Last year I wrote my first, real Surfacefine blog post during Diabetes Blog Week 2012. I am thrilled to be able to participate again this year as well. For more information on the 4th Annual Diabetes Blog Week (and be prepared to read some really fantastic posts from a variety of perspectives, Check this out http://www.bittersweetdiabetes.com/2013/05/diabetes-blog-week.html :
Here’s today’s topic:
Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see? (Thanks to Melissa Lee of Sweetly Voiced for this topic suggestion.)
Wait a second! Does the blog reading cut into our 15 minutes of seeing our medical team? If so, I’ll just copy the bullet points I read off my phone during my appointments and make those questions into my next blog post!
Alright this is serious, so here goes: My Endo is a T1D. She has been diabetic longer than I have (I was diagnosed in 1979). She is married and has two kids. I knew her long before all of that. I’m pretty sure as a fellow T1D, there would be nothing shocking or even surprising about my blog (well actually that I crack jokes when I write but I don’t have time for that when I see her) Although I have joked in the past that meeting with my endo is like this:
I appreciate that my endo is a T1D too. When I was kid and had been a T1D for a few years, my family switched pediatricians. Yep, we switched to a pediatrician who was a T1D too (what’s up Dr. Selig?). Guess what else? My podriatrist is a T1D too. Do you sense a theme here?
I don’t have anything huge that I would want my doctors to see or not see if they read my blog, BUT if the question were about my health insurance company, then yes, I have a strong opinion on this one:
Dear Health Insurance Company Who I Will Not Name Because As Much As I Fight You, I Also Fear You,
Do you remember last year when you sent me a letter about how I should be getting regular A1Cs and then explained what an HbA1c is? Do you recall how the letter pointed out that I am missing items/tests for “good” diabetic care? Do you also remember that I chose to ignore it instead of confront you on how insulting it was? I did that because you scare the hell out of me. You and I both know I am on a private plan since although I work in a partnership, I am the only one who needs health insurance (as in: others have spousal health insurance or Medicare). We also probably both know that I have found alternative plans over the years but what I would save in premiums would be spent covering deductibles, so here we are.
We started together for a few reasons, but the most important one was my opthomologist had switched plans and I had to scramble. I hope to never know how low I would sink to keep seeing my opthomologist (his group treats a celebrity with diabetes. If that doesn’t matter to you, great. It is a HUGE vote of confidence to me). My primary care physician is also part of your plan and she’s got a great working relationship with my endo so that’s an added bonus. You know who doesn’t participate with your plan? My Endo! Crazy right? Especially because she DID participate with your plan, left her hospital, went into pharma sales, came back to another hospital about 30 blocks away and I am happily back under her care, but she isn’t one of your plan’s endos.
At one point I saw 3 endos in your plan. 1 is my current endo. Another was a very young doctor who although “nice” she seemed to want to be my friend more than my doctor. I stuck with her for awhile although I questioned her T1D experience. She left for a pharma job too. I even had an appointment with her replacement. It became very clear that not only did I know more than he did, BUT that he couldn’t answer ANY of my questions.
So Insurance Company, I have given you the benefit of the doubt with that letter of yours about what I’m doing wrong with my diabetes care. I pay out-of-pocket to my endo. I am beyond lucky to be able to do that. I get all blood work done a week before my appointments, with a prescription, at one of your labs. I don’t get any labs at all done in her office like her other patients. For all you know, I do not see an endocrinologist at all… EXCEPT you pay for my blood work at your labs. You pay for my HbA1c and microalbumin tests. The prescription for the tests and the results come from and go to that very doctor who is not part of your plan. You can continue acting like I don’t see an endo. You can pay for my Dexcom which had all the proper paperwork for medical necessity as did my pump. You can keep covering my ACE Inhibitor under my prescription plan too. You can keep seeing these prescriptions come through my endo’s office and you can remain clueless when I tell you I wave my right to have YOUR on staff nurse (with no specialty in diabetes) review my case to perhaps give me some pointers and recommendations.
Getting back to the question above, my dear health insurance company, you can raise my rate $100 a month EVERY year for 4 years running, and I will work harder to make more money too. I don’t want you to ever see I have a blog. I don’t want to be anything more that a code number to you. I don’t want you to know about my challenges and victories as a diabetic. I will fight you over billing errors, but I don’t want to ever be on your radar. I will spend hours trying to figure out how to work with you and when or if that doesn’t pan out, I will spend those same hours working around you. I’ll keep signing the checks, and take care of myself. You keep making your “suggestions” so I’ll mock you in my blog.
Surfacefine or perhaps Diabetes Batman would be a little more secretive.
Oh, this is great. I am so tired of insurance treating to the lowest common denominator. I’m on a program where I get free test strips and $15 insulin if I’ll subject myself to condescending quarterly phone calls. My favorite question she asks:
“Do you know the warning signs of diabetes?” and then she proceeds to describe symptoms of high and low blood sugars. “Have you experienced any of these symptoms?”
Me: [laughing] “Yes, regularly.”
Her: [crickets] “Umm…”
OMG I want to have those kinds of calls and have totally crazy sounds in the background! Scare them silly! Like a chainsaw. Oh that’s so bad, it’s good! PS “crickets” is my favorite! Ugh the stuff we put up with to take care of ourselves!
I love how you just completely RIP into the insurance company for their illogical actions, tell them how you DON’T want to be friends and DON’T want to get know each other better, how you INSIST on getting your way – with or without them….. and then sign the letter “xoxo”, adding just the right amount of sarcasm!
(You know, almost 32 years with T1D, I’ve never seen a podiatrist. I wonder if I should)
Hey Scott! The xoxo is TOTALLY my charm 😉 . Usually it’s an xo but I figured this one need some extra oomph! And… if you ever want to see a podiatrist in the city, let me know. He’s a cool dude. I wasn’t seeing him primarily for D but I have broken a few toes in my day and my foot (OUCH) and I worry about healing so he’s my go to. I also wear orthotics in my running shoes (please note: I will do almost any other workout than running. If I’m running it’s most likely because I’m being chased).
Love this, Alecia! I’m pretty jealous of your wonderful care team! And I’m totally not jealous of your not-so-wonderful insurance company. 🙂
I love your post! I’m in a similar situation with my insurance company too but I just moved to a new area and haven’t found a good endo yet. It’s great that you have such a good team that you are willing to go out of pocket to see them! Hopefully they know you do that because I have found in the past doctor’s offices sometimes give a discount if you don’t use insurance
I like when the pharmacist tells me, “Many people don’t know that insulin needs to be kept in the refrigerator.” Thank you, your royal medical highness.