My six year old son is on a pump and doing great, but I need to find a new doctor for my son’s diabetes care. There seems to be only one doctor in this town who treats pediatric diabetes, and I cannot get along with the nurse practitioner who disapproves of me also. There is a doctor who comes once a month from elsewhere, but he said that he wouldn’t have put child as young as my son on a pump and that he doesn’t like the pump. I am not getting rid of the pump. Do you know of anyone who would treat kids? Any suggestions?

It can be frustrating to have few options in your community! There are some web sites that can help to locate a qualified professional. One lists professionals who have applied and received the American Diabetes Association Provider recognition. Another way is to call local education programs that are nationally recognized. Speak with the educators in the program. They often are able to recommend local physicians and specialists. The ADA web site maintains an updated list of recognized programs.

By the way, there is a national shortage of pediatric endocrinologists, so locating one may require some travel.

BS
Additional comments from Jane Seley, diabetes nurse specialist:

You have some difficult choices here. Either you see a doctor who doesn’t offer the management you prefer for your son or you see a doctor with a co-worker you don’t get along with. Is it possible for you to talk to this doctor about your difficulties with the nurse practitioner and see if he or she can help you smooth things over?

I would rather see you stay in the practice where you are receiving excellent care for your son and find a way to get along better with the nurse practitioner. The only other possibility is to travel to another town, and I don’t know how difficult that is for you.

JS
Additional comments from Dr. David Schwartz:

For anonymity’s sake, I will not provide specifics, but my directory of members of the Pediatric Endocrine Society in North America (actually called the Lawson Wilkins Pediatric Endocrine Society) does not list a member from your city in Texas. However, within your state, there are several very good pediatric centers that have pediatric endocrinologists.

You indicate that the visiting physician is not fond of using an insulin pump in this age child, but that does not necessarily mean that he would not be willing to help manage your son. Everyone may learn something. Perhaps an open dialogue is all that is required.

However, if you are willing to travel, contact the other large pediatric centers many of which are associated with medical schools. When you call them, ask if they have “outreach” or “satellite” clinics that may be nearer to your home.

As for the tense relationship with your local nurse practitioner, it’s best to reach a compromise there also (“agree to disagree”) because in an emergency, you will be using the closest place, not one you have to travel to. Besides, who put your son on the pump? If it was your local doctor, why not relay your concerns with the staff to him? I think you may benefit from a periodic consult with a pediatric endocrinologist if your local physician mostly cares for adults and is not certified in pediatric endocrinology.

DS