Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Manager of Marketing at T1D Exchange.
With Medicare Part “B” covering all my DEX and Tandem stuff, including Insulin. Along with my Federal Blue Cross Blue Shield, secondary Insurance. All’s well for me, nothing out of pocket.
Since going on MEDICARE – I am told I must see my provider every 90 days or no supplies will be dispensed from my DME provider. I have been going to a provider that lives 5 hours from me & I have been seeing this provider since the early 1990’s..
I may need to change now as since retired my income has changed anad i am unsure if I can afford
the gas to make the 5 hour trip. I have moved several times since starting to see this excellent provider(s). The state that my provider lives in requires that he/she be licensed in the state where they provide telehealth. They are not licensed in the state where I reside. It would not be cost effective for them to obtain this license at this time. So I may be looking for a new provider in the near future with the cost of gas & inflation! Sad!
I guess it’s age and diabetes going in tandem that led me to live in a city. I love being out in the country, but the time has come to be closer to providers and the drug store. Tomorrow is the 82nd birthday, and 68th anniversary since being diagnosed. Time sneaks up when you’re having fun!
Sadly, it did not when we relocated from New England to Florida nearly 20 years ago. I had excellent access to board certified endocrinologists when I lived in New England. They were affiliated with University hospitals and located within a 30-minute drive. We relocated to a more rural county about 90 minutes north of Tampa. There are NO board -certified endos in my county. In general, unless I wish to travel over 1 hour (to either Tampa or Gainsville), I feel that the quality of health-care here is not up to the level I enjoyed up north….and, as we age, access to quality health-care becomes even more critical.
I live near Cleveland Ohio. This area has world class medical services along with wonderful parks, sports, cultural events, and more not to mention we have the worlds largest fresh water reserve- the Great Lakes.
OTHER: I do insist on finding the best medical providers, including people who know diabetes, but that didn’t prevent me from leaving the world’s leading diabetes professionals [decades at Joslin Clinic in Boston] and move 1,700 miles away. After moving, I did seek out and find good medical care including two who understand T1D.
If I make any future move of residence, diabetes specific medical care will not be a primary deterrent as long as there is a relatively closeby facility with a physician who is open and able to listen.
I thought I hit no and when I hit the submit button I saw yes! I do not worry about the proximity of my health care provider. I will travel as far as I need to for good medical care.
I know that I considered it 50 years ago, more specifically public transportation access, when I was moving while pregnant. And now, no longer driving and considering moving closer to one of my children, available health care is certainly a consideration.
I said “other”. When I was young, and working, “no”. I used to drive 10 hours, round trip to see my Endocrinologist at Joslin in Syracuse, NY. I’m sure there were other Endo’s closer to me. I chose where to live based upon where my employment was located.
Since retirement, we moved to a warmer climate, and living near access to an Endocrinologist was an important part of where we chose to live.
Usually that was not a problem, since I have lived mostly in urban areas with plenty of endocrinologists. But I did live for 12 years in a rural area where the nearest sizable town was an hour away, and it had only one endocrinologist for that county and a few surrounding ones. Boy, was he ever busy! That town, Redding CA, with its population of around 100,000, could certainly use another endocrinologist.
Definitely. We have been considering moving to a different state. I live in the Seattle area and have had world-class care through the University of Washington Medical center. Proximity to health care is very high on the list of criteria. I have other health issues, kidney transplant, and a meningioma in the brain, which was benign; so a high-class health complex is important where we move next.
Yes, it certainly does now, it didn’t as much when I was younger. Transportation to/from medical appointments has become a major consideration now that I’m no longer driving and the pandemic eliminated the volunteer transportation assistance organization I had previously used. Even living in this urban environment with a relativity large number of physicians it’s still difficult to get consistent knowledgeable care on a timely basis. It requires making appointment far in advance and then being able to keep them.
I live in a small city about 65 miles north of Austin Tx. The town I live in does not have an endo so I prefer to just go to the endo that I used when living in the Austin area. If I could find a good endo closer to me, I would consider switching (i.e., $5.00 / gal gas……)
Most definitely. I have a multitude of health concerns one of which causes me not to drive and that need specialists, not GPs. We live in a city with many hospitals less than twenty minutes away that I can use buses for whose transportation keep improving.
Interesting question. I recently switched from a local endo to one in NYC, about an 8 hour drive or short flight away.
When I was first diagnosed, I used the endo assigned to me at the hospital. They were good, but not a good fit for me. When a bad snowstorm forced me to use telehealth, it got me thinking… why am I using an okay doctor when telehealth works for most appointments and my insurance covers any doctor in the state. So, I found an endo that is perfect for me. I’ve been incredibly pleased with my teleheath appointments with her and her staff is amazing. Although she’s not requiring it, I’m having my first face-to-face visit with her in July, followed by a long NYC weekend. Finally, T1D is an excuse to do something fun!
p. s. My local primary care doctor approved that this set up is medically sound before I transitioned to the new endo.
I would say yes in principle, but I does take me at least 90 minutes in order to get to see him. I can however communicate via phone or email if necessary.
