A question that I get asked often is, “Who is the best doctor for diabetes care?” What most people are really asking is, “Should I stay with my primary care physician (PCP), or should I see an endocrinologist?”
Do I need a diabetes specialist?
The answer is…. it depends on a variety of factors.
Let’s state the obvious first.
Primary care docs are well-trained to diagnose and manage diabetes. All physicians vary in their bedside manner, time spent with you, and how much they stay up to date with the fast-changing world of medicine. But PCPs know and understand the basics of diabetes and how to treat it.
There are not enough endocrinologists in the world to manage every person with diabetes. It is usually more difficult to get an appointment with any specialist physician, may require further travel or inconvenience to get to the appointment, and it generally costs more than a PCP visit. (My own co-pay is $25 for a PCP and $45 for any specialist.)
There isn’t a right answer for everyone on which physician to see, so consider these questions when working through this decision.
Primary Care Physicians for diabetes care
- Do you have a strong, trusting relationship with your PCP? If so, a health care provider (HCP) who is a good listener can tune in and hear the question behind the question and offer valuable insight into your care. If you have been a patient of your family physician for many years, their support through the ups and downs of diabetes will be important. PCPs are also generally more aware of the cost of medications and will work harder to find a regimen you can afford.
- Do you need frequent access to your physician? If so, PCP appointments are almost always easier to get, especially on short notice. You’ll typically need to have your diabetes monitored at least 3-4 times a year, and possibly more often if frequent changes are made to your medication regimen.
- Do you have lots of complications from diabetes? If so, your PCP will need to be involved in coordinating your care. You could have a cardiologist, kidney specialist, podiatrist, or other doctors, but your PCP will be the person who should keep track of what everyone else is doing. Sometimes it is tiresome to have ONE MORE APPOINTMENT with a specialist, so your PCP could be valuable in monitoring the diabetes plan.
Endocrinologists for diabetes care
- Do you feel your PCP has “tried everything” to help you and still can’t get your A1C down? Sometimes it isn’t a lack of skill on the provider’s part, but the time that they have to spend with you that limits their ability to identify the issues preventing you from A1C success. In any PCP visit, you might be asking about diabetes plus high blood pressure, plus a rash that just came up, plus chronic leg pain, plus insomnia. There’s not time in one visit to adequately address all of these problems, so an endocrinologist could be called upon to address diabetes only.
- Do you need access to advanced diabetes technology tools? Endocrinologists are usually the first to know about new technology related to diabetes care. PCPs are completely capable of managing patients on pumps, continuous glucose monitors and other technology tools, but specialists will usually have more experience and time available to explore these with patients. They are also more frequently exposed to representatives from the technology companies showing off the latest tools on the market.
Certified Diabetes Educators
- Are you newly diagnosed and overwhelmed? In this case, it may not be an endocrinologist that you need, but a Certified Diabetes Educator (CDE). A CDE can spend time with you explaining the basics of what you need to know to live well with diabetes. They have experience from working with many patients and can offer insight and perspectives that you won’t get from a physician. Diabetes education may be offered as in-person classes, or in individual sessions. (I work with people one-on-one over the phone. If you’re interested in learning more, click here.)
Regardless of which physician you see, you are in control of your diabetes journey. I have lots of experience working with family medicine physicians and place a ton of value in the patient-physician relationship and their ability to provide excellent diabetes care. If you don’t have a PCP you love and trust, work on finding another. There are excellent, caring HCPs out there!
If you would like to be seen by an endocrinologist but are having trouble getting an appointment, remember that one option is to get assessed once or twice, then return to your PCP for routine care and monitoring.
Your annual wellness visit can provide a great opportunity to discuss whether an endocrinologist or diabetes education is right for you.
Who is the primary HCP taking care of your diabetes? Let us know in the comments if you would recommend a PCP, endocrinologist or CDE.
Want some quick and easy diabetes-friendly snacks?
With this list, you won't have to wonder what to eat in between meals!
Download it to your phone or tablet and keep it handy, or print it off and keep it by your fridge.