Kathleen Stanley

50 Things You Need to Know about Diabetes


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3. How to get the most out of your visit to the registered dietitian

       4. How to call your doctor for help

       5. How to work with your insurance company

       FINDING YOUR DOCTOR

      Diabetes is a lifelong disease, so choosing a good doctor to take care of your diabetes will be a long-term decision. Think about other relationships you have established for your business or in your personal life. More than likely, good communication and trust are largely responsible for the successful relationships you have had. You will be working together with a doctor for years, so choose carefully, and expect to build the relationship over time, not just at the first visit. The following tips should help you in this important search.

       GET PROFESSIONAL ADVICE

      Ask your favorite current health care provider (family doctor, dentist, ophthalmologist) to recommend someone. If you like this provider’s professional style, chances are, they will recommend someone who uses a similar style.

       DO SOME SCOUTING BEFOREHAND

      Some physician offices and clinics have marketing packets or office information packets that could be mailed to you. The web is also an excellent resource. Many insurance companies, hospitals, and even municipal websites offer online physician finders. Many doctors and clinics also have their own website with information on credentials, services, and insurance policies.

       Making Peace with Diabetes Technology

      Many of us could happily live our lives without owning an MP3 player or sending a text message. But when it comes to your diabetes care, it’s time to accept some degree of technology, because it will to play an ever more important role in your health. For instance, some physicians use health data banks and software that allow you to input your blood glucose information and management information online. You can send in your numbers and get an update on your management without setting foot into a doctor’s office! Many health care professionals also communicate through e-mail, which can sometimes be more reliable than a phone call. And let’s not forget the number of diabetes management software programs available on cell phones, personal organizers, and computers. Most of these are very easy to learn and can make organizing data, analyzing your numbers, and spotting trends much, much easier.

      So even if you wouldn’t own a digital camera if someone paid you, it might be time to accept that some technology can simplify your diabetes management and improve your health.

       CONSIDER COMMUNICATION STYLES

      Start your selection process by considering your communication needs and preferences. If you are the type who likes to have frequent contact or ask a lot of questions, you might want to consider a physician who has an on-call resource for after hours or enough trained staff to answer questions when the physician isn’t available. Ask if the health care professional or physician takes direct calls, or if you are routed to others or through a frustrating electronic messaging center (“press 1 for more options, press 2 if you are tired of options, press 3 if you want us to disconnect you for no apparent reason, press 4 if you would like to throw your phone across the room”). If you are very comfortable with technology, seek out a doctor who is using the latest technology in their office (see sidebar).

       HOW MUCH TIME DO YOU NEED?

      If you prefer one-on-one time with a human being, you may want to ask about the time slots for appointments, or even take a casual visit to see the waiting room. If appointments are scheduled every 10 minutes, the waiting room is overflowing, and the staff looks harried, it may be sign that you may not get a lot of face-to-face time with this particular doctor. Conversely, some offices employ support persons to help with your visit, including a dietitian, laboratory staff, and diabetes educators. With this extra staff, you will probably get more personal contact. You will also get the scheduling flexibility of a multidisciplinary team, rather than being dependent on just one person. Remember that diabetes is a multifaceted problem, and a team can help in your overall health care treatment plan.

       GROUP PRACTICES VERSUS SOLO PRACTITIONERS

      Larger offices may have several partners, so ask if you will (or can) be assigned to one particular physician, allowing you to develop a relationship if that is important to you. If not, you may be scheduled with the “available” physician when you call, meaning you may be seeing a number of physicians or professionals. Finding someone you “click” with and can talk openly with is very important; you are developing relationships that will undoubtedly grow over the years.

       CHECK THEM OUT AT A CHECKUP

      The best time to make the first visit is for a simple checkup. This way you can see how the office works and meet the physician without the stress of an illness. At each visit you should generally expect:

      

Weight check

      

Blood pressure check

      

Physical exam

      

Feet and leg check (skin, circulation, and feeling)

      

Current medication review (take vials and bottles so they can verify them)

      

Home management plan review (diet, activity, and medications)

      

Blood glucose log book or records review (looking for highs, lows, and trends)

      

Lab work

      

Time for questions and answers

      

Discussion on preventative measures

      

A plan for your care

      

An appointment time for your next visit

      After the visit, consider how it went. If the checkup wasn’t thorough or the conversations didn’t go well, this may not be a good sign for when you have an urgent need or problem in the future.

       NEIGHBORLY ADVICE

      When choosing a doctor, common sense has you looking to neighbors and friends for a recommendation. This is indeed a good idea, as long as you also keep in mind that a friendly personality does not always mean quality care. When you get a recommendation, follow up by asking your neighbors and friends to describe their diabetes control. They might have a nice, friendly doctor, but if that physician is allowing your neighbor to have a long-term A1C higher than 8% or continuous unsolved glucose swings, well,