Why do Doctors Blame Patients when T4 Doesn't Work?

[HIFL]

Interesting article on the disconnect between doctors and patients. Looks like it was written by UK endocrinologists!

tiredthyroid.com/blog/2015/...

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Nothing changes, too many assumptions are made about the patients by hard of thinking, lazy doctors.

[shaws Administrator]

They are out of their depth and it would seem that they 'the top' are mainly men who haven't got a thyroid dysfunction or any knowledge of its effects on the body if deficient.

It is treating people by the 'numbers method' - they don't know any clinical symptoms. The assumption is that we must be well because our TSH is within 'a level'. Anything else is due to our 'lifestyles', family problems, work issues etc etc. Pain can be excruciating - they are puzzled. You complain how unwell you feel - you must be depressed. Sleep is interrupted - you're worried and anxious.

Why did different Specialists refer their patients to Dr Skinner - because they had no idea what the patients were suffering from - due to the TSH level being introduced as a definite diagnosis.

worldthyroidregister.com/Go...

Dr S diagnosed many of these patients as hypothyroid and prescribed.

Then because other patients wanted the same treatment 'the profession' ganged up against Dr S to get him to stop prescribing because he was using the method taught as a medical student - all clinical symptoms first, family background, and the 'look' of a patient as many had 'swelling'. Dr P also had the same treatment as did other doctors who did as they were taught.

How dare we ask to have a trial of NDT, or T4/T3, or T3 - who are we to demand such treatment after all the guidelines must be followed. We are mothers, sisters, daughters, husbands, wives, brothers, sons and life is such a struggle, lose jobs, marriages, unable to work. You may look o.k. but your pulse and temp is low - energy has gone out the window.

I think the priority of getting 'up the ladder' in thyroid physiology that it should be essential to have hypothyroidism and not get better on levothyroxine or a thyroid gland dysfunction.

I note that more patients are now being prescribed some T3 to their T4 and improving, so at least that's something.

It is not our fault that we have an autoimmune condition - it couldn't be prevented. It affects us from top to toe - not just one area of our bodies.

Most cannot afford Private Consultations.

[Aaargh81]

OT perhaps...Same old, same old. I suspect the "wall-to-wall grey suits" (which was how a former female endo described her meetings with colleagues) would include statistically higher than usual numbers of psycopathic individuals. (If you've not read it and experience feelings of empathy, then I highly recommend the book 'The Sociopath next Door by Martha Stout.') I would hazard a guess that these types are very much attracted to the power and control they can exercise over a patient base which is predominantly female? Who knows?

So, IMO coupling that hypothesis with the current drive for all things measurable, which also appeals to the male brain seems to me to be the reason.

Quite simply some really don't care but enjoy the mind games, and some can only do paint-by-numbers.

If we had more female endo's then statistically that would lift the empathy scores.

Ultimately we need more female endo's........who's up for training?

[Fr23 in reply to Aaargh81]

I am seeing a female Endo at the moment,and taking NDT!

[Clutter in reply to Aaargh81]

Aargh81, the second time I saw the senior consultant endo in 2 years, she told me TSH can be less suppressed and reduced dose by 12.5mcg! TSH stayed where it was but FT4 and FT3 dropped a little. I had no adverse symptoms. The male endo I usually see doesn't want FT4 or FT3 dropping further so I remain on the reduced dose with very suppressed TSH 0.01.

[HIFL in reply to Aaargh81]

I don't think being female necessarily helps. There are horror stories about female endos who are just as stuck on TSH as male endos, and have reduced doses based solely on the TSH. I think the profession itself attracts number crunching, statistical types, who think everything fits into a box. But TSH doesn't, and they just don't get it!

[greygoose in reply to Aaargh81]

I've seen two female endos. I wouldn't recommend them.

Although, to be honest, I wouldn't have classified them as sociopaths. I married a sociopath, so I can spot them rather easily.

Also, women can be sociopaths, you know, it's not just men. I worked for one. But having been married to one, I knew how to handle her.

My female endos were much more difficult to understand. One of them, I just had the feeling she was totally lost and out of her depth. She also looked very ill, and - despite hating her - I felt quite sorry for her. The second one, I felt, just wanted to play with the big boys - be one of them, perhaps. Couple that with defective training, and you arrive at a lot of sick patients.

However, I do know of one prominent endo whom I would possibly classify as a sociopath - can't name names but I think everyone knows who I mean. lol And he is leading the game, encouraging other endos in the same demeaning attitude towards patients. If someone shouts loud enough, most people with think they know what they're shouting about. Patient ignorance (no offence meant) and gullability, and the enduring belief that doctors are gods, also comes into play, strengthening their hold on us. Plus the fact that most patients are too sick to fight. It's so easy for them to kick us whilst we're down.

Then, of course, we have Big Pharma's strangle hold on all things medical, like education... Plus the ignorance and gullability of doctors which strengthens their hold... But I think I'll shut up now, because once I get started on Big Pharma, there's no stopping me!

[Clutter]

HIFL, patient blaming is probably one of the continual professional development modules all doctors have to study

Have a look at this link to see just how patronising some UK endos can be and read the comments to see how offensive some GPs can be. Most of the OHP comments are probably written by hypothyroid patients, referred to as "trolls" by one GP.

pulsetoday.co.uk/clinical/d...

Given that some UK patients get a phone call to collect a prescription because their thyroid level is low and no further explanation, instruction or guidance, it's no surprised to me that a lot of Levothyroxine is washed down with coffee and bacon sandwiches.

[HIFL in reply to Clutter]

Thanks Clutter, that link was some eye-opening reading! Trolls?!? No wonder patients in the UK have such a hard time!

[Clutter in reply to HIFL]

HIFL, some doctors don't get it that better diagnostics, sufficient dose, and the right combination of meds may be all it takes to get their patients well. They seem believe that patients are "frequent flyers" because the enjoy the ambience of the waiting room and consultations rather than desperate to find a way to feel well.