PCP recommendations for Duke area?

[Ray_Of_Fricken_Sunshine]

I'm relatively new to this area, and when I moved here, I immediately found my endocrinologist who just happens to be my gynocologist, as well. I asked her for recommendations for a PCP, but she just gave me a generic list of providers. I had researched a handful, but none of them were accepting new patients. The one I was assigned is awful. We clash and I think she's an uptight princess and I don't like her, but even more importantly, I don't trust her.
So, since I'm in the market for a new PCP anyways, I was wondering if y'all knew of anyone that was DS friendly here in the Dirty Durham? I've asked the surgeon's office, and they didn't have any recommendations. I hate picking a Dr. out of thin air. (In my best Forrest Gump voice) Ya never know what you're gonna get.
I have the document @DianaCox posted once you find one, but... Baby Steps.
I just know that I'm going to need one after surgery!

 

[southernlady]

Start with a younger one, not set in their ways. One criteria I use is the list of labs Dh and I need. Between that and the list of vitamins we take is a good indication. If they don't go screaming to the hills, there's a good chance of educating them.

I had one (I fired him) who told me I didn't need Cytomel (a thyroid med I'm on) cause my number was fine. My number was fine BECAUSE I took the med!

The one I've had for the last 3 years was worth educating. He didn't question my need to have my list of labs pulled every 6 months. He understands that Dh and I have small bowel malabsorption (although he still wants to refer to it as a gastric bypass) and deals accordingly with our meds. It's why I was able to get a referral to a hematologist for iron infusions without argument. It's why he went straight to the infusion drugs for bone health (I have osteoporosis). It's also why, now that my diabetes has made a return, while we are starting with metformin, the next step if needed is an injectable NOT a pill.

He also expects me to manage my own vitamin levels adjusting as needed.

At one point he was trying to bail on us...sent us to a local bariatric surgeon. The trip wasn't wasted because it accomplished several things:
1) The surgeon informed our PCP to continue to do our requested labs
2) We discovered the surgeon did know and understand the Hess Method DS and the requirement for extensive labs
3) We also found out that while he knew and understood the DS, he chose to not do them in his practice focusing on the RNY and VSG only. It's frustrating but I respect his choices.
4) He agreed that if either of us had an emergency complication DS related, he would be our surgeon but for most abdominal issues, a good gastro is all we would really need.

Oh, and another thing WE had to recently consider is how to handle a PCP while living full time on the road in our RV. Thanks to the fact that we are fairly stable in our needs, the state of the art of online access, we are able to keep our current one for awhile. I hate breaking in new PCP's.

My PCP and I discussed how to handle my requirement for his input on my diabetes. He wants to pull an a1c at the recommended 3 month intervals AND see my log book of testing. Both can be handled thru the portal for the hospital system his office is a part of...he set up a flow sheet for me to use for the blood testing daily and will send lab orders thru the system for me to get at a lab corp or quest wherever I am.The 3 month ones will just be the a1c but the 6 month ones will still be our DS labs.

When we were setting all this up, he asked me to see why some of his patients were having problems finding the chart or inputting the numbers needed (he also uses this system for his patients who monitor blood pressure who travel all summer and are computer challenged).

 

[Ray_Of_Fricken_Sunshine]

That's really cool that your doctor is willing to do all of that. I feel that so many doctors are so condescending, and would never trust a patient that much!
How did you find that doctor, though? Was he recommended? I think that's my problem... Y'all have given me a lot of tools to use once I find a doctor. Are there certain ways to search for DS friendly docs? Is there some sort of secret data base!? Because to me, it seems like we just have to look at the list of hundreds of doctors approved by insurance, and just kindof close our eyes and point! I'm not trying to be dense, but is there any type of sorting process that we can use before we go and spend the money to have the first appointment? Or do you just keep trying lots of initial appointments until you find someone who you feel will work with you?
Sidenote: You live in an RV year round!? That is SO SO awesome! My husband and I always talk about doing something like that after my son moves out. I saw pics of you once outside of an RV, but I just assumed it was a weekend excursion! How wonderful! Do y'all just drive until you feel like stopping, or do you have a "home base" that you typically stay around?

