Monthly Archives: June 2016

I Fired My Doctor

FiredI visited my endocrinologist last week, and that was the last time I will ever see him.  I fired him.  He made several key mistakes: he wasn’t prepared, he didn’t adequately answer my questions; he seemed irritated that I was even asking questions; he made a huge error on my prescription; and his office staff didn’t act like that was any big deal when I called to report it.

I’d had an ultrasound prior to my visit, and I had to have the results faxed over twice.  I wasn’t sure at the time who messed up, the testing facility or the doctor’s office, but after my recent experience I squarely lay blame on the doctor’s office.  I called the afternoon before my appointment to have the results faxed over, and I asked the receptionist to make sure the results were in the system when I checked in for my visit.  The doctor never told me the results (I already knew them because I ask for copies of everything), and never felt my neck for any lumps or changes.

My visit centered around some recent blood tests that showed I had low T4 levels, and everything else was normal.  My doctor said he wanted to reduce my dose of armour thyroid, which didn’t make any sense to me.  I’d had a blood test in November 2015 that showed I had low T4, and his nurse had called and said the doctor wanted to increase my dose of armour.  A test in January 2016 showed my T3 was too high, so we’d cut back down.  It made no sense to me that the doctor wanted to reduce my dose when it was already too low, and back in November he’d made the exact opposite recommendation.  When I questioned him he became annoyed and gave me curt, abbreviated answers that only served to frustrate me further, not inform me of the reasons for his recommendation.

The doctor also asked if I would consider stopping armour and switching to a synthetic thyroid medicine.  This isn’t the first time I’ve heard this suggestion from him.  Doctors generally don’t like armour because it takes more effort to calculate dosages, and because it is a natural substance it has more variation in the dose between manufacturers and batch lots.  I’d rather take my chances with varying doses of a natural substance than put chemicals in my body, so I once again declined his offer to switch to synthetic thyroid.

By the end of the appointment we had agreed to decrease my armour (which contains T3 and T4) from 120mg to 90mg, and add 75mcg of synthetic T4.  I wasn’t happy with this result and had no idea why we were decreasing T3 when my T3 level was completely normal, but I wasn’t getting anywhere in my communication with the doctor.  I’d decided to find a new endocrinologist, but needed to continue taking thyroid hormone in the meantime, so I filled the prescription.  The first day I took the new dose I felt like I was on speed!  Everything was brighter, I was hyper aware, my heart was racing, and I was extremely restless and unable to focus.

The armour I had been prescribed was made by Forest Pharmaceuticals.  I looked online and discovered their armour has 38mcg T4 and 9mcg T3 per grain or 60mg.  A quick calculation revealed that my doctor had effectively decreased my T3 by 4.5mcg (from 18 to 13.5mcg) and increased my T4 by 56mcg (from 76 to 132mcg) – that’s a 74% increase in T4.  No wonder I was having problems – I was furious!  My doctor had blindly prescribed medication without performing a basic calculation that I could easily perform based upon a quick Google search!

I called the doctors office and specifically told his nurse that I believed there was a big problem with my prescription.  She requested that I hang up, log in to the Patient Portal, and send an email message to my doctor through the Portal.  Don’t get me wrong, I’m a huge fan of patient portals for their convenience and access to health records, but I never expected that they would take the place of doctor-patient care when there was an important issue such as my incorrect prescription.  I was done.  I never did log in to the portal.   I did, however, log in to the patient portal of my family practitioner, where I requested a prescription for 15mg of armour (which I should have received in the first place) and a referral to a new endocrinologist at UC Davis Medical Center.

Have you ever fired your doctor?  I’d love to hear from you.  Please leave a comment.

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