It does and it doesn’t. I moved to a huge area with tons of endo’s and couldn’t find one I could tolerate. So I drive 6 hours round trip to see my Endo once a year and the rest are video or phone call appts. 💯 Worth it.
I’ve lived in areas where the closest endocrinologist was a 140-mile drive to Reno, Nevada with few towns, people or even cacti in between. Easy-peezie in the good ol’ days.
Then as the ravages of age take their toll – diminished eyesight, diminished public transport, diminished cognitive abilities – and guess what? Proximity matters.
So now, the answer becomes, Yes. Talis est via mundi. ╭ (o ㅇ‿ o#)ᕗ
While I have not let this affect where I live, I do miss my old doctors. It is very difficult to find new doctors in my current area that “measure up.”
From what I’m reading I’ve only seen one “good” endocrinologist in 24 years, and the lone knowledgeable primary physician died during first year of diabetic care. I’ve seen 5 specialists, the only one I’d consider efficient was during those medical trials when my diagnosed mysteriously changed from TYPE 2 to TYPE 1.
These two stressed never let anyone dictate my diet, meds, exercise, or life because they don’t work my hours, cook my meals, nor live my life. I had two specialists before those medical trials, two afterwards; but at least the last got me to consider the pump with a CGM.
I now see a GP 5 minutes from my home for convenience, altho he offered to send me to the local hospital to see a specialist (his first visit said he doesn’t see TYPE 1 patients because of their needs, until we talked and he saw my a1C, he agrees to all my requests including my last to add metformin to my care). I’ve since found the end~ that refused my request to start insulin 21 years ago saying I was too old to be a TYPE 1, with instructions to lose more weight (already 20 lbs underweight) is considered a top board certified endocrinologist. I follow the instructions of those two doctors and read everything on diabetes: now listen to various podcasts and blogs on TYPE 1. Thanks to the internet I visit boards from the ADA, I read literature and periodicals, and news releases. With UAB and the Babtist Health system Birmingham I’d considered a top tiered medical community but results vary, sometime I feel better educated than those educated.
40 years ago, yes it did. But now, with Telehealth and CGM/Pump data available via websites, proximity is not a requirement. I am blessed that the community I moved to after college had one of the best endos in the state.
With Medicare Part “B” covering all my DEX and Tandem stuff, including Insulin. Along with my Federal Blue Cross Blue Shield, secondary Insurance. All’s well for me, nothing out of pocket.
Since going on MEDICARE – I am told I must see my provider every 90 days or no supplies will be dispensed from my DME provider. I have been going to a provider that lives 5 hours from me & I have been seeing this provider since the early 1990’s..
I may need to change now as since retired my income has changed anad i am unsure if I can afford
the gas to make the 5 hour trip. I have moved several times since starting to see this excellent provider(s). The state that my provider lives in requires that he/she be licensed in the state where they provide telehealth. They are not licensed in the state where I reside. It would not be cost effective for them to obtain this license at this time. So I may be looking for a new provider in the near future with the cost of gas & inflation! Sad!
I guess it’s age and diabetes going in tandem that led me to live in a city. I love being out in the country, but the time has come to be closer to providers and the drug store. Tomorrow is the 82nd birthday, and 68th anniversary since being diagnosed. Time sneaks up when you’re having fun!
Happy birthday!
Sadly, it did not when we relocated from New England to Florida nearly 20 years ago. I had excellent access to board certified endocrinologists when I lived in New England. They were affiliated with University hospitals and located within a 30-minute drive. We relocated to a more rural county about 90 minutes north of Tampa. There are NO board -certified endos in my county. In general, unless I wish to travel over 1 hour (to either Tampa or Gainsville), I feel that the quality of health-care here is not up to the level I enjoyed up north….and, as we age, access to quality health-care becomes even more critical.
I live near Cleveland Ohio. This area has world class medical services along with wonderful parks, sports, cultural events, and more not to mention we have the worlds largest fresh water reserve- the Great Lakes.
OTHER: I do insist on finding the best medical providers, including people who know diabetes, but that didn’t prevent me from leaving the world’s leading diabetes professionals [decades at Joslin Clinic in Boston] and move 1,700 miles away. After moving, I did seek out and find good medical care including two who understand T1D.
If I make any future move of residence, diabetes specific medical care will not be a primary deterrent as long as there is a relatively closeby facility with a physician who is open and able to listen.
I thought I hit no and when I hit the submit button I saw yes! I do not worry about the proximity of my health care provider. I will travel as far as I need to for good medical care.
I know that I considered it 50 years ago, more specifically public transportation access, when I was moving while pregnant. And now, no longer driving and considering moving closer to one of my children, available health care is certainly a consideration.
I said “other”. When I was young, and working, “no”. I used to drive 10 hours, round trip to see my Endocrinologist at Joslin in Syracuse, NY. I’m sure there were other Endo’s closer to me. I chose where to live based upon where my employment was located.
Since retirement, we moved to a warmer climate, and living near access to an Endocrinologist was an important part of where we chose to live.
I travel 75 miles each way to continue care since he moved. Absolutely worth it!
We had chosen a location that had 2 medium sized medical complex 30 miles a way, where my Endo’s office is located. UVA is 90 minutes away….
