I think I'm firing my endocrinologist.
It's not a straightforward story, but the short version is that on my visit to said endocrinologist's office last week to follow up on that pesky kidney stone, I updated him on the diet adjustments I've been making with the help of my dietitian. And he wasn't happy -- the caloric allowances she'd laid out for me didn't jive with what he thought I should be aiming for (he was advocating a much tighter budget). Not one to sit helpless when given conflicting information, I asked him to speak with the dietitian so that we could determine where the disagreements were in their assessments of my needs. His response: "Tell her that I have a subspecialty degree in metabolic disease" -- or some such field, I can't remember his exact words -- "and if she still has questions after that, she can call me."
Huh. Did he really think she (or I) was going to accept credential-waving as an adequate reason to follow his plan?
Sensing I was getting the brush-off, I e-mailed the dietitian after I got home, explaining the discrepancies between the recommendations, and expressed my concern. She immediately got back to me, promising to contact my doctor so that we could get the diet guideline questions resolved.
Apparently, he wouldn't talk to her.
Instead, he left a message for her with his nurse -- one that wasn't far off from what he'd told me to relay, from what I've gathered. And he's still refusing to take the dietitian's calls.
Is it ego? Insecurity? A control issue? All of the above? I'm done speculating. I need a care team, one in which the various members work together. If someone's refusing to communicate, much less collaborate, there's no way this is going to work out in my best interest. So I'm removing myself from his responsibility.
This has been a long time coming -- over the last few months, this guy has said and done other things that left me feeling unsupported and unheard. It's not worth going into detail, but each incident eroded my trust in him just a little bit more. I'm glad to be able to leave his service, knowing without question that the problems with him aren't "just in my head."
But finding that next person. I can't say I've got a lot of confidence in the current remaining team members (with the exception of the dietitian) -- they communicate minimally, by faxed lab results at best. This endocrinologist was kind of the only person who at least went through the motions of examining the bigger picture (he made the referrals to other specialists, so he got their letters back interpreting the results of their tests). I need someone willing to take the time to look closely, to pursue answers.
I happened to read Big Little Wolf's commentary on the doctor-patient relationship as all this was going on, and that, among other things, has reinforced what I've known for a while: that my search isn't going to be an easy one. But I'm looking because I have to. This mess -- or message service -- masquerading as coordinated care has gone on too long.
And I will totally sic all seven pounds of my attack kitty on the next M.D. who tells me his degree is what makes his plan (or lack thereof) superior to anyone else's.
14 comments:
I'm really impressed by your decision. Too often I worry about stepping on a doctor's toes - which is a really ridiculous attitude to have when we operate in a medical system that requires us to be our own advocates. I wish you the best in finding a doctor who can act as a reliable and supportive point-person for your care.
Good for you! Shopping for docs is frustrating. Perhaps the dietitian knows of some endos she's worked with who would be a better part of the team? Good luck!
Way to stand up for yourself and your needs! And I was wondering what Sherlock asked: Does the dietician have any recommendations?
And, Dude. I would not mess with that attack cat. Maybe you should carry a picture of the kitty in your wallet.
Kristen -- I worry about that too! That's one of the reasons why it took me so long to say enough was enough. I think it's a two-way thing; yes, we go to doctors for their expertise, but when they don't help us feel that we've been heard, how can we feel that their advice is appropriate for what's hurting us?
Sherlock -- I remember you were recently shopping yourself; hope the person you'd found is still working out well. Good suggestion about the dietitian's connections. She's already doing some looking around (she hasn't worked recently with anyone in the field, but she remembers doing so in the past).
GEW -- that is a GREAT idea. I'll just flash the photo whenever I have to open my wallet to get my insurance card out. The office can consider itself duly warned! (In all seriousness, though, this kitty would probably just roll over and ask for a belly rub if presented to a stranger. I caught her mid-yawn in that picture.) As for potential recommendations from the dietitian, see above :)
You have had some high concentrations of assholery going on, there. I am proud of you for walking away from sub-standard care and taking matters into your own hands. The prior endocrinologist sounds like an asshole--so amp-ed up by his degrees that he considered it beneath him to talk to a "nutritionist." Ick.
Look forward to hearing your progress. Thinking of you...
Thanks, TKW. I have to laugh every time you cry "assholery!" I'm going to remember that as the search for a new person gets going. When in doubt, call the crap for what it really is!
Of course Important Male Endocrinologist cannot be bothered talking to and much less admitting that Female Less-Important Dietitian is right. Male egos must not be hurt!
Good luck finding a new and better one!
Hi hgg! Perfectly summed up. I'm still floored by his behavior and it's been more than a week since all this went down.
Hope you are well. I'm glad you're still out and about in the blogosphere :)
Oh man, CT. Unbelievable. I don't know what it is. I do wonder if this patronizing behavior is directed more often at female patients. I have no data to support this, but it's what I believe. And it's bullshit. No matter who it's directed at, it's bullshit.
"A care team." Now there's a concept. These days, I would just take one decent competent physician.
Keep us posted. And good for standing up for yourself and your right to being treating like an intelligent human being involved in her own health.
I'm hoping for better from the next doctor, BLW. Yes, just one competent physician makes a world of difference!
I hope you're well. I've been thinking of you through all this and how much you've had to put up with in your experience with the health care system. It takes guts to stand up to all that.
Well done on standing up to this 'specialist', I bet you feel much better and stronger for it. Does your dietician have anybody she can recommend to step into his shoes? It could be she knows just the person to help you.
Sorry I'm so late in coming here - it's been an exhausting time, my friend
x
Dear FF, how I can imagine your exhaustion! Your new job is a demanding one. The care facility where you're working is lucky to have someone like you; I can't say that enough.
I've done some querying and my interviews have led me to a potential internist who comes with positive reviews. From there, we can determine if an endocrinologist needs to be on board or if she can manage my case on her own. But the first appointment's not till next week, so here we wait ...
How frustrating! What ever happened to health "professionals" consulting over patient care? I hope this has all worked out by now...sorry I hadn't been by before now.
SuziCate, I'm glad you stopped by -- whenever, wherever is fine with me! New doctors this coming week. I'm crossing my fingers.
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