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Fire the Doc
December 8, 2009
“Do you still write for the paper?” the bookstore clerk asked as I was checking out.
I looked up from digging through my purse to grab money to pay for a New Moon whatzit before my granddaughter (the vampire wannabe) could see me.
“We met at a diabetes support group several years ago,” she interjected. Ahhh…another member of the club nobody wants to belong to. Not to mention instant rapport between two relative strangers.
“How are you doing?” I asked. And, pulling out my continuous glucose monitor (CGM), added, “Do you have one of these yet?”
To make a long story short, her doctor — an endocrinologist yet — told her it would be impossible to get her insurance company to cover a CGM. Furthermore, she didn’t even have a pump “because my doctor says I don’t take enough insulin.” Which would be 12 units of long-acting per day plus 1 unit of rapid-acting for each 15 grams of carbohydrate.
“There are babies on pumps,” I said. “How much insulin do you think a baby takes?”
Then, as I thought about it, my back arched, my fur stood on end, and I hissed, “Plus, it’s not like it’s his money or time fighting with the insurance company.” That’s assuming the doc is even correct about her insurance company not covering what I consider to be essential equipment. I mean, the insulin pump is gold standard treatment and I hear experts are saying the CGM should be within two years or so.
Back in 1998, my doctor believed my insurance company wouldn’t approve a pump for me. On the contrary, it gave approval so fast it made heads spin in that office. And that was before insulin pumps were relatively common for people with Type 2 diabetes.
But I digress.
Shouldn’t doctors advocate for their patients instead of throwing roadblocks in their way? Don’t we have enough problems fighting everybody else, from pharmacists who think they know best to Aunt Bertha, who also thinks she knows best?
I suspect the reason is that most doctors don’t have diabetes and have no idea what it’s like to try to rein in the diabeastie darned near every moment of every day. It isn’t easy being your own pancreas, you know.
My proposal is that every health-care person who deals with diabetes, but doesn’t have it, be given a really rotten case of it. Then they’ll have to stop in the middle of whatever they’re doing to eat something when they’re not hungry and wait for their glucose to climb out of the hole. They’ll have to realize the frustration of doing everything “right,” but having their diabetes act as if they’ve done everything wrong.
I know. I’m rotten. But I’ve had a primary care doctor scream at me that insulin pumps are dangerous and that my endocrinologist should never have let me have one. (I fired him; kept the endo.) I’ve had a doctor yell at me for eating a cookie, when he didn’t have a clue that I was doing so on the advice of my dietitian to meet an insulin peak so I wouldn’t go low. He didn’t understand why I was seeing an endocrinologist. I was his diabetic, he said. Psst! I’m nobody’s “diabetic.” (Again, fired him; kept the endo.)
For the woman in the bookstore, however, I suggested she fire her endocrinologist — and get another one. One who has a clue.
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