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Question:

From Waco, Texas, USA:

I am now 21 years old, have had type 1 diabetes since I was five, and I have had the hardest time finding an endocrinologist since I moved. There are only two clinics I can attend with my insurance -- one will not accept new patients unless they have cancer, and the other I am currently using, but I have had the worst experience with the doctors there.

I was told I had kidney failure, sent on my way, and, two weeks later, I was informed it was a "scare tactic." They changed my insulin from NPH with Regular to NovoLog and Lantus which caused radical changes so I tried for over a week to get back with the doctor, but my calls were not returned. My most recent experience involved the nurses not calling in my prescription refill and then having to hassle with doctor after hours to call it in. I do not care if I have to drive two hundred miles, but I need to find a new doctor who is good. Where can I find recommendations?

Answer:

I am not familiar with the medical professionals in your area. I would suggest that you contact the local diabetes educators association. They might be able to share with you the general reputation of other diabetes specialists in your community.

As for your insurance, I would strongly recommend that you contact them to complain about the experiences you have had with their providers and demand that they provide you access to other providers in your community. If they refuse, contact the Consumer Services Bureau of the Texas Department of Insurance and tell them that one of the two providers in your insurer's network is not seeing new patients and the other provides sub-standard care. In my past dealings with TDI, I have found them to be very pro-consumer and very pro-diabetes.

DSH

Additional comments from Barb Schreiner, diabetes nurse specialist:

It is frustrating when an insurance plan dictates who your provider should be. You are wise to look for a diabetes care professional who you can work with ! You might try practices in Dallas or Austin. Both cities have fine diabetes endocrinologists. I would suggest contacting the American Diabetes Association for names of physicians in these cities. One other suggestion. If you are unhappy with the benefits in your insurance plan, talk to the person responsible for purchasing your plan. This is usually somone in the human resources department of your employer.

BS

Additional comments from Lois Schmidt Finney, diabetes dietitian:

It sounds as though you need to seek care elsewhere, even if it means a bit of a drive. It looks like Dallas is not too far, so I would suggest looking for a diabetes team there. It is best to see your team every three months, but they may be okay with other arrangements. Do seek the care you feel you need.

LSF

Additional comments from Dr. Philip Ledereich:

Some suggestions:
  1. Contact the insurance company and let them know about your experience. They may "counsel" the physicians at that location and possibly get you better care.
  2. If they do not give you better care, consider asking the insurance company to allow you to go out of network.
  3. If the insurance company does not allow you to go out of network, you can complain to the supplier of your insurance (e.g., employee relations at work)
  4. Consider complaining to the physicians' employer if they work for a hospital.
  5. Complain to the supplier of your insurance (e.g., employee relations at work)
  6. Consider asking for help from the American Diabetes Association.
  7. Consider calling your state insurance board and your local government representatives about your situation asking for help.

PSL

DTQ-20030105122133
Original posting 10 Jan 2003
Posted to Community Resources

  
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Last Updated: Tuesday April 06, 2010 15:09:42
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