Primarily careless

I should Probably thank Rachel for the inspiration for this post (Lord knows I’ve been short on it lately, exhibited by my sparse blogging as of late). And, depending on the response I get from you folks, perhaps I should thank her for inspiring me to do something that will be good for my health long-term.

But anyway. here’s the confession: I don’t have a so-called “primary care” doctor.

In fact, I’ve only had one PCP in my entire life. He was young and naive when I started seeing him. I was one of his first-ever patients, and my propensity to pee without discretion (as babies often do) was a quick lesson to him in why he should leave the expensive silk ties at home. He was a smart guy though, which is evidenced by the fact that, six or seven years later, he postulated diabetes when – even today – many pediatricians would dismiss the symptoms as “nothing to worry about”. But Dr. Goldman was a pediatrician, and by the time I reached college age, that waiting room filled with wooden blocks and colored beads on a twisty wire just didn’t appeal to me anymore. So I told my mom that I didn’t want to go back. She understood.

In college, they had the Health Center. I’m not quite sure what they did there, but it sufficed for my medical needs while I was on campus. During semester breaks, I figured I could see my father’s doctor if the need arose. It never did.

Of course, I still had my regular endocrinologist (I had also graduated from a pediatric one to an adult one) to take care of my diabetes.

When I got my first job and had to sign up for a health plan, I was in for a bit of a shock. I’d always been under my father’s plan and didn’t worry about it, but now I had to select from a bunch of plans, all with varying premiums, payments, and rules. Somehow I ended up on an HMO and needed to designate a primary-care doctor. Somewhat arbitrarily, I again chose my  father’s PCP but had never seen him. It’s a good thing too, I suppose, because a few years later he was arrested for doing certain inappropriate things to certain patients that no one should ever do to anyone – and I’ll leave it at that.

That job — and that insurance plan — didn’t last long. I’ve never been on a plan that requires PCPs or referrals since then. And I’ve never had someone, other than an endocrinologist who tended to a very specific, focused need, since,

Sure, I’ve seen doctors. Sometimes they were at the “instant care” clinics where you don’t need an appointment or a prior relationship with the doctor (these are not Urgent-Care centers, they are more like a medical McDonald’s, where you come in, wait in line, and eventually get some mediocre service from a doctor who can’t seem to rely on repeat business).

Once, when I was particularly ambitious about resuming a healthy lifestyle, I made an appointment with a real so-called “family doctor”, just to have him examine me (beyond my pancreas) and make sure I was OK – and to hopefully build a relationship for future needs, but he repeatedly questioned why I was even there. Another time I made an appointment with a local practice because of a killer ear infection — all I remember is that the doctor’s first name was Brandon, he used the term “like” a lot, and I’m pretty sure he was born during Beverly Hills 90210’s heyday. Being in my late 30s, putting my well-being in the hands of Dr. Doogie just didn’t sit too well with me. I got my antibiotic, but I haven’t been there since.

Still, every time I see a specialist (whether diabetes-related, like an ophthalmologist; or non-D related, like a dermatologist) there’s a line on the form asking who my “primary doctor” is. Either I put my endo’s name there or I leave it blank. It always leaves me feeling a bit guilty — like I’m neglecting a part of my health.

When one has Type 1 diabetes, it most certainly is responsible for 99% of the ailments that person faces, but every so often, “real-people-sickness” rears its ugly head. Then what?

I’m happy with my endocrinologist. I’m happy being part of the ninety-nine percent. But should I have someone to handle the other one percent?

Should I get annual (or semi-annual, or once-a-decade, or whatever) physicals? I’m pretty sure my blood-work will all come out fine, but that I’ll only last two or three minutes on a treadmill. So what?

What would you do? What DO you do? What should I do?