|Entry # 5 - My First Endocrinologist: Second Disaster|
|My Story - The Beginning|
|Tuesday, 28 October 2008 17:00|
About two weeks later I met with the endocrinologist. This endocrinologist was probably about 70 years old with one foot in the grave. He actually had to turn his hearing aid up in the beginning of the exam in order to hear me. Maybe I’m a little soft spoken (or more likely he’s just a little def.) Again, I have nothing against older doctors this is just how things are turning out for me. My introduction with this endocrinologist was fine however my experience with him quickly went downhill.
The endocrinologist briefly discussed my thyroid nodule and....surprise! He insisted that the only option would be to have it surgically remove. I asked him about doing a fine needle aspiration biopsy and he said he would not do that. He stated he does not do fine needle aspirations. In the back of my mind I am thinking “well maybe I can see a doctor who does do fine needle aspirations.” I also question him about thyroid nodule having a 95% chance of being benign, "why is the only option surgery?" He stated confidently that is the only way to know for sure if the thyroid nodule is cancer. He also stated that the fine needle aspiration is very inaccurate and unreliable. However, this contradicts the literature which states that the fine needle aspiration is very accurate, 1-5% error rate (false negative rate.)
I think the endocrinologist realized that I was not confident in his treatment methodology so by the end of the exam he gave me one more option. This was to get a low dose radioactive iodine thyroid scan. If the nodule was a “cold nodule” then he said the only option “would be to surgically remove the thyroid gland.” If the nodule was a “hot nodule” then he stated we can just monitor the nodule yearly. He also stated that he wanted to get some blood testing done to cover himself. What? I don’t care about him, I care about me!! Nothing made sense here. What’s going on? This was just a disaster.
Determining if a thyroid nodule is "hot" vs "cold" is important. Most "hot" thyroid nodules are not cancer. Here is an article explaining in detail "Hot Thyroid Nodules vs Cold Thyroid Nodules."
This endocrinologist was also very impersonal. While trying to ask this endocrinologist further medical question with regard to my condition and treatment he was short and provided no reassurance. At one point he actually got up and walk out of the room during one of my question, which of course he didn’t answer. This endocrinologist treated me as if I was a burden on him being there. I was referred to help understand my condition better and the possible treatments available. However, it was the exact opposite that happened. I left this appointment feeling much worse and even more confused about my medical condition.
This endocrinologist was very pushy and demanding. He took no interest in hearing what I had to say or questions I had. The few comments he did make were belittling. It was as if he was saying, why are you asking such stupid questions? Just do what I say.
Obviously, there were many red flags from this experience.
1. His treatment plan and methodology really made no sense to me
2. This doctor would not answer my questions
3. He was very unprofessional
4. What happened to the standard of care here?
5. Again an old school endocrinologist, not up-to-date with the current standard of care
At this point I was very discouraged with my medical care. This situation was very frustrating. Again, I discussed this with family and friends and I decided (and was recommended) to get a second opinion out-of-network.
I was not going to go through this again so I decided to go where I can get leading edge care, a medical school. I actually found an endocrinologist, of whom specialized in thyroid nodules at the Medical College of Georgia. After about a month, my insurance authorized the referral and I was off to Georgia. This was a blessing!
Interestingly, months later from talking around with other doctors in the network I discover that this particular general surgeon and endocrinologist work as a team, self referring to each other. The general surgeon had an okay reputation but the endocrinologist had many complaints and investigations regarding his standard of care treatment. I’m surprised he is still licensed to practice medicine. I wish I knew this before I had to go through this inter-referral chaos mess. I’m glad I didn’t buy into their little game. If you ever feel uncomfortable with a medical doctor just say, NO. You are your best advocate and you can deny care. You also always have the right for a second opinion.