Should I Change Drs. (again)?

TommyC1 · #1 (**permalink**) 11-13-2009, 06:41 AM

I'm on Dr. #4 for the D. Thinking about going back to my GP.

I decided to go into Joslin in Boston about 18 months ago because my then current Endo was no help with lousy numbers and frightening hypos.
Joslin got me straightend out pretty quick, switching me from 2shot's of NPH/day to MDI Lantus and Novalog, as well as teaching me to adjust my Novalog to my carbs.
At the same time I found DF where folks clued me in to basal testing and "Think Like a Pancreas" and a whole lot more.
By my second visit to Joslin my A1C was greatly improved and my hypo's were well controlled. My new endo was so pleased that he told me to get my next A1C locally and to come back to see him in 6 months.

So why would I change?
Because getting to Joslin and back is a half day out of my life. Going in there to be told I'm doing a good job, here's your updated scrips and see ya in six months seems like a waste of time. My GP can do that and her office is 5 minutes from my house.
Half a day twice a year vs. half an hour?

Of course my GP didn't know that 2 shot's of NPH/day was not the best treatment for a type 1. I couldn't count on her if my control got difficult or complications started messing me up. But I've learned more here on DF and other sites that folks at DF pointed me to than I have from Joslin. So long as I can manage this and my GP is willing to support that I'm not sure I really need Joslin.

I got lucky getting into Joslin on short notice. If I left and wanted to go back I'd expect a wait to get in.

Hmm... what to do?

Subby · #2 (**permalink**) 11-13-2009, 06:48 AM

Tommy, here's my response. It sounds that you have been getting better tools and better medical help. You've gone through a process of change, now you are settling into it more. Unless there is another issue or set of issues you want to get endo advice on or feel they need to help you with, I don't see why you need to find another endo. Why not work with your GP on the regular basis, run tests, get needed references to specialists as needed, and chat about subsidary issues that come up, and just go back to this endo in 6 months with a hand full of complete records? That's pretty much what I do, when things are running smoothly.

That way if things go off the rails or you get new endo related questions, you have this guy lined up, you are a patient and can make a closer appointment, etc. If things continue to be working better, and you are well versed in working on things like insulin use, and you have that little flame of motivation to keep on top of things or improve when you can (and I detect that in you), then let the endo, any endo be present but in the background for the moment.

kgm0612 · #3 (**permalink**) 11-13-2009, 06:56 AM

Tommy..........Joslin is one, if not the best, diabetes center/hospital in New England. In my opinion, a 30-minute drive to & from (1 hour) twice a year is nothing. From where I live in RI, if I were a patient at Joslin, it would take me over an hour each way and I would not think twice about it. Stick with the endo you have now, along with Joslin and use your GP for a yearly exam and or sick visits.

Karen

jenb · #4 (**permalink**) 11-13-2009, 07:41 AM

I'd stick with Joslin. Of course, I live in L.A., so what's half a day sitting on the freeway

?

Jen

davef · #5 (**permalink**) 11-13-2009, 08:05 AM

Tommy,

I guess I'd look on being in Joslin as an insurance policy. As you mentioned your GP would be fine for writting scripts but if things became complicated then it would be unlikely that your GP could handle it. I'd stick with Joslin, that way if things were to become complicated you have them to rely on.

I don't suppose you could talk to the Endo and see if you could get your bloods done by a local lab with the results sent to Joslin, and suggest if the bloods are fine that the Endo could renew your scripts without seeing you?

Subby · #6 (**permalink**) 11-13-2009, 08:15 AM

Out of interest, can your GP prescribe your scripts? That's how it tends to work here: once it's established you use a medication (often through a specialist) then a GP will be happy to prescribe. Hence, when I wanted to try metformin, I needed to see an endo, but now that I am on it I foresee no issues getting a script from my GP (who will have correspondence from the endo, or can ring up to verify if not sure).

Can it work that way there Tommy? I see script writing from a specialist if not needed, a waste of time. Better to use the time in useful discussion, if possible.

TommyC1 · #7 (**permalink**) 11-16-2009, 05:25 AM

Thanks all.
I guess I'll stay where I am. Right now I'm the only loose screw (and the only one who can fix that

). But if the D goes wonky better to have Joslin on tap and up to speed than to start over.
Besides I kind of enjoy the scenery walking through Backbay and Newbury Street

inkvisitor · #8 (**permalink**) 11-16-2009, 07:51 AM

A little late here, but I'd alternate them..

And yeah, it doesn't sound so bad coming from a place where it can take an hour to drive five miles

TommyC1 · #9 (**permalink**) 11-18-2009, 08:17 AM

It's the driving in the city thing.
If I get the timing just right and there's no accidents/construction/events going on then I can, in theory at least drive in in half an hour.
Unfortunatly that can be quite unpredictable as can parking and besides I tend to catch a bad case of cabdrivers disease whenever I drive in the city. GET OUTA MY WAY!!!!!!!

So I take the train and the hour walk from the train station to the clinic because I hate the subway worse than the drive and it's often faster walking.
Makes it a two hour trip each way.
Still it is only twice a year.