High Expectations for Doctors?

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As I get older, I’m beginning to wonder if I have too high expectations for doctors.  Almost to the point where I am really frustrated with doctors in general.  I’ll start with my most recent dealings with my endocrinologist.

I actually LOVE my endo.  After searching for a good one in my area, I finally found my current doctor after the third try.  I’ve talked about my struggles with endocrinologists in the past, but I’ll summarize my dealings.  When I was growing up, I had a great pediatric endocrinologist (at least for my memory’s perspective).  I had an AWFUL one when I was in college.  Then when I was in my early 20’s I had a doctor who wasn’t the nicest.  I think she meant well but she was always frustrated that I didn’t have better records (I didn’t test my blood sugar too often back then and this was before the CGM).  So I have never had the greatest of luck with endocrinologists.  When I was in my 20’s, though I did find a nurse practitioner at my endo’s office who was great.  Even though I didn’t have the best records, she would take the time to go through what blood sugars I did have to see if any adjustments were needed.  Sometimes, I would see her for over an hour! I was sad when I moved and had to say goodbye to her.

Now fast-forward to my current endo.   She was/is definitely the best of the three I have found in the area.  The first doctor I found didn’t even know how to read my Medtronic reports so that wasn’t helpful at all.  The second doctor only spent about 2 minutes with me and didn’t really give me any advice.  I had started my first pregnancy with her so I was very frustrated to not be given more guidance.  So when I found my current endocrinologist, who seemed to have experience with pregnancy and T1D I was very excited.  I do like her a lot.  On a personal level, I think we are very compatible.  On a professional level, she has always come across as very knowledgeable.

So where is the disconnect?  Well I have become a little frustrated because she isn’t harder on me or doesn’t want to help me improve.  Granted, my latest A1C was 5.4 so I think she thinks I’m doing amazing but I’m questioning the legitimacy of that result.  She didn’t think it could be off so no reason to investigate.  For pregnancy, the recommendations are pre-meal blood sugars of 60-90 and post-meal blood sugars of 140 (1 hour after eating).  I rarely fit into this mold.  My blood sugars seem to average around the 130’s (again questioning the A1C result) which isn’t bad but I very rarely start a meal below 90.  I generally don’t have high blood sugars above like 170 which I guess is a good thing but I’d really like to see my blood sugars more in the 90mg/dl range.  My endo was so concerned that I was being too strict that she actually change my target blood sugar goal from 90 to 100.  This did not help my average at all.  Granted, I very rarely have low blood sugars so I guess it worked out the way she wanted but I don’t even seem to have blood sugars in the 80’s.  I’m not sure if I am being too hard on myself or if my expectations for my endo are too high but I want a doctor that is going to strive to perfection (at least while I’m pregnant) with me and help get me to where I want my goals to be.  I’ve told my doctor that I work from home and my husband is here with me all day (he works from home too) and I wear a CGM so the threat of lows isn’t too concerning but she still wants to see me higher which is going against what I want.  Sometimes, I just listen to what she says but when I get home I change my results but I would still like to have a doctor who is working with me not against me.

A second doctor that I wonder if my expectations are too high is the eye doctor.  I am now seeing an eye doctor who specializes in retinal disorders ever since my diabetic retinopathy diagnosis last year.  I grew a little frustrated because at my last appointment, he looked at my eyes and said everything looked fine.  I guess I should be glad about this but I wanted more information, especially now that I’m pregnant. What does fine mean?  Do I still have the retinopathy?  Has it gotten worse?  Is my right eye still hemorrhaging? Will it get worse with this pregnancy?  Is there anything I can do to avoid issues in the future?  I had a ton of questions and felt rushed to ask him.  Instead, I just asked if there is anything I should be concerned about with the birth and he said no.  While I’m so relieved that the eye didn’t look worse, I just didn’t leave the appointment comforted with the information.  I don’t notice the blurriness in my right eye anymore but is it because I have gotten used to it and it’s still there or is it because the bleeding has stopped and cleared up and my eye is looking better?  I wish I had had the time to ask this question.

