How Much Doctoring is Too Much for a Type 1?

This is a tough topic to write succinctly and coherently about. And no doubt I’ll hear back from some readers both agreeing and disagreeing. I am interested in what you guys have to say. So, up front, I apologize for any incoherence. I may be all over the map on this topic.

OK, I get a lot of my news from a lot of different sources. I have RSS feeds for my home page that trickle in from major media outlets such as CNN, CBS, The New York Times, and nearly a dozen others, as well as places such as The Huffington Post and The Daily Beast and The Daily Dish (have you gleaned my political leanings yet?). I also listen to NPR on the way into work.

Lately I’ve been inundated with news about our health-care system. Now, no big surprise there, given that health-care reform is one of the major political issues in Washington these days. However, the reason I want to bring up health-care is because one of the issues I’ve heard quite often regarding this nation’s health-care system has bothered me.

In a nutshell, what concerns me is when I hear the discussion about “Are doctors doing too much?” Are they overtreating their patients? Are they prescribing too many treatments, procedures, medicines, specialists, etc.?

It’s difficult to boil this down to a simple yes or no when I think about it on a personal level. Nationally, I’m sure, this is happening. I don’t doubt it. A month ago I read an article called “The Cost Conundrum”[1] by Atul Gawande, and it was the first time I really started to think about too much medical care. The article explains pretty well the reasons it’s proliferating. And I agree, yes, it seems there’s too much.

Since reading Gawande’s article, I’ve been hearing more and more about this issue of too much doctoring — or, what’s more likely, I’ve been more aware of it. Legislators, health-care experts, other doctors… most people tapped to speak on behalf of health-care reform seem to mention this problem.

For my part, sure, I know the system’s broken, and obviously something has to be done.

But while the system may be broken, there are many places where it works, and there are many ways it’s working wonders on an individual level. For me, the “are doctors doing too much” question is one that I can easily answer: No.

As a person with Type 1 diabetes[2], it doesn’t bother me one bit that I have an HMO and a primary care physician who errs on the safe side by sending me to get an ultrasound to make sure there’s nothing wrong with my thyroid[3], or who will send me to the dermatologist when I am concerned that the sore on my forehead that won’t go away might be basal cell carcinoma.

If she — my PCP — can’t make a conclusive diagnosis from her examination, I don’t want her to think that, because the chances are it’s nothing, she should just send me on my way. I want her to do what she did and tell me that while she thinks the chances are it’s nothing, she’s not 100% certain and wants a trained specialist to evaluate it. In that same way, if my endocrinologist recommends a certain medicine, I’m probably going to go on it. If he suggests I see X specialist or Y specialist, I’m going to do that, too.

See, it’s different, because I have a chronic condition that affects every part of everything related to my health. I want my health-care team to do as much as they can. And yes, I have good health insurance (I’m very fortunate), and yes, it does get expensive to run here and there for this and that procedure or to see this doctor or that doctor. I’m covered, so while I think about the cost, I really only have the small co-pay to worry about.

And with that, I’ll finish the entry for this week. So much more I want to say…

  1. “The Cost Conundrum”:
  2. diabetes:
  3. nothing wrong with my thyroid:

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Eric Lagergren: Eric Lagergren was born in 1974 but didn’t give much thought to diabetes until March 2007, when he was diagnosed with Type 1. He now gives quite a bit of thought to the condition, and to help him better understand his life as a person with diabetes, he writes about it. Eric is the senior editor for the Testing Division at the University of Michigan’s English Language Institute in Ann Arbor. (Eric Lagergren is not a medical professional.)

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