Switching doctors with the seasons

Disclaimer—I am also venting with this letter as well as asking for opinions


I have a concern. It seems as though I am going through doctors like I go through Omnipods. I have been through 2 clinics and at least 5 doctors total since I was diagnosed with T1D five years ago. My current endocrinologist is great. He is a nurse practitioner and is also T1D. So ANY advice, instructions, etc., that he gives me I follow. My PCP…well… I had to switch from another PCP due to the fact that he sent me to a behavioral specialist and said I was depressed when I provided him with a 2 page list of symptoms. When he wouldn’t listen, I dumped him like a bad habit.

Now, I’m at the same clinic, but a different site (closer to home). My current PCP started to exhibit the same issues as my previous one. I am also dealing with PTSD from an unrelated incident, so his focus has been on that. I recently reminded him of my physical issues along with some alarming test results. My cousin is also a NP, and she believed that due to my symptoms and blood test results I might have another autoimmune disease (or worse). I brought this up to my endo, who in turn said “Yea—you need to see a specialist ASAP” and sends a referral to my PCP. My PCP in turn, sends my info to an …allergy specialist??? What the H. E. double toothpicks!! An allergy specialist?? Needless to say, I wasn’t real happy about that.

He claimed that the powers-at-be reviewed my chart, and sent it to an allergy specialist instead of a hematologist (who he recommended view my chart). The allergist in turn said—although you have ALL these other issues–you have no reoccurring infections…so you’re fine…walk it off. So, I go online and send in requests myself to see a hematologist for my blood results, and a rheumatologist for the autoimmune concerns. My PCP shoots both requests down. I then called the complaint office for the clinic just to vent my concerns. They then decide to call the PCP on my concerns FIRST instead of talking with me about it (way to keep my concerns confidential there guys). My PCP sends me an email saying he’s sorry for not handling my needs and that he did not know all of my issues. He then sends in the request to see a rheumatologist and lets me know if I want to part ways, there’s no hard feelings (hey, I got my referral!!).

I might be paranoid and I REALLY like my endo (since he is also T1D). My question is should I switch my PCP? Or should I give another chance? (I’ve already made peace with him in another email and he has done the same—I think even with the ‘complaint’ the relationship will be OK). My endo and PCP are at the same site, so there’s my ‘dilemma’. I can get another PCP there, but I have the feeling there will be some awkwardness??? Besides, this will be #6 or 7 in switching doctors, and I’m honestly tired of going through the phase of “getting to know your doctor”. I already have chronic fatigue, so I just really don’t have the energy to deal with all that again. Any advice, thoughts, similar complaints will be appreciated. Thanks.

hey hi @dmannone, sorry it sounds like you’ve been through a lot.

an endocrinologist (in my area) is a doctor, specialist, and can order tests with any of my laundry lists of medical codes directly. i am confused about your endo being a nurse? maybe you need a specialist M.D. that can order proper tests and is familiar with autoimmune diseases?

if it makes you feel any better, i’d fire a doctor if they didn’t offer an exact reason why they wouldn’t authorize some test.

regarding allergies, well I sometimes describe t1d as an allergy, just like any allergy, your body immune system rejects either benign proteins (think milk allergy) or actually rejects necessary cells, beta islet cells (as in diabetes), nervous cells (as in multiple sclerosis) skin, joints, and/or organs, like lupus and RA, etc. it’s closely related in my opinion.

hope you are having a better day

Thanks for the response Joe. As for my endocrinologist being a nurse practitioner, that is a good question. The clinic I go to for all of my medical needs is a big one. I wont say the name, but it goes great with sandwiches. For the most part, the place has been pretty good, especially in comparison to some others that look and operate like “garage” clinics. When I had an issue with a previous endo (who was also a NP), I expressed my concerns to the admin staff. I told them that I wanted to see THE endocrinologist from now on. I was told that since he had about a billion patients (true quote…I think…I might be exaggerating a little—but it was alot), they had to ‘farm’ out the menial appointments to NP’s. But I do get to see HIM every 3 years??? And apparently, any requests for a new specialist has to go through my PCP (even from other MD/specialists I see). You got me on that one…

So I been taking the good with the bad, I guess. Trust me, the level of treatment from here is outstanding in comparison to the last clinic I was going to. I think, for now, I will keep my current PCP. I do like the allergy analogy regarding T1D. It makes sense. Trust me though…After reading the report from the allergy specialist, he was not sharing that view at all. But I think that this incident has put my PCP on notice that ALL of my needs require attention. And if he fails again, I be contacting the head physician myself—before I go to another clinic. Thanks for the advice, and for listening. I needed that more than anything else.

Does your insurance require you to have a referral from your PCP to see a specialist? Its not uncommon for people with T1D also have other autoimmune diseases, so keep advocating for yourself. I think that if you feel like you have a good working relationship with your PCP now after emails and whatnot, to try to stick it out, but if its not working see someone else. Each doctor I see is associated with different practices & while its more work to keep all of the separate patient charts up to date, it allows me to see doctors I like.

Also, I wouldn’t be concerned about seeing a nurse practitioner. Depending on your location they likely have a lot of the same capabilities of other doctors. Maybe ask him if he can schedule tests for different autoimmune diseases because if you convince him its necessary, I am sure the doctor he “works under” can sign off on it.

Best of luck! this certainly is one of the frustrating side-effects of disease, but I think you are doing the right things in switching doctors until you find the right one and continuing to advocate for yourself!