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endocrinologist next to a family doctor

Primary Care Doctor or Endocrinologist?

Diabetes is a very complex disease, so complex that it may require specialists to deal with the magnitude of it. Or does it? There are many knowledgeable primary care physicians (PCP), or as some of us refer to them ‘family doctors,’ who are quite capable of dealing with diabetes. In my end of the world, there seems to be a strong preference for specialists. There seems to be the feeling that a PCP doesn’t have the skill base to deal with diabetes. I disagree, but with a couple of asterisks. If a PCP uses their training to the fullest, they can deal with the complexity to a point but the PCP has to know where their ‘point’ ends and the specialists begins and is needed. Unfortunately, not all PCPs are reflective in their practice and know when to refer out. Here is my list of the pros and cons for care by PCP vs Endocrinologist.

Pros and cons of primary care physician vs. an endocrinologist

Primary Care Physician vs. Endocrinologist

Primary Care Physician

Endocrinologist

Generalist
Specialist/Expert
Has a basic or more advanced knowledge of what diabetes is, the impact on our health and how to treat
Has expert knowledge of what diabetes is, the impact on our health and the expertise to treat/combining treatment options
Often have a long established relationship of trust with the patient
Often meeting at a time of crisis, no trust relationship (yet) with the patient
Can take time to help you understand what diabetes is and treatment options
May or may not have/take the time to teach you about diabetes, may jump to a treatment they decide
May or may not give you a voice in your care
May or may not give you a voice in your care
Will have good/excellent knowledge of common medications for diabetes
Will have expert knowledge of common and new medications for diabetes
Will have basic knowledge about treatment options including lifestyle changes needed
Will have excellent knowledge about routine treatment including lifestyle changes needed, and new treatment options available
May not have the research to back up a discussion about new treatments
Will be able to discuss the research behind new treatments
May be more accessible in person for changes in health related to diabetes (days to weeks to get an appointment, Canadian system; may be different where you live)
May be less accessible in person for changes in health related to diabetes (several months to get an appointment, Canadian system; may be different where you live)

Primary care physicians and endocrinologists can be valuable for diabetes management

As you can see, very much like diabetes, the care we receive and value can be very individual. Some of us will be happy with the care of our PCP, others will be happy with the care of an endocrinologist. For me, I only gave up my PCP when he told me he had taken my care as far as he could with the knowledge he had; it was time for a specialist. And interestingly, I returned to my PCP and taught both he and his Nurse Practitioner about Trulicity injections. PCPs aren’t supposed to know everything about one thing, that’s why they are generalists but many know more than we give them credit for.

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