Got questions about navigating life with diabetes? Ask D'Mine! Our weekly advice column, that is, hosted by veteran type 1 and diabetes author Wil Dubois.

This week, Wil looks at the question of how to go about finding an endocrinologist or other doctor well-versed in diabetes care. As all forms of diabetes become more common, and the number of endos across the USA is shrinking, this becomes an even more critical challenge.

{Got your own questions? Email us at AskDMine@diabetesmine.com}

 

Jessie, type 1 from California, writes:They say you should “shop around” to find the best doctor for yourself, but how can you do this if your insurance requires a referral every time to see a specialist like an endo? How do you get insurance to cover a bunch of appointments with different doctors you might be interested in? 

 

Wil@Ask D’Mine answers: Realistically, your health insurance is not going to subsidize a proper doctor search, even though having a doc that’s a good fit is likely to result in better health outcomes for you, saving them money in the long run. It sucks, but that’s the way it is. So why on earth is everyone saying you should shop around? Because, more than anything else, this is just a socially acceptable way of saying that you shouldn’t stick with a lemon.

Oh dear. Surely no properly educated, licensed, board-certified doc could be a lemon, right?

Well, yes and no. Usually when we talk about shopping for a doctor, we’re not talking about simply finding someone who’s medically competent. Most docs are. Instead, we’re talking about something more ethereal. We’re talking about finding a medical professional whose communication style meshes with your own. Someone who understands your issues, and in turn, someone who gives you guidance in a way that you can understand it -- a doc who is a good cultural fit, or at least someone who understands your culture. In short, we’re talking about shopping for a doc you can trust, feel good about, and communicate with.

So the first part of shopping for a doctor is not settling for one who’s just not working out for you. This is your right. More than that, it’s really your responsibility. The right doc is the key to your health success, and you owe it to yourself and to your loved ones to find the right one. 

Now, if you go to a larger specialty practice, finding a new doc can be as easy as shifting to a different provider. If you don’t like the one you’ve got, when you check out, ask the scheduler to set you up with a different doc next time. While specialty visits are commonly at quarterly intervals, you can probably get away with one visit per month for a few months to work your way through the available docs. It’s slow shopping, but it works. 

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But if that’s not an option, or if you are newly diagnosed and looking for your first endocrinologist, how can you, literally, shop for the right doc?

By doing your homework.

Start by asking your primary care doc who he or she likes. Then don’t be afraid to ask their staff. Nurses, technicians, and even office staff in the trenches tend to know which docs are beloved by their patients, and which aren’t. Other resources you shouldn’t overlook in your personal medical network are your diabetes educator (if independent) and your pharmacist. If you don’t have a good relationship with a pharmacist yet, cultivate one. They are amazing people with tremendous knowledge and substantial resources at their command. Lastly, ask your dentist. The medical community is one big family, and while they rarely speak ill of each other, they also won’t recommend a “bad apple.” 

Next, read what other patients are saying at doc-rating sites online such as HealthGrades, RateMDs, or Vitals. You can also find reviews of medical pros on Angie’s List and the massive business rating site Yelp—which despite being best known for restaurant reviews, actually got it’s start as a site to find online recommendations for doctors. Of course, it goes without saying, but I’ll say it anyway: The voices of the unhappy are louder on the Internet than the voices of the happy. So read the reviews with a grain of salt. Don’t take them for gospel, but rather, use online reviews as one part of your research.

While you’re online, see if any of your potential docs are speaking in public so that you can get a better in-person sense of their communication style. As part of your online research, leverage social media networks to get a deeper sense of how fellow PWDs (people with diabetes) in your area feel about the various specialists practicing there.

Beyond online reviews, blogs, and chats, you need to do some boots-on-the-ground research too. If possible, go to local support group meetings and talk to fellow PWDs in person. You’ll learn more about the docs that way, and you’ll also be able to evaluate the person giving you the info. Angry kook? Weigh that review lightly. Diabetes soul sister? Listen up!

Of course, ultimately, you need a face-to-face visit with the docs on your short list to find out which one is the best choice for you. If you’ve used up your specialty visits through your insurance, call the offices and ask what the cash pay cost is for an initial consult. Be honest that you’re searching for a doc but your insurance company isn’t keen on paying for the interviews. Unless the practice is overwhelmed with patients, in which case you wouldn’t be a priority anyway, they are likely to cut you a break.

Lastly, don’t forget that a doctor is the leader of a team. How do you feel about the rest of the team? Years ago, when my wife was pregnant with our son, she had an awesome gynecologist, but there was a problem. The doc’s staff were so surly and awful to deal with that we dreaded every visit, at least up to the point of getting safely into the treatment room. Then after the visit, the dread returned as we ran the gauntlet between the treatment room and the parking lot, suffering through checkout, payment, and scheduling. Mid-pregnancy isn’t a good doc shopping time, but postpartum you can be sure there was a switch-a-roo.

Start with considering how the front desk sounds on the phone, if they even answer the phone. Then, when you walk in, what’s the vibe? Is it friendly and welcoming? Cold and clinical? Or worse: Is the staff testy, irritable or condescending?

Who needs that? Diabetes is rude enough as it is.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. Bottom Line: You still need the guidance and care of a licensed medical professional.