Dealing with your compliant doctor or healthcare professional (HCP’s) might not seem like a problem to people with diabetes but it can be a really big problem. The problem begins when the compliant healthcare provider wants to do everything by the textbook. S/He reams off a list as long as your arm of things you SHOULD do to manage your diabetes but doesn’t give you any information on how you can LIVE with diabetes not let diabetes dominate your life.
They graduate from medical school with the best intentions in the whole world, full of energy, learning and plans to revolutionise diabetes care. Then they meet us, the people with diabetes. The non textbook, non compliant patients who never, never seem do what we are told:-S
Bless!
There are times when my healthcare providers just didn’t give me what I needed. There are times that they made me feel like I was failing in my diabetes management because I couldn’t make what they were telling me to do work like they thought it should. They were being “compliant”. Teaching to the textbook, when I know my diabetes hasn’t read the textbook (thanks Liz Warren for that quote). They still believe that it’s me who is being noncompliant not my diabetes.
Living with diabetes isn’t written in a mass produced textbook. It’s more like a personal diary because each person living with diabetes is different to the next. And in my opinion the less health care professionals talk about “compliance” or “noncompliance” and more about “engaging”, “partnering”, “helping” and “caring” the better.
I’ve had and have very, very good HCP’s but I’ve also had very, very terrible ones, such as the one who had the secretary call me with my HbA1c results and tell me “it wasn’t good enough”. Yes, those are the exact words used. Then there was the one where my I had to make sure I asked for a HbA1c test to be done because they didn’t believe it was important. The one who freaked out about how dangerous ONE nighttime hypo in previous six weeks was! The one who increased my long acting insulin based on my fasting glucose from my labs without reviewing my glucose logbook (yeah, I didn’t do that one) and I could go on but it’s depressing.
So over the years of living with type 1 diabetes I’ve adopted a couple of tactics that protect my confidence in my own ability to manage my diabetes, so to speak. And to make sure that I am an active partner in my own health.
Ways to Deal with Your Compliant Healthcare Professional
Say “No thanks”.
If I don’t think my HCP’s suggestion for my diabetes management is something I’m going to do I say so and give an explanation. Sometimes, they come up with another solution that might work better which is great. If this HCP’s insists I will say “fine” and ignore the advice. When I leave I will make a mental note of who I don’t want to see at my next appointment.
Use the deadpan stare and the power of silence.
I really love this one. It’s kind of like that “Superhero” pose they have started to us in “Grey’s Anatomy”. This is when my HCP says something that I don’t agree with but I’m not sure how I want to respond. I give them a deadpan stare! A serious one and don’t say anything. When I don’t respond to a “directive” my hcp feels compelled to explain further. Great! And then I can respond, hopefully in a more rational manner.
Avoidance
Sometimes, your HCP becomes a parrot or a broken record: giving you the same advice over and over even though you have explained and explained. This is the HCP who does listen or hear. In this case, if you’re lucky enough, you can tell other members of your diabetes team that you don’t want to see that individual again.
Time for a change.
(I think Kerri Sparling from SixUntilMe.com inspired this one but I can’t find the post). If you feel like you have to lie to your HCP to avoid a scolding it’s time for a new HCP. If you’re HCP makes you feel so bad about being honest then this relationship is not going to improve. Unless of course you tell them. This has served me so well. For the last seven years, I have made sure that I have a diabetes team that doesn’t only focus on my failings but gives credit where credit is due. And I travel to access that team because my health is my wealth.
I’m also of an age in life where I don’t hold much back and have very little concern about what others think. This can be a good thing but sometimes I get into trouble;-)
Always remember that a medical degree does not trump years or decades of living with diabetes. They may have taught you all the basics in the beginning but now you have applied that knowledge and adapted it into your own life bringing your valuable experience to the table.