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December 22, 2009
There’s an old joke that goes:
Q. What do you call the person who graduates last in his medical school class?
Or is it a joke? How can you know if a health-care professional is competent? I’ve managed to put together a darned good team, but it wasn’t easy — and it took awhile.
Sometimes it seems to me that you need to have a degree in medicine just to determine if your doctor knows what he’s doing. Take my Achilles tendon, for example (please!): Despite perfectly describing the symptoms of a torn tendon (“I heard a pop, then felt something roll up the inside of my calf”), the health-care professional in the emergency department diagnosed me as having a strained muscle.
What if I’d just taken her word for it and not called my podiatrist to describe the symptoms to him? He’s the one who arranged for an MRI and found a surgeon for me. (Let me interject here that I am healing well, but still not walking worth a darn. And I hurt. But it’s getting better.)
And how did I find that podiatrist? I asked my now-retired CDE. That was after I’d complained of foot pain a couple of times to my former podiatrist. “Aw,” he’d say, waving me off, “you’re a diabetic.”
Turns out I had broken bones in my foot from a tumble down some stairs. Diabetes had nothing to do with it. A stair riser that was a tad higher than the others did. And maybe a little bit of clumsy.
Oddly enough, it wasn’t the assumption that my foot hurt because I have diabetes that caused me to fire the podiatrist: It was his assertion that he didn’t need to do a baseline assessment of my feet, but would wait until there was a problem, then take care of it. I don’t “do” waiting until there’s a problem. I much prefer doing what I can to prevent having a problem in the first place.
The same CDE found my long-time endocrinologist for me, too. But I had to be dragged to him, kicking and screaming. I already had a wonderful endocrinologist, who was very personable, but he left the practice for a teaching job in another state. She stuck me with the crabby one. I don’t think he much liked me, either.
But a funny thing happened: We came to respect each other and I learned how much he really cares about his patients. I don’t remember how long I’ve been seeing him, but do recall taking my granddaughter to a visit with me when she was four years old. She’s now 16.
I fired my former primary-care physician (PCP) after he told me my blood pressure was “fine” and I knew it should be lower because I have diabetes. He didn’t like being corrected. The last straw was when he told me insulin pumps were dangerous and that my endocrinologist was “stupid” for letting me have one when all I needed was metformin.
What made me choose my current PCP? One thing was recommendations from friends. The determining factor was when he expressed an interest in learning about insulin pumps. If they’re willing to admit they need to learn something instead of pretending to be omniscient, I can live with it. He’s pretty good, and even knows about diabetes. I went to a talk he gave once.
My ophthalmologist has diabetes, so he knows first-hand the importance of checking for impending eye problems. In the spirit of full disclosure, I knew him socially before I began seeing him. Same thing with the rehab doc. Despite the personal connection, however, I would have no problems firing either or both of them if necessary. It’s a good thing they’re both great doctors.
The cardiologist and pulmonologist were recommended by friends who work in the medical field and who go to them. And my dentist, who was recommended by a friend, is picky, picky, picky when it comes to both dental care and looks.
My team did not appear overnight. It took some time — like, years — to put it together. However, the time it took was well worth it for the confidence I feel when I need one of them, even though I have no idea what any of their class standings were.
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