Talking to Your Doctor

The Support We Need from Our Doctors

David Mendosa Health Guide October 04, 2009
  • When we pick a doctor to help us control our diabetes, with luck we can find one who will support us with action and not just words. Getting practical support is important for us in improving our blood glucose levels.

    When our doctors help us to set goals and proactively follow up their recommendations, their actions are a lot more meaningful than if they are just good listeners and help draw out our preferences. Some of us probably already suspected this, but a new analysis of 3,897 Germans who have diabetes show that empathic listening and eliciting our preferences doesn't help us to achieve lower A1C levels.


    The lead author, Jochen Gensichen of University Hospital Jena, says contrary to what they expected, good communicative support alone didn't help.

    "Patient ratings of physicians' communicative support were not associated with glycemic control," he said. But "measures of communicative and practical support were correlated, so these two forms of support may be viewed as complementary."

    Dr. Gensichen and his colleagues published their findings in the September 29 issue of BMC Public Health. The full-text is available free on-line.

    As a patient who has diabetes rather than a doctor who treats us, I am not as surprised by these findings as Dr. Gensichen is. Few of the doctors who have treated me for my diabetes have given me any support. But two doctors who supported me with their actions made huge differences in my life.

    More than ten years ago I enrolled in a telemedicine program that Dr. Joe Prendergast in Palo Alto, California, organized. I concluded that I was able to control my blood glucose level better simply because I knew that somebody was watching and giving me feedback.

    For more than half a century we have known that people "improve an aspect of their behavior being experimentally measured simply in response to the fact that they are being studied, not in response to any particular experimental manipulation," as a Wikipedia article says. This is the Hawthorne Effect. People in industry know it well, but medical people generally don't seem to have caught on.

    Later, Dr. Joe was a pioneer in prescribing a new diabetes medication called Byetta to hundreds of his patients. Still later, he wrote the foreword to my second book, Losing Weight with Your Diabetes Medication: How Byetta and Other Drugs Can Help You Lose More Weight than You Ever Thought Possible.

    But in 2005 my doctor in Boulder refused to prescribe Byetta. So I did the only reasonable thing and fired him. Fortunately, Dr. Jeff Gerber in Denver wrote me to say that he would be delighted to prescribe it, as I wrote here.

    The actions that Dr. Joe and Dr. Jeff took changed my life. I hope you will be so fortunate in choosing your doctors.