Psychosocial

Why and How to Fire Your Diabetes Doctor

Are you unhappy with the way your doctor deals with you? Maybe your doctor doesn’t listen to you or support your low-carb diet. Perhaps you’re tired of being scolded for noncompliance. Or maybe you just don’t like him or her.

You have a choice. When you realize that the relationship that you and your doctor have isn’t working, you have a decision to make.

Should I fire my doctor?

If you want to fire your doctor, you have two choices, and both of them work. You can tell him or her why you are dispensing with his or her services. Or if you tend to avoid confrontation, like I usually do, you can just find another doctor and walk away.

But I hope you won’t have to fire yours. Sharing your concerns about people’s behavior can help if they listen to you. Then, your words can encourage him or her to change.

“Some physicians are open to feedback and can change,” William Polonsky, Ph.D., told me when I met with him. Dr. Polonsky is the president of the Behavioral Diabetes Institute in San Diego and an associate clinical professor of psychology at the University of California, San Diego. “Give them a chance,” he suggests.

“When you show up with a short list of the things that need to be addressed, a good physician will think, ‘Wow!’”

Trust

But Dr. Polonsky continued. “When I talk to folks with diabetes, I tell them to be successful with diabetes you need to work with someone who you feel is on your side. You need to have a doctor you trust.”

How much you trust your doctor depends a lot on empathy. When our doctors have more empathy, we do better than when our doctors have low empathy scores, according to a study that I reported here in 2012. Because their empathy plays a huge role, you need to find a doctor who you like.

When to move on

But if the relationship with your doctor is clearly hopeless, move on. “There are terrible physicians who should never be allowed to interact with people,” Dr. Polonsky told me.

When your blood glucose levels aren’t low enough or you don’t take the diabetes medicine that your doctor prescribes, he or she may complain about your noncompliance. In addition, when you follow a very low-carb diet, as I do, in my experience, most doctors and nutritionists will give you a hard time. But as soon as you get excellent blood glucose levels, they will usually stop making a fuss.

Noncompliance

When doctors and nutritionists call us noncompliant, they may be forgetting their supportive role in our health. We hire our doctors. This means we can fire them too.

Several years ago when exenatide (Byetta) first came on the market, I knew that taking it would help me control my blood glucose and lose weight. Because the doctor I saw at the time had never heard of the medication, he had to read up on it.

I fired him

Then, he refused to give me a prescription for it because he was sure that I would lose only a few pounds. I fired him and proved him wrong by losing about 150 pounds after I hired a compliant doctor who prescribed Byetta.

A “compliant doctor” is one who not only talks to his patients but also listens to them. But when our doctors are not on the same wavelength as we are, they often blame the victim — us — when we don’t do what they want us to do.

It’s our body

It’s our body, and we are responsible for it. One of the ways in which diabetes differs from almost all of the other diseases is that between our rare visits to the doctor’s office, we are in control. We have the right to set our own goals and decide how we will manage our diabetes because we have to live with the consequences.

We go to our doctors because we want help. I’m not writing about those unfortunate people who are in denial and don’t see their doctor or go only under duress from their spouse. I’m writing about those of us who are responsible for our own care.

Why we fail

But almost everyone who reads my articles wants to manage diabetes. I also know that most of our doctors try to help us. Why then do we so often fail to communicate?

This is because we don’t speak up enough. Those of us who have diabetes need to become equal partners with our doctors. If they fail to work with us, we have a duty to our bodies to find someone who will.

This article is based on an earlier version of my article published by HealthCentral.

Never Miss An Update

Subscribe to my free newsletter “Diabetes Update”

I send out my newsletter on first of every month. It covers new articles and columns that I have written and important developments in diabetes generally that you may have missed.

Previous Post Next Post

You Might Also Like These Articles

13 Comments

  • Reply S.Moore March 18, 2017 at 3:07 pm

    I live in a town where almost the entire medical community is under the banner of one organization. Even if a certain doctor is not in this group, they are still an overall tightly knit community. I have experienced going to another doctor besides my own, and I was treated very badly. It has happened more than once. It is like they all talk to each other and have each other’s back, even with the patients health at stake.

