Need Letter of Persuasion for My GP

[Jacksatlast]

Hi Folks,

My Endo said I could have T3 but my GP is worried and reluctant to prescribe the 65mcgs I currently take.

She rang today and says shes spoken to another Endo and he says because my Free T3 is high I can't have it. (I stupidly forgot to not take my CM dose before the lunchtime Bloods were done)

She also states she isn't allowed to prescribe due to PCT guide lines!

I believe somewhere their is a letter to give to our GP's to help us get other Thyroid Meds. Can anyone point me in the right direction to find it. I'm going to need to write and state my case.

I've now seen a copy of the first Endo's letter to my GP and he clearly states my current doses of T3 and agrees to prescribe but then writes that 20mcgs should be enough if I take T4 with it! Frustration all around, he agreed that I didn't need to take T4 anymore.

The fight goes on!

[Clarebear]

Can you contact the first endo and get him to correct the letter he sent to your GP? xx

[boo16]

Could you not also ask your GP to give you a print out of the PCT guidelines that she is refering to that catagorically states she is not allowed to prescribe T3?

[Jacksatlast]

I have drafted a letter off to the Endo I saw and asked him to clarify his letter and to confirm that I can have it.

Everyone seems so worried at this practice!

Good idea to ask my GP for a copy of her letter since she's asked me to send her one stating she can prescribe!

Mind you have just read what Nobodydriving just posted I might not get any anyway!

[NBob]

if i was in this situation I would get the first Endo to clarify what he said.

Then I would write my GP a letter something like: (copy paste and edit to suit your circumstances)

Dear Dr...

Request for T3 therapy.

Endo 1 has advised that 65mcg of T3 is an appropriate medicine for me to take. and states this in his letter to you of ../../..... He also suggests a combination of T4 and 20mcgT3 may be appropriate. My preference is for T3 alone therapy as Endo1 has said that I don't need to take T4

Endo 1 has adequately assess my conditions, taking account of my history (including my symptoms and psychological, spiritual, social and cultural factors), my views and values; and examined me and therefore is in a position to make a suggestion for my treatment in accordance with paragraph 15a Good Medical Practice.

You have told me that Endo 2 has said that I cant have T3. Endo2 has not seen me at all and therefore is in no position to comment on my diagnosis or treatment. If he has expressed an opinion on my treatment, this is contrary to Good Medical Practice.

You have a duty to work in partnership with me, listen to, and respond to, my concerns and preferences and to respect my views and values. I am clear in my mind that I want to be treated with T3.

With regard to the PCT guidelines about prescribing T3, you must be aware that there is plethora of case law stating that guidelines are just guidelines. There is case law to show that rigidly adhering to guidelines can be negligent.

There is case law that says that PCTs - now Clinical Commissioning Groups - cannot blanket ban a medicine. See R v North Derbyshire Health Authority ex parte Fisher 1997.

I can see no logical reason for a PCT/CCG to effectively ban T3 as it is a properly licensed medicine that is listed in the British National Formulary.

If such a policy does exist, it is placing my health at risk. In such a case you have a duty under paragraph 25b of Good Medical Practice to raise your concerns in line with GMC policy and also in line with your CCG policy.

Further, Good Medical Practice places a duty on you to treat me as an individual and to make my care your first concern. This means that a GP should not hide behind guidelines but seek to work outside any guidelines that are not in my best interests supported by evidence. the best evidence you have is from Endo 1 and me.

Any refusal to prescribe T3 by you or fund treatment by a CCG must be based on an assessment of my individual needs. You know my preference is for T3 alone therapy, You have a letter from Endo1 supporting T3 therapy. Endo 2 should not have offered an opinion at all without seeing me. The evidence for T3 therapy in my case is strong.

I am aware of the signs ans symptoms of thyrotoxicosis. I will reduce the dose immediately and inform you as soon as possible if I do develop any signs or symptoms of thyrotoxicosis.

I should be grateful if you would commence T3 therapy forthwith.

Yours faithfully

[tingles in reply to NBob]

See, this is why I love this group! People like you give your time, your knowledge, and your help. Although this is not my post I thank you for taking the time to write that letter, it's always there in the archives (if you can find it!) to help others x

[Jacksatlast]

Many thanks NBob, for this great post, I ve spent the morning drafting a letter to my Endo 1 and asked him to clarify his first letter as you suggest. I have also just finished a letter to my GP which I' ll now adjust a little to bring in some of your suggestions.

I've also included The Secretary of State for Health letter to The TPA stating not to rely heavily on blood tests and confirming that our GP's can prescribe any Hormone treat,ent of choice if they deem in essential.

Fingers crossed for me