Re: Interesting chat with a young GP!!

[Guest guest]

Hi all

Ive been away for a couple of days on a course. I took the opportunity of having a chat with a young GP - hes about 32 ish. I asked him what he would do if a patient went to him with various symptoms compatible with hypoT (being tired, puffy face/ankles, memory and concentration problems etc) but whose TSH was 2.5 (as mine was), what would he do? He said, straight away, it would depend what the T3 and T4 were! He said he had one patient with a goitre whose TSH was about 1.9 and he started her with a trial of thyroxine.

I was very impressed!! He said the TSH is 95% accurate, which means that there will be people who dont fall within that range who do have hypoT. He went on to say that its mainly pure ignorance, with many older GPs not doing the full GP course as they were actually failed hospital consultants, down to there being a shortage of jobs for them in the past. I said what could I do and he suggested getting the endocrinologist (who in my area understands this and will treat outside the 'normal' range and use Armour) to come and talk to the GPs - but make sure the title was something contensious like 'still only treating hypothyroidism outside the normal range?' or they would think they know all about thyroid treatments!

Thats good on a local level but is there any scope for something wider here?

What is really good to know is that he's only a couple of years into being a fully fledged GP, saw another young GP who has treated her although she's inside the 'normal' range. This sounds like the newer generation of GPs are being taught properly about hypoT - I therefore recommend that we all find young GPs!!!! (the older ones might get the message when their list sizes start falling - which means their income falls too!!). He also mentioned that a lot of GPs dont like the fact that we get free prescriptions and some think that fibromyalgia means we are depressed etc.

Gill

[Guest guest]

If this young doctor was as fired up about TSH etc as you say and

there are others like him then it sounds like there could be a big

divide forming in the medical community. We can only hope that at

some point these enlightened GPs will eventually grow strong enough

to take on the GMC.

If you ever see him again do ask him if he and his like-minded

peers/superiors are going to deal with this on a larger scale than

just your local area.

Luv Bella

>

> Hi all

> Ive been away for a couple of days on a course. I took the

opportunity of having a chat with a young GP - hes about 32 ish. I

asked him what he would do if a patient went to him with various

symptoms compatible with hypoT (being tired, puffy face/ankles,

memory and concentration problems etc) but whose TSH was 2.5 (as

mine was), what would he do? He said, straight away, it would

depend what the T3 and T4 were! He said he had one patient with a

goitre whose TSH was about 1.9 and he started her with a trial of

thyroxine.

>

> I was very impressed!! He said the TSH is 95% accurate, >

[Guest guest]

Hi Gill - perhaps you might think again when you read the following paragraph. This is taken as an extract from a letter sent to me by Dr Skinner that is going elsewhere. He is talking about his clinic in Birmingham. It seems to me this might be one problem as to why the diagnostic and treatment protocol for hypothyroidism is not being aired:

"The Louise Lorne Clinic has not had its reputation properly highlighted although I do admit this may be slightly tangential. This is not a fly by night clinic. We have been arguing vociferously for many years to the GMC, the Royal Colleges, Department of Health, the British Medical Association on this question of the misdiagnosis of hypothyroidism and have received encouraging letters from the Department of Health. We have submitted many papers for publication but as Professor Weetman said he is on the Editorial Board of all the journals to do with endocrinology, therefore, he has not allowed anything to be published. It is very difficult to publish novel ideas when the medical world will not allow contrary opinion to be aired in public."

I will say no more - but after Dr Skinner's FTP is over, I will be putting out some serious questions under the BTA/BTF/.GMC section on our new website www.tpa-uk.org.uk/

Luv - Sheila> > I doubt they will actually do anything themselves to get this message across but its positive in that at least the younger ones do understand that you can be hypoT and still have a TSH inside the 'normal' range, and must be getting this message from their training(??). The education of the older docs will come about informally, e.g. their discussions at meetings, it will be for GP consortia or PCTs to take forward any specific education.>

[Guest guest]

Dr Skinner has a clinic in Birmingham? How much would it cost for an

appointment, anyone know? I am getting desperate!!

[Guest guest]

I would complain to the PCT and I would write the GP a letter

expressing the feeling that he cared nothing for your health and let

his own prejudice take precedence over medical judgement. You have

every right to demand a letter to see a private doctor / consultant and

the doctor is supposed to prescribe what the consultant says regardless

of his personal feelings!! After all in these days of PC you can even

demand birth control from a Catholic GP so why should any doctor be

allowed to pick and chose what he will listen to or not? You are the

customer, and your health and wellbeing should come first!

[Guest guest]

I know that docotrs can refuse to offer Armour all too well but that

does not give any doctor the right to refuse a letter for anyone to see

a private doctor. Anyway if the consultant prescribed it the doctor

should still carry on with the prescription, they're always telling me

the consultant knows best!!

[Guest guest]

In theory it should be that way but once I wanted to try a new

unlicensed medication for Fibromyalgia which worked wonders for other

certain people but the GP where I used to go took pleasure in refusing

full stop to give you certain things, just for the sake of being

awkward and to give himself the feeling that he was " winning " and in

control. I saw 2 consultants for my fibromyalgia. One locally who

didn't have many suggestions so I went to a second one of my choosing

and he did prescribe me the meds I wanted and my GP said that the

consultant would have to continue prescribing it if it worked for me,

because he would not prescribe it at all.

Later I found an asthma preventer that has fewer side effects (I sing

and inhaled steroids really affect my vocal chords) and he refused to

prescribe it because it was not on the PCT list of recommended drugs

in my county. I rang the PCT and I mentioned the words " Postcode

lottery " I also said it was ridiculous as that drug was actually

licensed for asthma, so why shouldn't I have it. They had a talk about

it and said ok. I changed GPs at that time, it was the last time my GP

upset me. I now have my inhaler which was happily prescribed by my new

asthma nurse and was approved for me by the PCT. But now the nurse and

GP found it interesting, the nurse rang me to thank me for pointing

out that new med to them. Mad world huh?

But yes some GPs will be awkward for the hell of it.

Lillian, your doctor shouldn't refuse to refer you to another doctor,

unless he has a really good reason, and especially as you are willing

to pay for the consult! It isn't even going to put a strain on the

system. I would ask him why he is refusing you a referral. Or contact

PALS and see what they suggest.

On second opinions:

http://tinyurl.com/3c4t8h

Good luck Lillian.

Callista x

>

> I know that docotrs can refuse to offer Armour all too well but that

> does not give any doctor the right to refuse a letter for anyone to see

> a private doctor. Anyway if the consultant prescribed it the doctor

> should still carry on with the prescription, they're always telling me

> the consultant knows best!!

>

[Guest guest]

>> It would be like asking Dr.Wheetman to write a referral letter for

one of his patients to see Dr.Skinner lol.<<

say no more *grin*

(altho I would love to try and have a camera ready to take a pic )

Callista x