  • Reply LaBerta E Finck March 18, 2017 at 12:29 pm

    Wow, great article and such good responses.
    I had to get a new doctor when I moved in 2014. I acctually see an ARNP and when she saw the results of my blood tests her first words were that I was pre-diabetic and to cut back on my carbs and sugar. I kind of suspected something like that was going on and had already been eating less and trying to eat better. I had lost about 35 lbs. and then gained back 15 of it so I tossed the candy out, my chocoholic self would have to learn to do without. I cut my carbs back to about 70 per day and got my glucose under control. I lost that 15 pounds and another 20 besides. I can’t seem to get my A1c below 5.9. Now some other issues have come to light.
    Without going into the long story, I have been having bouts of diarrhea and with that and my blood work being up and down my NP has been thinking that I am flip/floping between Hypo and Hyper Throidism. This has been going on for the past 7 months. I have been diagnosed with Sjogrens Syndrome. It is difficult to gauge how well my A1c is doing when I keep having to use the BRAT diet to help control the diarrhea. She also thinks the Sjogrens is attacking my lungs and I now have to see an RA doctor. I keep thinking to myself “what next?”.
    Mainly I know from experience that cutting back those carbs and sugar really do make a difference and I can’t understand why people I know with Type 2 diabetess take medicine and eat whatever they want.

    • Reply David Mendosa March 18, 2017 at 4:13 pm

      I can only comment on one of your excellent points, LaBerta. Chocolate itself isn’t any problem. The problem is when it’s combined with any form of sugar, as it almost always is. But I satisfy my desire for chocolate by drinking a chocolate-flavored protein powder. Several brands are sweetened with stevia, a natural sweetener that has no carbs or calories.

  • Reply Andrea March 18, 2017 at 1:41 am

    David,
    This is what I am going through right now. This Dr. Talks at me, doesn’t listen and is rude. Even though I’m still in the prediabetes stage , is an Endocrinologist appropriate? This last Dr. Was not one.

    • Reply David Mendosa March 18, 2017 at 4:15 pm

      If I were in your shoes, I certainly would get another doctor, Andrea. My guess is that it’s not important for you whether she or he is a primary care physician or an endocrinologist.

  • Reply Kent Snyder March 17, 2017 at 8:39 pm

    Thank you David for all of your writing over the last few years – and especially your photos. I use one you took at Haast Pass as my Desktop background. We loved it there.
    I’ve had a great doctor for 10 years – not an endocrinologist – who is winding his practice down. Finding a new Dr. who both knows of and follows Bernstein’s low carb methodologies is challenging, even in large urban areas. Perhaps you could write about ways that people are finding those good doctors: what user groups they can join; what certifications are helpful or not; how people can share worthwhile recommendations; etc. It is information I could certainly use these days and I suspect I’m not alone.
    Keep up your great work.

  • Reply Melodee Currier March 17, 2017 at 1:26 pm

    David, it’s reassuring to hear this. I thought I was unusual going through 5 endocrinologists in about 7 years — for varying reasons. One insisted I took a drug that had an FDA warning. When I told him I wouldn’t take it, he became enraged. I found out on the Internet that he was a speaker for that drug company. Never went back.

    • Reply David Mendosa March 17, 2017 at 4:02 pm

      What a terrible conflict of interest! You are wise, Melodee.

  • Reply Lee Hunnicutt, Jr. March 17, 2017 at 1:18 pm

    I’m a diabetes fanatic. When I was diagnosed I immediately dieted by simply cutting back on my food intake and lost 35 pounds and have since lost ten more pounds. Except for cauliflower, I don’t eat anything white and maybe once or twice a year eat my favorite dessert.

    I have never taken any meds for my diabetes and my a1c runs between 5.5 and 5.7. It frustrates me that all of my friends who have diabetes have no will power and eat whatever they want.

    I guess I’m wired to control my diet and others aren’t. Like I said. I am a fanatic.

    • Reply David Mendosa March 17, 2017 at 4:03 pm

      Wonderful, Lee! Your success is something that I would like to write an article about. If you would like to work with me on that. OK?

  • Reply Bob Fenton March 8, 2017 at 10:45 pm

    When my endocrinologist let me go about three years ago, I searched for a doctor and went through three doctors before realizing that my Veteran Affairs doctor was very knowledgeable about diabetes. Now she has retired and the search will have to restart. I will wait until my next appointment with the VA clinic before I go searching. I may not need to search – I hope.

    • Reply David Mendosa March 11, 2017 at 1:02 am

      I hope that your search is a lucky one, Bob. I had to go through 10 doctors in 10 years to get one that I like and respect.

    Leave a Reply