This leads me to my next doctor that I have issues with, my OB.  Again, are my expectations too high?  I LOVED my old OB but I was forced to switch practices and doctors when my new insurance wouldn’t work with my old doctor.  My new OB is nice enough but I just haven’t gotten a good feeling from her.  I haven’t gotten a bad feeling either but our appointments are about 2 minutes long.  I have seen her four times now and each appointment is the same.  We listen to the heartbeat then I quickly rush to ask any questions I have before she leaves, often without saying goodbye.  All in all I have seen her for 2 minutes.  Since I am new to her and she will most likely be the one performing my c-section, I want to get to know her better.  With my old OB, I spent a ton of time with her and I really got the feeling she knew what she was doing and talking about.  I have no concerns going into the birth of my first child.  This time around, I just don’t know the doctor very well at all.  I haven’t gotten time to form an opinion and I wish I could spend more time with her.  I do go armed with questions but I don’t have as many as I did with my first pregnancy so maybe that’s the difference.  But again, I just feel so rushed and before I know it she is gone without my having the opportunity to ask everything. I thought about switching but based on what friends have told me, most doctors in that practice are like her. Again, are my expectations too high that a doctor should spend more time with me?!  I feel like one recurring theme is the fact that all the doctors just rush through the appointment.  Do I expect too much for them to spend 5 minutes with me instead of 2?

I recently went to visit a Primary Care Physician in my area.  I don’t have a PCP so I googled to find one that was open on a Saturday.  I don’t have a PCP because usually my endo and my OB can handle my issues so I haven’t had a need for once since I moved here four years ago.  However, about a month ago I woke up one Friday morning with the WORST sore throat I have ever had.  I suffered through all day with it and it didn’t improve.  I didn’t sleep at all overnight because I was in so much pain so Saturday morning I woke up and I contemplated going to the ER.  Because my last ER visit wasn’t too great, I decided to try and find a doctor that was open on Saturdays.  Luckily, I found one.  I went, the nurse did the strep test on me, it came back negative and the doctor came in, barely looked in my throat and told me “well it’s not strep so go home and if it’s still bad in a few days come back”.  And that was it! Thanks to Dr. Google, I knew it wasn’t strep but it was the worst pain I have ever felt and I’ve had a kidney infection (those are extremely painful!).  I was guessing it was just a sore throat but I guess I wanted the doctor to make sure it wasn’t anything worse and possibly tell me what to do to relieve the pain.  I didn’t get anything out of him.  It honestly felt like a waste of an hour and $20 copay.  Are my expectations too high?  Should I not have expected him to spend more time with me or give me recommendations on how I can survive the next few days?  My sore throat ended up lasting about 3 weeks and it was so painful.  I even asked my OB about it and she just told me it was probably post-nasal drip from the pregnancy.  I’m not sure I agree with that but who knows.  It’s finally gotten better but I do still have some pain from time to time.  I really wanted answers and the only answer I got was that it wasn’t strep.  Thanks doc.

So I’m frustrated with doctors.  I don’t know if I have a right to be or if I just have too high of expectations.  This isn’t the first time I’ve been frustrated.  I’ve talked about it before.  Is this just something I need to get used to as I get older?  Maybe its the pregnancy hormones but I’m frustrated.  Because I work for my husband’s business, I know what health insurance costs and because of how much we are paying, I don’t think it’s too much to ask for good care.  I want good care.  I want doctors that are actually going to spend time with me.  I want doctors who are going to answer my questions and not make me feel rushed.  I want doctors who will actually take time to evaluate me and really help figure out what’s going on.  Is that too much to ask?!

3 thoughts on “High Expectations for Doctors?

  1. Definitely hard to find a good doc who takes the time! About the A1C, I recently read a study that values from the same sample can vary by as much as 0.6!!! Also, according to my endo who is awesome and very smart, the A1C is not as accurate during pregnancy due to “changes in the hemoglobin molecule”. About her wanting you to run higher, I think manu docs are so scared of lawsuits (like if someone, especially a pregnant someone has some sort of accident due to a low) – something like 50% of docs are sued for something by age 40 :O In the end, when it comes to diabetes, I think you know best what is right for you- there is no reason in my opinion to run higher or to not strive toward normal blood sugar all the time, especially durinh pregnancy. It sounds like you are responsible and on top of your numbers, so I see no reason why you shouldn’t strive for 80s and 90s if that is what you want!!!

  2. Finding a great doc is amazing difficult. But finding a mediocre Doc is easy. I have an endo I really like and have been wit him for 17 years now. I may retire my diabetes when he retires. Can I do that? 🙂

    I referred your blog to the TUDiabetes blog page for the week of April 11, 2016.

  3. I hear you…Im often pushed out the door quickly because Im doing better compared to the other younger patients in diabetes clinic, even though I want to do better myself. It’s great that you have expectations and I hope you strive to achieve them. Best of luck with the rest of your pregnancy.

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