Sometimes, you can't please everyone. I freely admit to my patients, "I'm not smart enough to figure everything out!". As a subspecialist, we're hopefully very good in some specialized areas of medicine, but that also means we have the blinders on, and aren't very good in things outside our field of practice.
And so, the challenging issue is that sometimes, patients come with preconceived notions and are convinced something is wrong with their hormones.
I've studied in this field for 12 years. I still have trouble understanding and describing exactly what a hormone is; how these people all just KNOW their hormones are off is beyond me.
And so, the other day I saw a patient with a list of symptoms (yes, she brought a list) that had over 20 lines. And it was obvious she has done some reading, for she basically went from one gland to the other- "so could this be my thyroid? What about my pancreas? And my parathyroid?". Despite her normal thyroid labs, she was keen on getting on thyroid hormone because she had trouble losing weight.
So I spent the better part of my consultation with her going over the labs that had already been done (and were normal) trying to reassure her. I went over how the labs (indeed the clinical picture) did not suggest there was a problem. I knew as she left that she wasn't satisfied, and was not surprised to later read her negative comments that she sent to admin.
And so, the challenging issue is that sometimes, patients come with preconceived notions and are convinced something is wrong with their hormones.
I've studied in this field for 12 years. I still have trouble understanding and describing exactly what a hormone is; how these people all just KNOW their hormones are off is beyond me.
And so, the other day I saw a patient with a list of symptoms (yes, she brought a list) that had over 20 lines. And it was obvious she has done some reading, for she basically went from one gland to the other- "so could this be my thyroid? What about my pancreas? And my parathyroid?". Despite her normal thyroid labs, she was keen on getting on thyroid hormone because she had trouble losing weight.
So I spent the better part of my consultation with her going over the labs that had already been done (and were normal) trying to reassure her. I went over how the labs (indeed the clinical picture) did not suggest there was a problem. I knew as she left that she wasn't satisfied, and was not surprised to later read her negative comments that she sent to admin.
"... bad doctor, said he practices using SCIENCE only..."
Coming from my alma mater, I actually took this as a compliment. I pride myself as someone who is cautious, who practices evidence-based and research-based medicine. There are practitioners out there, who use medications purely for symptom relief without scientific merit (using thyroid medications for weight, or Prednisone for low energy etc). I demand proof, that a test is reliable, and that any medication indeed does benefit my patients and do not harm them (and I demand proof that the newer more expensive medications are better than the cheaper generics 
). I'm a scientist, and so my work is based on scientific data.
). I'm a scientist, and so my work is based on scientific data.And so, to accuse me of practicing based on science, would make my mentors proud. For, there are other places to go to to find a quack.
posted by vagus at 6:23 AM
<< Home