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Re: [IP] rep starting pump

On  5 Nov 99 at 22:25, email @ redacted wrote:

> Unless your rep was a medical person, he or she could be considered to have
> been practicing medicine without a license. The reps I knew who did start
> people up on a pump received the start up rates from an MD before starting the
> pump.

The problem is that many doctors don't have a clue about the proper start up 
rates... do you remember the flap a year or so ago when one of the doctors 
wanted the patient to continue UltraLente while on the pump?  I've talked to 
several pump trainers and CDE's who have "recommended" startup rates based on 
the published rules of thumb from "Pumping Insulin" because the doctor's 
initial suggestions were way out of line and dangerous...  and when they have 
been able to convince the doctor to use these "suggestions" things have worked 
well...   Even the good endo's tend to "fall back" on the old "one basal rate 
fits all startups" when they are trying to minimize patient contact time so 
they can maximize revenue...  With pump starts it seems that most of the time 
the doctor is in a "management" position (clueless about what is actually going 
on) while the nurses, trainers, CDE and pump user do all the real effort...

Randall P. Winchester
* The views expressed here are mine and do not necessarily *
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