Switching Healthcare Providers: The Transition form Pediatric to Adult Endocrinologists and All the Switches in Between

March 13, 2018
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Allyson S. Hughes
University of Texas at El Paso
Allyson S. Hughes, M.A. is a doctoral candidate in the Psychology department at the University of Texas at El Paso. She was diagnosed with type 1 diabetes in 1995 at the age of 7 years old.

Switching health care providers (HCPs) can be challenging, especially when seeking a provider who is skilled in type 1 diabetes management for adults. The to-do list is long and includes (but isn’t limited to) building rapport with a new provider, explaining medical history, and also discussing device data and/or medical needs. It doesn’t have to be maddening though. I’ve written some helpful tips to ease the burden of the process of finding a new provider.

To begin with, I believe that it best to approach this process in a positive light and view finding a new HCP as an information gathering mission.

Gather Information on Potential HCPs.

There are several steps to information gathering. First, figure out what your insurance provides. Often insurance plans change approved providers, so make sure that you have an updated provider list. Second, know the difference between HMO and PPO plans—you have to get a referral for HMO plans but not for PPO plans. Knowing what you have (and the hoops you need to jump through to see a specialist) will save you a lot of time and money.

Once you have a list of potential providers, it is time to dig in and gather opinions about them. It’s good to look for HCPs who are up-to-date with current medical equipment and new medications. I recommend:

1) Getting reviews from several sources (the online community, your local community, and local diabetes representatives).

2) Prioritizing what provider details are most important to you (e.g. close proximity, wait time on phone, diabetes devices they are trained on).

3) Assessing availability (e.g. how long it will take you to get an appointment).

Get Ahold of your Device Representatives.

Device representatives’ information can be accessed by calling each company’s helpline and asking for your region’s territory manager or device representative. Even if you do not have a device representative, because you aren’t using an insulin pump or a continuous glucose monitor, know the representatives who are located in your neck of the woods. These representatives see area HCPs regularly and they will be able to give you an insider’s look into: 1) how long it takes to get a new prescription, 2) how long it takes the office to get back to patients, and 3) their fax policy (extremely important for medical billing and prescriptions for diabetes device orders). Overall, device representatives do in-house training and they will be able to guide you in the right direction.

“Device representatives do in-house training and they will be able to guide you in the right direction.”

Reach out to the Online Community and Local Community.

Many members of the Diabetes Online Community (#DOC) are located in the same state as you. In fact, several groups make it a point to connect local members. Find these members and see what hospitals and clinics they recommend. Other sources of local information are support groups in your area or a College Diabetes Network Chapter nearby (you can email CDN to get in touch).

“Do not be afraid to bring a list of questions for the HCP, but also be prepared to provide your new doctor with your medical history as documented by your previous physician.”

Prepare for the Appointment.

After you have collected the relevant information about your new provider, it is important to go into your appointment completely prepared. Maybe you need some new prescriptions, some advice on basal rates or a referral for another physician. Do not be afraid to bring a list of questions for the HCP, but also be prepared to provide your new doctor with your medical history as documented by your previous physician. Often physicians need a few weeks’ notice in order to get the documents to your new provider. In addition, do not forget to bring an updated list of medications to your appointment. Lastly don’t forget bring anything that technicians may want to download: meters, pumps, and CGMs. Let your provider know exactly what you need and how they can help you- this is their job! This is a great way for you to be your own advocate and stand up for yourself.

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