appointment with our PCP, me, my husband, and our neighbors were discussing this very same issue of cost, care, etc. The neighbor had just gone to the dentist that day and its the same in that field of care. I was explaining I was called by this dermatologist's office and because I am self pay they explained I would need to pay somewhere between $122-$195 for the initial visit ( They sure better do something besides shake my hand, look at my legs and send me home for that kind of money.)
Unfortunately I have found that insurance or not a specialist will NOT take you on as a patient without a referral from your PCP and I believe this is more than likely a money thing as well, especially if you have no insurance. I seriously don't remember ever getting a call from any doctor before in my life that leaves you a message on the answering machine that tells you "in order to see you it will cost you between $122-$195 for the initial visit please have payment with you in this amount when coming to the office." To me that is sort of rude…sure we'll treat you but ONLY if you have XXX amount of money with you…and people wonder why people like me with no insurance find it hard to treat our medical issues. Sure, it is nice to know ahead of time what it is going to cost so I can plan ahead and budget, but the tone of voice on the other end of the line has a lot to do with how it makes me feel about getting such a call too. There is nice and then there is that " oh God another one without insurance expects us to help them" voice.
My husband's idea on this, getting back to the conversation with neighbors last week, is that maybe PCP's rush you through to a specialist because they don't want to be held liable if things go wrong when treating a disease or condition that there are specialist's available to take care of.
Anyway, will stop my book here, I agree the health care system is as broken as our government and our economics but I don't see a clear answer to this issue anymore than there is for those issues. But again, I am lucky to have a PCP that listens, helps, and understands and I'm not just another number on a list she has to get through for the day.

lipsie 2009-03-11 07:14:08 -0500 Report

Oh I do agree with you fully here. I must admit I am intimitated myself. My doctor's office, we get TEN minutes scheduled with our doctor! I feel like I have to hurry thru and that I am just a bother more than anything so I do not get everything I need to said or asked. I am left in the dark on so much and that is like you said where we can come here for instance and get some of those answers we are looking for. Now, I can't much about the finances…well, I use to work regular and yes, I remember the increases, etc. but now I am disablied so I am covered. I have oftern wondered of a specialist for my Diabeties but with this coverage you HAVE to get a refereal from your primary doctor, which is like pulling teeth. I not too long ago started at the doctors I am at, I came in from out of town…currently on Metformin, I was out of EVERY medication I had, he did not put me back on it so I just let it go thinking it was odd. Later to find out he just make the oversite of it, cause I was having problems and that was because he did not spend that extra minute with me. So yeah, I do understand where you are coming from. Phew! Anyhow, thanks for letting me vent, lol. Take care! Sheila