[foxl]

Originally Posted by georgepds

Not to be too cantankerous.. is there any possibility that the doc is assuming she's incompetent to mange her own care because she's obese?

The unspoken logic goes something like this.. one of the best things you can do to control diabetes is to loose weight, she obviously hasn't done the best thing she could, therefor she's incompetent.

That she covers what she eats suggests to me she knows what she is doing and has made a conscious attempt to control her own glucose response. That it is not the path that is "ideal" or the one the doctor would choose is not material. She's made a choice and is using the tools available to control the consequences of that choice.

At the limit let me pose the the question : would it be better if she did not inject to cover what she eats? In the short term (danger of hypo ) that's the case.. but it goes counter to what most of us have come to understand about the long term benefits of strict BG control

--G

No, this is my friend, and she knows better than that -- it was that when asked to hold off on some of the carbs, the pt refused to do so.

[foxl]

I think some of the problem here is that the MD in this situation is frustrated b/c she is stuck complying with hospital policy too. Does that shed further light?

[TommyC1]

Originally Posted by foxl

OH ... but they DO. They do know. $$$$$

Nah, $$$$$ would be the LEAST of their worries.

But I'd walk away long before I'd let them push me to that.

[jmrasmus]

ok let me put some perspective as far as why the pt might be injecting for the carbs she eats at lunch: hospitals in the US work on a sliding scale taking into account the BS of the pt and not the amount of food they consume. hospitals do not count carbs. you get an injection based on your bs, and then when it goes high bc you just ate you get another injection.

i was hospitalized and i was allowed to do my own care up until surgery and the next few hours after. They wanted to continue my injections for me, but when they put my "dinner" infront of me i asked for my injection. they checked my BS and it was 147, they said according to the written orders they could not give me any insulin until my BS went above 150... annoying but at that moment i insisted (politely) to speak with the resident in charge of my orders and had them changed to self care for the remainder of my stay.

There are pt's out there who are unwilling to control themselves, may be just ignorant to their situation, or at the end of the day just don't care. I have met all of the above.
If the pt is acting "snotty" and childish and medicating herself in hospital under the table I would certainly assume she is not mature enough to maintain herself on her own. I think if you act immature and childish you should be treated as a child. There is a way to go about taking care of yourself and a way to show you are responsible enough to do so.

[Joeprep4820]

I don't mind a hospital taking care of my BG when I'm hospitalized, but if that is the case, I want to meet the endocrinologist who is making the decisions. Most doctors aren't much more knowledgeable about diabetes if any more than we are. Why would I want someone who doesn't know what he is doing to take care of a crucial health aspect. I usually ask for the endocrinologist making the decisions, when and where he received his degree, and his transcripts from medical school. For nurses I'm a bit less worried, but I only allow nurses with 4 year degrees to be responsible for my care. If these conditions aren't met, I would rather take care of my own Diabetes care when hospitalized.

[jtausch]

Originally Posted by foxl

Heck, they never even explain why they put you in a wheelchair in order to discharge you ... they HATE bringing up the L word, ever.

I was in my own wheelchair and when I was discharged the last time i was in they had to push me out would not even let my wife do it.

[jmrasmus]

Originally Posted by Joeprep4820

I don't mind a hospital taking care of my BG when I'm hospitalized, but if that is the case, I want to meet the endocrinologist who is making the decisions. Most doctors aren't much more knowledgeable about diabetes if any more than we are. Why would I want someone who doesn't know what he is doing to take care of a crucial health aspect. I usually ask for the endocrinologist making the decisions, when and where he received his degree, and his transcripts from medical school. For nurses I'm a bit less worried, but I only allow nurses with 4 year degrees to be responsible for my care. If these conditions aren't met, I would rather take care of my own Diabetes care when hospitalized.

you request his transcripts form med school? have you had any luck in ever getting those?
I'm not making fun of what you said but it sounds truely unrealistic, not to mention you really don't learn much in med school... it's the 6+ years you spend in residency that you leanr how to deal with pt's and how medicine really works

[Joeprep4820]

Originally Posted by jmrasmus

you request his transcripts form med school? have you had any luck in ever getting those?
I'm not making fun of what you said but it sounds truely unrealistic, not to mention you really don't learn much in med school... it's the 6+ years you spend in residency that you leanr how to deal with pt's and how medicine really works

I've received them via fax or email from each of my current doctors - GP, endo, and opthamologist. I figure I was requested to submit my official transcripts before I was hired for my current position, I feel I should see a doctor's before I hire him/her as my doctor. Of course I check out their experience and patient ratings as well.

[Moonglo]

Originally Posted by Joeprep4820

I've received them via fax or email from each of my current doctors - GP, endo, and opthamologist. I figure I was requested to submit my official transcripts before I was hired for my current position, I feel I should see a doctor's before I hire him/her as my doctor. Of course I check out their experience and patient ratings as well.

Actually, my health insurance company even goes so far as to list the educational information for in network doctors on their provider list.