How Good is Your Care?
Your medical care deserves to be taken seriously.
By Ilene Raymond Rush
May 2008 — "Doctors don't listen once you reach a certain age," complained an older aunt recently. "They just don't seem to care as much."
It's not the first time that I've heard this complaint from the over-70 crowd. Not one of them expects their physicians to perform miracles, or even to have the answer for every ache or pain that might accompany aging hips or knees.
But what they do want is to be taken seriously.
According to a recent article in the New York Times, frustration between older patients and doctors can run both ways. Not being able to solve common medical conditions that can make patients miserable can turn normally empathetic doctors cranky.
The upshot of this combination can lead to dismissive doctors and dissed patients.
A dismissive doctor strikes me as particularly problematic for people with type 2 diabetes, whose treatments depend on keeping to a diet, exercise, and medication routine. For some older patients who have struggled with the condition for years, the discipline involved to stay on track may be second nature, but for those confronted with type 2 diabetes in the second half of their lives, the changes in lifestyle can prove difficult, even overwhelming.
So what makes a responsive physician? Each of us probably has our own criteria, but here are mine, based on a recent visit to my new endocrinologist.
First, I want a doctor who shares my information with me. I've had doctors who have rattled off my A1C and shut the results of my lab tests in a file as though they were marked top secret by the FBI. My endocrinologist took a different approach. Rather than reporting selective results and snapping the file closed, he sat down and explained all of the blood test results to me. Then – a first – he offered to send me home with a copy for my files.
Second, I want a doctor who reacts to my concerns. When I told him I had nicked a toe, he examined it, and then went on to survey the nails, and to conduct a pinpoint neuropathy test. Not every concern deserves an expensive CAT scan or MRI, but an acknowledgement of the problem you bring to the table and an explanation of why or why not a test might be of value, could go a long way in making a patient feel more secure and acknowledged.
Third, I want a doctor who talks to me. When I asked whether he believed Byetta might be a better choice of treatment, the endo explained the mechanism of the drug in detail, and then compared it to my present medication, weighing the pros and cons. He spoke clearly, simply, and with patience, his relaxed body language letting me know that I had an absolute right to ask questions and that he really wanted me to understand type 2 diabetes biology.
Lastly, and maybe most importantly, I want to leave a doctor's office feeling well treated, in both senses of the word. I exited that particular appointment with a fresh prescription, a new blood sugar monitoring machine, and a sense of well being, all of which – I suspect – will help me to keep to my personal treatment plan until the endo and I meet again.
Everyone is entitled to a bad day: doctors, administrative staffs, even patients. But if you're dealing with a doctor who consistently appears disinterested, clueless, or even bored, it might be time to switch to one who will look at you with a fresh eye and take your issues seriously.
It can make the difference between leaving the office in hope or despair.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Years before I was diagnosed with type 2 diabetes, The Other Half came out of a doctor's appointment with a diagnosis of "borderline diabetes" and an ADA exchange diet sheet. His health insurance agency followed up on the diagnosis with a glucometer and test strips. After a year or so of trying to follow the diet plan and test his glucose levels, things appeared to be back in "normal" range, and stood there until a couple of years after my own diagnosis. Shortly...