Why must people be obsessed with testing their blood sugar? Its about 3 times a week where I run into the typical uncompliant patient who needs a refill on 100 test strips they picked up 2 weeks earlier. A quick scan of their profile shows only oral meds, no insulin, and uncompliance. So then the 20 questions starts:
- Are you on insulin? “No”
- Do you adjust your oral medications based on your readings? “No”
- Do you have any problems working your machine? “No, it works fine”
- Do you waste strips or get errors which make you waste strips? “No, this machine is easy to use”
- Do you bring your doctor your machine to look at? “No”
- Do you do anything with the readings other than just collect them? “No”
- Why do you test that often then? “Doctor told me to”
- So if the doctor told you to wipe your ass 20 times a day even though you dont need to, you would do it? (alright, so I didn’t ask this question.. 🙂 )
- Its been a month and a half since your glyburide refill, did doctor change the directions? “No”
- Then why do you test this often even though you don’t do anything with the results? “Doctor told me to, I dont know. Is my vicodin due yet?”
At this point my head explodes as I fight the urge to say “Your doctor is an idiot”. What doctor worth any sort of medical degree will tell their patients whom are solely on oral meds to test 5 times a day? They aren’t adjusting insulin nor are they adding additional doses of glyburide or anything like that. Does the doctor realize that test strips average about $1/test? Oh, wait, $ + MD = ???
Patients on insulin is another issue because these patients are expected to adjust their dosage based upon readings (sliding scale) or will call the doctor for dosage adjustments (Take as Directed as sig). So I very simply put that if they are on ORAL MEDS then they only need to test once maybe twice a day.
Hell, I have patients who after getting 10 test results of 112 every morning they pretty much assume that the next one is going to be around 112 and test every other day or every 3rd day (These are the patients who pay cash for the strips, go figure). But of course, being on Medicaid/Medicare with your FREE/Low copay test strips means that you can just waste them as you wish, because they are in fact “FREE” and the nanny government will in fact supply you with more because you are too fucking stupid to use some common sense.
Best dialogue I ever had:
Me: “The F in Pharmacy stands for Free”
Them: “But TAP, there is no F in pharmacy”