Diabetes Self-Management Blog

People with diabetes are often encouraged — with good reason — to take control of their condition. This often requires a degree of independence not needed to manage other diseases, and it is likely to involve seeking information from a variety of sources — not just from one’s doctor. With the increasing availability of health information, this self-guided approach is becoming common far beyond the realm of diabetes.

Yet as a recent essay at Time.com suggests, rising patient independence may also lead to rising costs without improving health outcomes. Using the example of a torn Achilles tendon, the author — a doctor — outlines how patient demands can lead to unnecessary, expensive tests and treatments being performed (in this case, an MRI). Trying to change the mind of a patient set on a course of action, he writes, is time consuming and usually futile, since patients can — and often do — find a new doctor when they don’t get what they want.

The article highlights a broader dilemma: How do you know when to trust your doctor? As we wrote a few weeks ago, some doctors might be biased by promotions and gifts from pharmaceutical companies. Still others could be under pressure from an insurance company to cut costs. And while there may be a risk in accepting the perspective of a single doctor, seeing many doctors leads to a more expensive health-care system.

What do you think — when do you trust the advice of your doctor? Should insurance plans try to limit how many doctors a patient can see for one condition? Should companies be banned from advertising drugs, tests, or procedures to consumers? To doctors? Ultimately, whom do you trust the most for medical opinions and information? Leave a comment below!

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Comments
  1. “Trust but verify”

    Posted by Ben |
  2. News flash: Doctors are human beings. They are subject to the same weaknesses as all of us. Greed, corruption, prejudice, stubbornness, arrogance, laziness, and ignorance all may contribute to a physician acting in a way that is not in the best interest of their patient.

    In the end, quality health care has to come down to building a long-term relationship of trust between caregiver and patient. Doctors who see patients as revenue streams and patients who see doctors as dispensaries are both part of the problem. Patient education -not advertising- is helpful, but focusing on developing a health care system that is care based rather than profit based is the real answer.

    Posted by RWoodward |
  3. Doctors, in this area, know little about diabetes. There are no endocrinologists for many many miles, and after 10 years I still can’t find anyone knowlegable about neuropathy.

    Posted by Tomas R McHale |
  4. I stayed with my physician for years because I like and trusted him. The last couple of years were as a diabetic and the more I learned the less I was willing to accept the answers I received. It came to a point when I was asking for help with a problem about my husbands hypoclycemia, and the I knew the answer I received was wrong.

    I changed Dr’s at that point and discovered the last 80 pounds I had gained could have been avoided since I also had hypothyroidism.

    I always research. If I disagree with my Dr. I tell her so and ask her to explain. Often times we will work out a treatment plan using her suggestion but I know there is an alternative if it doesn’t work for me. She works with me and it is much better.

    Posted by Terri Phillips |
  5. My doctor changed my diabetes medication at my request because of the cost of the drug that he initially prescribed to me (Janumet). He complied with my request with a drug from the same class but doubled the dosage (Metformin) and added a companion drug (Glimeperide). 1 week later I was still having the “common” side effects of nausea and not feeling well. These side effects were getting worse. I had no energy and felt ill. The clincher though was when I woke up from a nap with severe pain in both of my lower legs. This was a side effect that was supposed to be reported to your doctor immediately. I was told 3 times to keep taking the medications, twice by the nurse who also asked me “Do you want to be on insulin?” and once by the doctor. The doctor informed me that I was not having a side effect because that was extremely rare and that it was a new symptom. After I refused again to continue the medication and asked again that he prescribe another type of medication he seemed annoyed and told me to stop taking it, track my blood sugar readings for 2 weeks, and make an appointment to see him. I now have a new doctor!

    Posted by Barbara |
  6. I dislike doctors who tell me to go on a diet since I have been dieting all my life and know my body better than they do. Or they tell me to exercise without knowing that I also already do that too. They don’t consider other health problems that cause me to be overweight. One look and they make wrong judgments about me.

    Posted by Heidi |
  7. Trust should definitely be tempered by your own research as well as intuition. I had back pain/sciatica which had reached intolerable status and sought advice of several local spine surgeons. Both advocated spinal fusions on 3 levels of my spine, which would have left me without the ability to ever bend from the waist again (try drying between your toes without that little ability). At the urging of friends, I searched further, and located a top surgeon in Los Angeles. He advised that the other doctors had erred, and that their recommendations would have left me not only unable to bend, but possibly with as much or more pain as I had!

    End result, I trusted him and his vastly superior credentials, and got surgery that eliminated the pain and left me with the ability to still dry my toes! Had I trusted the first 2 doctors, I would still be suffeering. Had I not trusted the third, I would still be suffering. My conclusion: sometimes you have to trust–but don’t do it without checking as much as you possibly can first (in my case including lots of internet research).

