You know being a D is just too much work. I think I am going to quit 
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Hi all, I met with a concierge doctor who is willing to sign off on whatever I need for diabetes care, which is great.
I’m trying to consider any downsides to not having an endo, and one I just thought of is if I need hospitalization or outpatient surgery, would the hospital require that I am in care of an endo? I take good care of myself overall but things can happen.
Other downsides to a relatively-educated diabetic not having an endo that I’m not thinking of??
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Not sure how much help this will be but here it goes…
If your PCP is willing to order all your D Meds. that is a great. My new PCP as of Jan. 2024 would not. I had to get away from my current Endo because they constantly showed a lack of care for my condition. I start my new Endo in about 3 weeks. If my PCP would have ordered my Meds. I would not see an Endo. This is me, YDMV
If you choose to have your PCP order your Meds. in FUD you have come to the right place to keep informed. There are folks here that are trying to maintain & better their D care & there are those cutting edge folks that are already trying the new iAPS/Trio app. You can find a lot of information here to keep you in the know.
About having to go to the hospital. I have been twice in the last 5 years. Never once did they ask me who my Endo was, they only ask who your PCP is.
I hope this will help you in making your decision.
Cheers 
Edit: I was never hospitalized for D. Could be why they never asked about the Endo but my feeling is that it just wouldn’t matter. 
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Thank you, this is very similar to my experience. There is so much good info online and I’m in “good enough” care that my endo office really doesn’t offer me anything above and beyond. I appreciate your thoughts 
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Does Medicare require endo visits for type 1? Or would PCP visits on the Medicare required schedule (is it really every three months? that hurts my heart) suffice? For me, I’m not suuuuper close to Medicare age, but getting closer and want to have an established r’ship with an endo by that point if it’s required. @Allison I’m not sure if you’re anywhere close to my age.
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I have no idea. I’m about 30 years away from Medicare, so don’t plan on it being around when I’m older.
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I am on Medicare & they have never once insisted that I see any doctor let a lone an Endocrinologist. They do however keep pushing their annual data mining err I mean wellness visit 
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I am type 2 but on a CGM and a pump. I don’t know whether it is Medicare or the DME company requirements. The DMEs won’t fill the orders unless I see the endo a minimum of 6 months. It may be a Medicare thing as I have quarterly endo visits with labs.
As bothersome as those quarterly visits, it was confusing blood and urine lab results that got me diagnosed with bladder cancer at a relatively early stage.
My kidney function was excellent per blood test but there was elevated protein in the urine. This lead to a visit with a nephrologist, sonogram, referral to a urologist, a cystogram, TURBT, chemo, surgery and immunotherapy.
So I am happy to see my endo every 3 months. Fortunately they are not far away unlike my urologist/surgeon.
Back to Medicare requirements, I just don’t know the answer. I do know I will not get my CGM or pump supplies with out an endo visit every 6 months. This is true with Solara, CCS Medical and other DMEs.
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The definitive answer is in the regulations, in section 280.14; look at page 133 in this pdf
In particular, it says
Continued coverage of the insulin pump would require that the patient be seen and evaluated by the treating physician at least every 3 months.
The pump must be ordered by and follow-up care of the patient must be managed by a physician who manages multiple patients with CSII and who works closely with a team including nurses, diabetes educators, and dietitians who are knowledgeable in the use of CSII.
So that doesn’t explicitly require an endo, but the rules say the physician and team need to know what they are doing with insulin pumps, and you aren’t their only patient using a pump. I don’t know how thoroughly they check to make sure that rule is obeyed.
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@CarlosLuis is right I forgot that business of not being able to get my supplies because I hadn’t been to the doc for 6 months.
@bkh is also right your PCP may be able to do all that your EndoDoc would do.
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I do not know and couldn’t find a Medicare “requirement” for other than a “doctor” for scripts for meds and other treatments, i.e. no “Endo” requirement and it makes sense as some areas don’t have Endo coverage. Anecdotally, when I was dx’d T2, my PCP sufficed for all coverage and scripts both before and after I joined Medicare enrollee status; the only reason I now have an Endo is my PCP didn’t feel he had sufficient knowledge and recommended I see an Endo (he mis-dx’d the T2 to begin with, though fairly common, if not understandable, at the time). The frequency may be deemed a “requirement” based on Medicare’s requirement for a doctor’s evaluation and script writing for meds and treatment. I did find an exception for telehealth visits, but it wasn’t very specific and may have been due to Covid. My Endo has referred to Medicare requirements for two visits per year, NFD. I’d be interested in any source documents anyone comes up with!
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@bkh Thanks for finding this, didn’t show up in my search. I agree 280.14 is good for anyone on Medicare with an insulin pump, it doesn’t seem to cover the more general T1/T2 requirement to be seen by a doctor. Anyone know an additional reference?
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