 

[southernlady]

That's really cool that your doctor is willing to do all of that. I feel that so many doctors are so condescending, and would never trust a patient that much!
How did you find that doctor, though? Was he recommended? I think that's my problem... Y'all have given me a lot of tools to use once I find a doctor. Are there certain ways to search for DS friendly docs? Is there some sort of secret data base!? Because to me, it seems like we just have to look at the list of hundreds of doctors approved by insurance, and just kindof close our eyes and point! I'm not trying to be dense, but is there any type of sorting process that we can use before we go and spend the money to have the first appointment? Or do you just keep trying lots of initial appointments until you find someone who you feel will work with you?
Sidenote: You live in an RV year round!? That is SO SO awesome! My husband and I always talk about doing something like that after my son moves out. I saw pics of you once outside of an RV, but I just assumed it was a weekend excursion! How wonderful! Do y'all just drive until you feel like stopping, or do you have a "home base" that you typically stay around?

Honestly I got lucky. He was my daddy's PCP and I was able to sorta interview him for us when I was there with my daddy. We had just moved to that area.

As far as the RV, we've been full timing for almost 2 months now. The IRS considers FL our home state but other than 2-3 months of winter, home is where we park it. And even in FL, we will be in an RV park. We are looking along the Panhandle area kinda near Tallahassee as my sister/BIL lives there. She has her own vet clinic. So she's all our critters vet of record.

 

[Ray_Of_Fricken_Sunshine]

@southernlady I wish there was a system. I tried calling my insurance company and asking if any of the PCP's specialize in DS or even bariatric knowledge. Dead Air. Oh well...

That really is cool! My sister lives in the Pensecola area. Sounds like you have an amazing setup! I'm super jealous. Are y'all retired?

 

[Clematis]

A suggestion, Ray: go to different WLS group meetings (doesn't necessarily have to be group meetings sponsored by your surgeon) for the sole reason to ask the attendees who their PCP is and what they think of him/her.

I have been through 3 PCPs leading up to DS through now and none of them had heard of DS. All you need is someone malleable and willing to write the lab orders -- YOU keep the excel spreadsheets of the results and adjust your own vites.

 

[Ray_Of_Fricken_Sunshine]

@Clematis That's a great idea. There are 4 "support group" meetings per month with Duke Weight Loss program. I can ask people there. They ask that their prospective patients attend at least two of these group meetings, and I have only met one individual that had a DS. He was 6 weeks out, and couldn't wait to brag to me that he had already eaten several pizzas, and he was still losing weight.
Anyways, yes, that is a great idea! Thanks!!!

Oh, and by "Adjust your own vites", you mean bring them here and beg y'all to teach me, right!?!?

 

[southernlady]

Oh, and by "Adjust your own vites", you mean bring them here and beg y'all to teach me, right!?!?

LOL, we will help but some of your own work is required.

 

[Clematis]

Always ask to receive a copy of the lab results. (Mine are available online through My Chart.) Lest you think a PCP looks through the reams of results, they don't. The LAB marks results above (H) or below (L) norms so their eye usually just scans that column. You'll know immediately which vitamin/nutrient/mineral you need to adjust. However we also like to be high normal in some labs and low normal (like PTH) in others.

If you are familiar with excel, it helps to keep your results in one worksheet so you can scan across and note trends up or down. It's also helpful to take a copy of this to doctors appointments. You can also record all this by hand.

 

[southernlady]

That really is cool! My sister lives in the Pensecola area. Sounds like you have an amazing setup! I'm super jealous. Are y'all retired?

Yes. we are...both of us disabled/retired.

 

[Ray_Of_Fricken_Sunshine]

LOL, we will help but some of your own work is required.

Yes Ma'am!!