FUDiabetes

Endo problem

#1

@Nickyghaleb This title is misleading, my endo is wounderfull but his CDE is about her story.
I had first appt. with her at the beginning of this month. She didn’t even know I was on pump, asked no questions or offered any advice, only upped my script for 100 units daily looking my use from pump down load.
I have been approved for the omnipod by medicade, sent in tidepool report for last 30 days, so yesterday I spoke with them because they haven’t received script from indo yet. Talked to endo this morning (e-mail) and was told they haven’t received request. Gave me there hippie compatible fax# and asked me to have them fax it to him. So I did. He contacts back about 30 minutes later and said he got it and was giving to his CDE to process.
So I get e-mail from CDE stating I she got last week and forgot, but my current pump has two years left on warranty so I can’t get one and that I didn’t need new one.
I was /am livid, responded my pump warranty expires on 8/19/2019 and that omnipod has already been approved and that I do not expect or will except her dictating my treatment, all I need her to do is send prescription.
I copied endo and sent separate e-mail letting him know this is twice I have had problem with her "forgetting ". Asked him about request I sent in for new prescription because existing is not covered. He responded he sent to her 2 weeks ago and that he was doing rounds at hospitals but would handle this “problem”.
Is it wrong for me to hope she gets hell for this. If my truck was legal I would be sending this from the waiting room.

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#2

My experience comes from working on the other side of the aisle, i.e. I spent many years working within cardiology practices and while the type of body parts they work with are a little different, the issues are very similar. i.e. needing to prescribe a number of pharmaceuticals and devices to help the patient. Hard to keep it all straight.

If it were me, @T1john, I would be pissed. However, I would never let the CDE know you are pissed. If you followed that CDE, you would see someone who is trying to keep up with the scrips the doctor is ordering, dealing with insurance issues the doctor doesn’t have time for, seeing and educating patients in the practice and rounding on hospital patients. Sometimes multiple hospitals depending on the physician coverage. You would see someone who is running 100 mph because good staff is hard to find and the physician is probably offloading a huge amount of work. This is very common in the physician practice world where margins are actually pretty tight. Things falling through the cracks is the norm, and staying on top of it is ultimately up to the patient, and it seems you are quite on top of it.

Rather than hoping the doctor read the CDE the riot act, it may be more productive to let the physician know that they are probably overworking the CDE and perhaps he should look for additional staff to help out since things keep falling through the cracks for you.

My 2 cents.

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#3

Good point, I know he forwards to her and she writes scripts. Couldn’t imagine what her day looks like. Guess her telling me I don’t need new pump pissed me off more than anything else.

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#4

Nothing wrong with getting pissed, it happens to all of us. Polite firmness should get you what you want.

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#5

Having been on both sides of that aisle as well, I have a different perspective. I don’t think it serves anyone to make assumptions supporting or criticizing the performance of the CDE. I certainly have worked with folks who simply weren’t good at their job and shouldn’t have been working in the medical field. I think we can all draw on past experiences to support that conclusion - no matter what where we have worked, or who we have dealt with, doctor, lawyer, CDE, grocery store clerk, fast food cashier, politician, etc, we have all recognized coworkers or other people who simply weren’t good at their job.
Honest facts are always best. I would certainly tell my endo that the experience disappointed you (that IS a fact), that the endo told you one thing, the CDE didn’t fulfill that, that the Omnipod is already approved, etc. It’s ultimately the endo’s job to deal the issue once they have the FACTS.
About 10 years ago I had an endo who had a nurse who consistently needed repeated messages from me to complete things like prescription refills. He eventually got a different nurse and on the very next visit commented how incredibly efficient his new nurse was, and that he was getting out of the office an hour earlier every evening. Maybe your CDE is overwhelmed. Maybe your CDE is simply inefficient.
I have also experienced STANDARD procedures and responses from the doctor’s office. I will NOT argue with a nurse or clinic staff. I simply say I WOULD LIKE X. IF THAT CAN’T HAPPEN, HAVE THE DOCTOR CALL ME TO EXPLAIN WHY. 9 times out of 10 the doctor has no issues doing what I am asking for.
In general I also firmly believe a CDE is nothing but a money making scam by the clinic. I just love it when someone at the clinic tells me I should see a CDE because a CDE can adjust my insulin. If someone thinks I am on a pump and NEED a CDE to adjust my insulin, they are likely one of the people I talked about above who should be working in a different field.
They insisted I see a CDE for help in choosing my last pump. Apparently some policy somewhere had decided I was illiterate and too much of a simpleton to have that new fangled interweb thing. I complained -FIRMLY AND LOUDLY. No one has suggested I see one since.

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#6

That’s very helpful, @Chris. I love that you started it with recognizing his right to feel pissed because he absolutely has one, but it won’t get him far. I also appreciate hearing the other side. It’s hard to think that way when you’re the one falling through the cracks.

@T1john, yeah, I’d be pissed, and yeah, i’d vent, and then I think I’d gather myself and do exactly as Chris is recommending. Get on top of it. If you have direct communication with your endo, and he is not the one who is upsetting you, you’ve got a great outlet. Even more important, you may have part of the solution. I’m not sure if the CDE is just over her head or is being snippy and short, but I suppose it doesn’t matter. You’ve communicated it to the endo, and I doubt he’ll soon forget. If you were to have another problem, or if others report similar problems, I’m sure he can add it all up and deal with it accordingly.

@Dc53705, those are all great points. Having never been on the other end, I can certainly let emotion get the best of me sometimes, but I also understand that it’s wasted energy and rarely leads to solution. So I’m nodding like yeah, I get that, but really I’m filing it in the front of my brain for my upcoming week of medical appointments where things are bound to be flawed. I’ll try to do this. It’s good stuff.

T1John, that’s awesome though… that you’re all clear for the OmniPod?? You know we have a few people in the other group making the move, too. I hope you’ll let everyone know how it’s going!

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