    Posted by Vicki Blakeman |
  8. I have an Endocrinologist that I have been seeing for almost a year. I have been told for the last 20 years that I am a Type 1 diabetic. I have taken 4 shots a day for almost 18 years now. This new Dr. told me that he thinks I may be a Type 2 diabetic and started me on Metformin twice a day while still taking my 4 shots a day. He said that I may be able to cut back on the amount of shots I take, back so far, in the last 5 months, I have not been able to do that! I have an appt. to go back in a couple of weeks…I just feel like no body really knows much of anything but they are willing to give you more drugs to try to make you feel like thay are doing something! It’s so aggrivating…specially since I work hard at living with Diabetes!

    Posted by M. Scott |
  9. I agree with RWoodward. Doctors are human. My experience has been that when they don’t know they fall back on “it’s in your head,” “it’s stress” or “it’s a virus and we can’t do anything about it.” When I get those answers from my GP I look for a specialist and do research on the Internet. I don’t believe people should be penalized by withholding insurance when the one doctor you see most can’t figure out what is wrong. We pay too much to be treated like we’re spoiled children who just want to drive up the cost of health care. If I’m sick, I want to get better so I can get back to my life.

    Posted by M Gabehart |
  10. I truly like my current doctor, and for the most part, I trust her judgement on the treatments she prescibes for me. However, the key word here is “treatments”. Most doctors are trained in “treating” medical problems, NOT “curing” them,! and hence, prescription drugs are their ultimate answer for just about everything. Any discusions about and natural alturnatives are usually blown off as “those will not work” despite not knowing much of anything about them.

    My doctor exclaims that ALL diabetics will eventually have to use insulin when the pills don’t work anymore. Bottom line here is, doctors don’t “cure” ANY desease! They only offer “treatments”. Not necessarily because they can’t, but moreover because they won’t! Afterall, it’s definately in their best interest not to! Go figure….

    Posted by Danny |
  11. I must really be blessed. I have a GP and we work well together. When he finds or hears about something new, he gives me a heads up and I do my research and then we discuss it. Some times we disagree but usually find a way to work out a deal or decide to nix it at this time. And the same goes if I find out about something new. I wear a pump and before I got it (after I had done the research,) my Dr and I decided to go to a specialist first and that specialist did more harm than good. My Dr. and I are a team and I think that is the way it should be. I live in a rural part of my state so making long trips to the only specialist in many miles who treats me as if all I want is another pill or what ever is not worth my time or well being. For the most part I think most of our Dr.s try to do their best on our behalf.

    Posted by I Christensen |
  12. I had an experience with a new endocrinologist a few years ago. I had the flu and could not stop vomiting. My first endocrinologist told me to call him as soon as this happened and he would prescribe a medication to alleviate the symptom so my blood sugar could return to normal as quickly as possible.I called first thing in the morning, but my call was not returned until after 5pm at which time I was already dehydrated and knew I would have to come in and get hooked up with an IV to get hydrated again. I wasn’t pleased, but did as I was instructed. However, when I got to the hospital, my blood sugar was so high that they injected me with an overdose of humalog. Consequently, the next day, I passed out walking the halls because I was so low. This yo yo effect went on for several days and then the doctor ordered a pregnancy test even though I told him I had my tubes tied for the previous ten years. After that test came back negative (no surprise there!) I checked myself out of the hospital and changed doctors. Last spring I was home for a wedding and ended up with a heart attack. I was horrified when the same doctor walked into my room and told me he was in charge of my diabetic care. I followed his plan while I was in the hospital just so I could get out! I called my current endocrinologist for instructions. Thank God for cell phones!

    Posted by Marlene Whitby |
  13. I feel if you trust your doctor, or medical provider, you will have an honest open conversations about what you feel your needs might be or if you want to try something.If you have done research on the subject show your provider or ask them to give you information you need. If your provider isn’t intersted in talking to you about this or looking into a new idea, than its time to look for a new doctor.My doctor/np doesn’t believe that supplements that are ad on tv, radio or magazines are always a good idea. But we have a good communication with each other and she is up to date in knowledge and allows me to check things out and we can talk about it. I have shared a lot of information with her that I have gained from my illnes and with other doctors. She listens to me and Yes! there are times we tottally disagree with each other, but we have enough respect for each other that there isn’t a problem.

    Posted by Dena Chesney |
  14. Unfortunately, physicians have compromised themselves both by taking advice and money from drug companies that have a vested interest in promoting a particular drug and often a particular methodology of treatment and their cooperation with managed care to limit services. I have been the victim of a hospital being forbidden of telling me of a particular treatment because my insurance would not cover it. I had to sue to get the prosthesis prescribed to me by my physician. Bayer called it a Cadillac and not covered. (Krodel v Bayer). The efforts of attempting to curtail treatment through misinformation has unintended consequences of driving up costs and increasing litigation.

    Posted by Louis Krodel, Ed. D. |

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Flashpoints
Weight and Diabetes Risk (09/10/14)
Caving to Cravings (09/03/14)
Control Solution = Better Control? (08/27/14)
Candy-Carrying Crisis (08/20/14)

 

 

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