What emotion do you experience first when you think about your upcoming Endocrinology appointment? We can help make it a better and more productive visit.
10 steps you can take between now and your next Endocrinology appointment that can help you feel more comfortable, relaxed, and confident walking in those clinic doors.
Tip #1)
Remember that most Endocrinologists decide to become Endocrinologists because they like how complex the endocrine system in the body is.
They are naturally intelligent and problem solvers. Most Endocrinologists decide to go through many years of schooling and sit through grueling board certification exams to be able to help people with diabetes and other endocrine disorders.
Tip #2)
Endocrinologists want you to meet your A1C, Time in Range, cholesterol, blood pressure, and healthy weight targets.
Keeping that in mind may make it easier to discuss some topics that can be emotionally charged and uncomfortable. For example, if you forget to bolus often, the reason the Endo will tell you they NEED you to bolus more, or count carbs more accurately is not because they are making a judgment call on your intelligence or ability. They are stating what they see from the data that can better help you meet your Time-in-range or average glucose targets.
Tip #3)
Speaking of data, data is what your Endo needs to help you with adjusting your diabetes medication plan.
It helps the Endo be able to better help you if there is a report to look at from a blood glucose meter, a continuous glucose monitor, and/or an insulin pump. If you can take notes for 5 to 7 days before your next appointment with information about food intake, carb counts, insulin doses (if taking injections without a linked smartpen or using an insulin pump), and notes about physical activity, stress, illness, snacking, low prevention or low treatments, this can also really help with reviewing glucose data.
Tip #4)
Prepare for your visit by making a list of questions or list of things you need to obtain during your visit.
Are your annual diabetes-related labs overdue? Do you need a new prescription for insulin pen needles? Is your glucagon expired? Do you know what to do to manage your diabetes safely if you are sick? Do you have a question about how one of your medications works? Is there a pattern in your blood glucose or sensor glucose readings that you need help with? List these items on a piece of paper. Make a copy for your Endocrinologist. Hand it to them at the beginning of your visit and let them know you made a short list to prevent forgetting anything important.
Tip #5)
The healthcare system today does not typically allow for long appointments.
It may feel like the Endocrinologist wants to spend the very least amount of time possible with you during your visits. In reality, it is more likely that your Endocrinologist is tasked with seeing a very high volume of patients every day, managing phone messages, faxed inquiries, signing prescriptions and pump or sensor paperwork from pharmacies or insurance companies, answering questions from family physicians, and ensuring all of their documentation and billing is completed for each visit they have. Most providers would prefer to have more time in each visit to allow for further discussion, and more education, and to ensure that you leave with a clear plan that you understand.
Tip #6)
If you have a longer list of questions, or if you realize at the end of your visit you have clarification questions about a new medication or adjustments to your insulin plan, ask at the check-out desk if you can either ask the provider or a Diabetes Educator.
If the office does not have a Diabetes Care and Education Specialist, ask to speak to the Endocrinologist’s Nurse or Medical Assistant. You may need to be scheduled for an additional visit with another member of the Endocrinologist’s team to get your questions answered promptly.
Tip #7)
Your Endocrinologist does not get reimbursed based on the number of people to whom they prescribe a specific medication or specific insulin pump.
If you choose not to fill the prescription, that impacts your health. It does not impact your Endocrinologist’s pocketbook. When you get to the pharmacy to pick a medication or diabetes supply, if the pharmacy staff tells you the amount you owe and you feel the price is too high, ask the pharmacy if other options work similarly. You can call your insurance to see if a different medication or insulin that works the same way but is produced by a different company is on your insurance formulary and will cost less for you to fill at the pharmacy.
Tip #8)
Get a paper copy of all labs and tests you have done. Always.
Put them into a binder or save the info on a USB thumb drive. Review your lab results before every Endocrinology visit. List any out-of-target results that you have questions about on your questions list. Do NOT let people tell you “All of your results are normal” without looking at the results yourself, too.
Tip #9)
Do some research before you go to your appointment.
If you are interested in the latest diabetes technology, review summary information on the websites of the diabetes technology companies, and summary information from reputable websites such as Integrated Diabetes Services. Watch videos or listen to podcasts made by people who use the device themselves or who provide updates regarding new technologies that will be available soon. This will help you be prepared to discuss with your Endocrinologist specific questions or to ask to switch to a different insulin pump or continuous glucose monitor, for example.
Tip #10)
If you happen to work with an Endocrinologist who seems condescending or rude, it is ok to call them out on poor behavior in a respectful manner.
“Dr. Bob, when you draw a frowny face on my pump data report because my Time in Range is not to target, this does not help me get what I need to improve my diabetes self-care. I would like you to stop doing this moving forward.”
If, after discussing what you are dissatisfied with, the bothersome or problematic behavior or issue remains, if possible based on your insurance and where you live, it may mean it is time for you to look for a different Endocrine provider!
If your A1C or Time in Range is not where you would like it to be, or if you need more time to discuss your questions, or glucose patterns, reach out to your local Diabetes Care and Education Specialist(s) to ask for help.
If you are looking for a Diabetes Care and Education Specialist, contact our office at Integrated Diabetes Services at +1 (610) 642-6055, or [email protected]
March 2024 NewsletterOriginal Article
