Good Doctor or Bad Doctor?

What is the difference between a good Doctor and a bad Doctor? What should someone expect from their Doctor? What do I personally need to do to assure I get the best medical care possible?

Recently, I was thinking back to a Doctor I had about 20 years ago. The Endo I had previously seen as a youth was in a different city and difficult to see, so I started going to an Internist who happened to be a personal friend. This Doctor was one of the kindest men I knew and his bedside manner (e.g. the compassion he showed to his patients) was incredible. He informed me that he had other Diabetic patients and that his training as an Internist was just below that of an Endo in knowledge of Diabetes. So I trusted his expertise. I trusted him with my life, thinking he'd obviously tell me what I needed to know and do.

As I look at my current level of BG control (A1C = 6.2), I now realize that this Doctor from 20 years ago had not served me well. At the time I was on a single dose of insulin (even though most T1's were then on 2+ shots) and only testing my glucose about once a day. When I had an A1C test and just barely got under 10, he gave me the "you're doing OK, a lot of people are much worse, so just keep doing what you're doing" spiel. I remember well thinking "all I need to do is keep up the same thing and I'll avoid complications". I had been mislead.

I now know that this Doctors encouragement was really a discouragement. It discouraged me from testing my glucose more often. It discouraged me from thinking I needed to keep track of my carbs. It discouraged me from even thinking I should strive for better glucose control. This Doctor, probably due to the busyness of life (e.g. marriage, kids, new house, community activities, etc.) was obviously not keeping up with the latest treatment methods in Diabetes, as I naively assumed. This Doctor (probably because comforting rather than challenging his patients, was his strong suit) had literally failed to help me get the care I should have gotten.

It took years, and both this Doctor and myself moving away from the area before I really started to consider that I might need to take more daily shots and test my glucose more frequently. When I moved to another town I found another Doctor (sadly, only for 1 year) that strongly encouraged me to strive for better control and switch to 4 daily shots and 4 daily glucose tests. Using MDI and more frequent testing my A1C started averaging in the low 7's. Then through the benefits of the Internet, I started educating myself and realized that I needed to take charge of my own health and be proactive (not waiting for a Doctor to tell me I should do something). This past year I went to an actual Endo (the first time in decades, since I'd never been told by any GP's I should), I got on the pump, and I got CGM (all on my own initiative). The improvement in my control and the way I feel is shocking. Why didn't I do this years ago (other than CGM, which is quite new)?

In some ways, I still feel fondly toward that Doctor from 20 years ago (he was a very nice man). I'm sure that he provided good care and service to many of his patients over the years. But I wonder, how many people are getting less than the level of care they should get, just because their Doctor is either too busy, too far behind in treatment advancements, or too nice to kick them in the butts and tell them what they really need to do to achieve optimal health?

How much unnecessary damage was done to my body because I wasn't instructed sooner to take tighter control of my Diabetes? I'll never know.