This is the first of several posts reviewing the individual spokes (or clusters) of help in my Diabetes Wellness Wheel. This post focuses on Medical Professionals … below is the Diabetes Wellness Wheel, evaluation criteria, my assessment of 2022, and the adjustments planned for 2023.
Diabetes Living Well Model
Diabetes wellness requires patient partnerships with trained medical professionals to inspect, measure and improve our diabetes wellness and results. Our medical professionals include:
- An endocrinology practice with endocrinologists and certified diabetes educators
- A primary care practice with physicians and nurses
- A dental practice with dentists and dental hygienists
- An Ophthalmologist
- Other specialists as needed
- Knowledge of their specialty area
- Working prescriptions and prior authorizations with insurance companies
- Bedside manner
Assessment (Score: 3 of 5; 5 = high)
- I continued to work with the same endocrinologist and Certified Diabetes Specialists (now over a decade). Scripts and Prior Authorizations with insurance companies were timely and effective (I spent little time with these). I was disappointed with their knowledge of Basal and Control IQ algorithms when I was evaluating the Tandem Diabetes X2 pump. I was even more disconcerted by their lack of engagement in my diabetes care during my two hip surgeries.
- 3 of 4 quarterly teeth cleanings were done … the Q4 cleaning was missed due to hip surgery (not permitted within 90 days of surgery). My dentist is thorough, consistent, and reliable. I rely on the practice for my oral health.
- Missed a scheduled10-year colonoscopy scheduled in December due to hip surgery (not permitted within 90 days of surgery).
- Results from my annual physical and blood profile were in normal ranges, except for the 6.1 A1C (but I’ll take it!) and chronically low white blood cell count levels. My PCP and staff were accessible and responsive, except for their lack of follow up after my hip surgeries.
- My annual eye exam was with a new Ophthalmology practice recommended by my Endocrinologist. The doctor did a thorough check that included dilating my eyes. He described a few micro background retinopathy spots but said they were nothing to be worried about. For me, these come and go. All good here.
- I did not have a choice in my orthopedic surgeon for my hip fracture surgery as I was taken to the closest emergency room immediately after my fall while cycling (he was the on call surgeon). Two weeks later it was deemed unsuccessful and the practice recommended a hip specialist to perform a total hip replacement. There were options, but after researching them I chose to work with the recommended hip orthopedic specialist in the same practice. I am still in recovery, but the prognosis is good.
- Even though all of my physicians are in the same hospital system, there was no coordination during and after my hip surgeries. I was advised that the lead is my PCP, but repeated calls to them were not returned.
2023 Plan & Adjustments
- Continue to rehab my left hip with the hope of being recovered in Q1 or Q2.
- Commence a search for a new endocrinology practice as the CDEs were not knowledgeable about smart pump algorithms and the practice fell short of my expectations during my two hip surgeries.
- Continue a relationship with my PCP practice. He is toward the end of his career but is part of a practice with triage nurses, Physician Assistants, and a large hospital system. They are effective with my annual physical, blood labs, specialty referrals, and treating the occasional cold or sinus infection. They are responsive and have excellent bedside manner.
- Quarterly teeth cleanings restarted in Q2.
- 10-year Colonoscopy procedure done in Q2.
- Annual physical in Q2. Inquire about the breakdown following my hip surgeries.