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Question:

From Rowland Heights, California, USA:

My five year old son, was diagnosed with type 1 diabetes a month ago, received excellent treatment by the hospital, but we encountered trouble after leaving. My son's pediatrician doctor and HMO referred us to an endocrinologist who sees children two days a week and adults three days a week. This doctor does not have a diabetes program nor does he have a dietitian or any type of counseling for my son or the family. Shouldn't HMO's refer families of a newly diagnosed child to a doctor that has a program and will follow-up with that child?

Answer:

describe. When I was working in a hospital setting, newly diagnosed children stayed at least five days for the education of the parents and to stabilize blood sugar regimens. Now, it is unique for a child to even spend one night in the hospital at diagnosis. Parents and children must have follow up! It is like being told you have to learn a new language without a teacher. It is frightening.

I tell folks to be very proactive in finding a team to work with their family. I suggest contacting the local Juvenile Diabetes Research Foundation and American Diabetes Association for recommendations in your area. Network with other parents and get their feedback. Diabetes is a family condition and the entire family needs support and education. That is my $.02 worth of input.

CMB

Additional comments from David S. Holtzman, Esq.:

I would take your concerns to the child's pediatrician. He is the primary care physician for your child and usually is the gatekeeper to specialist or health education programs. Get your primary care physician to make a referral to a diabetes education program that is covered by your plan. If you have a point of service option as a part of your plan consider going outside of your network to obtain the care you would feel most comfortable with, but be prepared to pay the deductibles and co-pays usually associated with point-of-service providers.

DSH

Additional comments from Dr. Stuart Brink:

You are correct but with HMOs and some other insurance companies in the USA, you will sometimes have to be an advocate for appropriate and reasonable care. You should demand and insist that you see a board certified pediatric endocrinologists with a diabetes education program. The folks at children's hospital in L.A. are excellent. You can also call them yourself and they may be able to give you some advice about how to get into their program.

SB

Additional comments from Dr. Larry Deeb:

I will go ahead and say it for myself and the children I care for. Push them as hard as you can -- your child deserves the best.

LD

DTQ-20030127031601
Original posting 1 Feb 2003
Posted to Insurance/Costs

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