Usually that was not a problem, since I have lived mostly in urban areas with plenty of endocrinologists. But I did live for 12 years in a rural area where the nearest sizable town was an hour away, and it had only one endocrinologist for that county and a few surrounding ones. Boy, was he ever busy! That town, Redding CA, with its population of around 100,000, could certainly use another endocrinologist.
Definitely. We have been considering moving to a different state. I live in the Seattle area and have had world-class care through the University of Washington Medical center. Proximity to health care is very high on the list of criteria. I have other health issues, kidney transplant, and a meningioma in the brain, which was benign; so a high-class health complex is important where we move next.
I’m willing to drive 170 every 3-4 months. When he retires, this may be a different story.
Yes, it certainly does now, it didn’t as much when I was younger. Transportation to/from medical appointments has become a major consideration now that I’m no longer driving and the pandemic eliminated the volunteer transportation assistance organization I had previously used. Even living in this urban environment with a relativity large number of physicians it’s still difficult to get consistent knowledgeable care on a timely basis. It requires making appointment far in advance and then being able to keep them.
I live in a small city about 65 miles north of Austin Tx. The town I live in does not have an endo so I prefer to just go to the endo that I used when living in the Austin area. If I could find a good endo closer to me, I would consider switching (i.e., $5.00 / gal gas……)
I chose “other” because I changed endos after relocating. I haven’t stayed in a location because of an endo
Most definitely. I have a multitude of health concerns one of which causes me not to drive and that need specialists, not GPs. We live in a city with many hospitals less than twenty minutes away that I can use buses for whose transportation keep improving.
No! We live where the work and good schools are for our son. I will commute to an Endo as necessary since I only see mine 1x a year.
Interesting question. I recently switched from a local endo to one in NYC, about an 8 hour drive or short flight away.
When I was first diagnosed, I used the endo assigned to me at the hospital. They were good, but not a good fit for me. When a bad snowstorm forced me to use telehealth, it got me thinking… why am I using an okay doctor when telehealth works for most appointments and my insurance covers any doctor in the state. So, I found an endo that is perfect for me. I’ve been incredibly pleased with my teleheath appointments with her and her staff is amazing. Although she’s not requiring it, I’m having my first face-to-face visit with her in July, followed by a long NYC weekend. Finally, T1D is an excuse to do something fun!
p. s. My local primary care doctor approved that this set up is medically sound before I transitioned to the new endo.
No it doesn’t. My Endo is an hour and a half away. BUT, it does have an impact on how close to a hospital I am, in case of an emergency.
I would say yes in principle, but I does take me at least 90 minutes in order to get to see him. I can however communicate via phone or email if necessary.
It does and it doesn’t. I moved to a huge area with tons of endo’s and couldn’t find one I could tolerate. So I drive 6 hours round trip to see my Endo once a year and the rest are video or phone call appts. 💯 Worth it.
I’ve lived in areas where the closest endocrinologist was a 140-mile drive to Reno, Nevada with few towns, people or even cacti in between. Easy-peezie in the good ol’ days.
Then as the ravages of age take their toll – diminished eyesight, diminished public transport, diminished cognitive abilities – and guess what? Proximity matters.
So now, the answer becomes, Yes. Talis est via mundi. ╭ (o ㅇ‿ o#)ᕗ
While I have not let this affect where I live, I do miss my old doctors. It is very difficult to find new doctors in my current area that “measure up.”
From what I’m reading I’ve only seen one “good” endocrinologist in 24 years, and the lone knowledgeable primary physician died during first year of diabetic care. I’ve seen 5 specialists, the only one I’d consider efficient was during those medical trials when my diagnosed mysteriously changed from TYPE 2 to TYPE 1.
These two stressed never let anyone dictate my diet, meds, exercise, or life because they don’t work my hours, cook my meals, nor live my life. I had two specialists before those medical trials, two afterwards; but at least the last got me to consider the pump with a CGM.
I now see a GP 5 minutes from my home for convenience, altho he offered to send me to the local hospital to see a specialist (his first visit said he doesn’t see TYPE 1 patients because of their needs, until we talked and he saw my a1C, he agrees to all my requests including my last to add metformin to my care). I’ve since found the end~ that refused my request to start insulin 21 years ago saying I was too old to be a TYPE 1, with instructions to lose more weight (already 20 lbs underweight) is considered a top board certified endocrinologist. I follow the instructions of those two doctors and read everything on diabetes: now listen to various podcasts and blogs on TYPE 1. Thanks to the internet I visit boards from the ADA, I read literature and periodicals, and news releases. With UAB and the Babtist Health system Birmingham I’d considered a top tiered medical community but results vary, sometime I feel better educated than those educated.
I’ve had the same endo for 30 years and he has changed practices more times than I can remember but has always stayed in the same general vicinity.
Just the opposite. I choose the facility closed to me, but actually now there are three different providers within the same 20’ walking distance.
40 years ago, yes it did. But now, with Telehealth and CGM/Pump data available via websites, proximity is not a requirement. I am blessed that the community I moved to after college had one of the best endos in the state.