| As patients, we all like to think our doctors are on | | | | |
| top of their game -- they know everything there | | | | 1. Do your health homework. No matter what |
| is to know about our particular health problem. | | | | doctor you see, you need to verify and discover |
| We like to think this because we are putting our | | | | information yourself. Go to reputable medical |
| health and our lives in their hands. | | | | sources on-line and print out copies of information |
| However, what we really should be thinking is | | | | you want to discuss with your doctor. Reputable |
| how can doctors stay current on all the new | | | | medical sources are sites run by well-known |
| developments, knowledge and recommended | | | | doctors, organizations, or universities like or Avoid |
| treatments available? After all, there are so many | | | | sites written by unknown individuals merely |
| new medical findings/reports given everyday it is | | | | express an opinion and not verifiable facts. For |
| impossible for any one doctor to stay current in | | | | rarer medical information, visit medical libraries and |
| all areas of medicine. It is even a challenge for a | | | | ask the librarian for assistance in finding answers |
| doctor to stay current in one specialized area of | | | | to the questions you have. No matter how you |
| medicine. | | | | do your homework -- have a hard copy to show |
| Yes, doctors are required to take continuing | | | | your doctor. |
| education classes, but the number of hours | | | | 2. Ask your doctor for some time to answer |
| required per year is minimal compared to all the | | | | your questions and show him or her printed |
| new medical information available each and every | | | | material. They may want to see the specifics for |
| day. To stay current, doctors need to make a | | | | themselves before they can comment. One of |
| concerted effort to learn what is new in their | | | | several scenarios should then follow: The best |
| particular practicing area. Doctors who are expert | | | | scenario would be for your doctor to already be |
| lecturers even hire full-time staff to review all the | | | | aware of the information you are providing and |
| available new medical information. That is how | | | | for you both to have a thorough discussion about |
| they stay current and can be considered experts. | | | | it. The next best scenario would be for your |
| The point of sharing these thoughts with you is, | | | | doctor to be unaware of the information and for |
| no matter how good your doctors are there may | | | | him or her to be willing to look into if further for |
| come a day when they cannot answer your | | | | you or refer you to someone who is more |
| specific questions. They may not know about a | | | | knowledgeable in that area. Perhaps the worst |
| particular new treatment, may not know about a | | | | scenario would be for your doctor to be unaware |
| change in the current standard of care. You, the | | | | of the information and be unwilling to take the |
| patient, may find yourself educating your doctors | | | | time to discuss it with you. |
| about something you have read. Think this is not | | | | 3. Smart doctors will react to information a |
| likely to happen, then think again! This happens | | | | patient presents by either already knowing the |
| much more often than we like to admit. Here is | | | | information or by wanting to know more about |
| an example of a real-life situation a friend recently | | | | the new information. Smart doctors know they |
| shared with me . . . | | | | can always keep learning and they are not |
| Sarah (not her real name) recently told me she | | | | offended by patients asking questions and |
| had been feeling very tired and was gaining | | | | providing information. They are often grateful for |
| weight. Her doctor was running some blood tests | | | | patients who bring important issues to their |
| and was checking her thyroid function. She would | | | | attention because it may help them treat other |
| know about her test results in a few days. A few | | | | patients better in the future. You should seek out |
| days later she told me her blood tests came back | | | | doctors who are willing to discuss information with |
| fine, within the normal lab ranges. I asked her | | | | you and have a true partnership relationship when |
| what her TSH value was and she said it was 4.8. | | | | it comes to your care. |
| Her doctor thought they could repeat tests in | | | | 4. On the flip side, you should avoid doctors who |
| about 3 months. | | | | are unwilling to discuss new information with you. |
| I was shocked to hear her doctor thought a TSH | | | | If they are too busy to answer your questions, |
| of 4.8 was normal. I thought she was probably | | | | then you don't need them. Stay with them only |
| becoming hypothyroid. I explained to her that the | | | | long enough to find a new doctor who will have a |
| American Association of Clinical Endocrinologists | | | | quality doctor-patient relationship with you. You |
| (AACE) established new guidelines in 2003 for the | | | | need a doctor who has your best interests in |
| TSH range and the new normal range for TSH is | | | | mind. Remember in the end, it's your or your |
| now 0.3 to 3.04. Using this narrower range, Sarah | | | | loved one's health at stake. |
| would be considered hypothyroid (not enough | | | | 5. Doctors are human beings too. They genuinely |
| thyroid hormone) and would be given thyroid | | | | want to help people. That is why they went into |
| supplements. | | | | medicine in the first place. Just like you, they have |
| I suggested Sarah visit the AACE website [ or | | | | many time pressures on them and in this |
| Mary Shomon's thyroid column at to learn more. | | | | fast-paced world it is not easy to keep up on |
| (Mary Shomon is the guide for thyroid issues and | | | | everything new in medicine. Give your doctors the |
| she provides patients with a great deal of helpful | | | | opportunity and flexibility to help you before you |
| thyroid information.) I encouraged Sarah to speak | | | | decide to move on. If they are willing to spend |
| with her doctor now and not wait three months. | | | | time answering your questions, but ask to do so |
| Sarah's doctor was following old standards and | | | | at an alternative time or by an alternative means, |
| most likely did not know about the narrower TSH | | | | then try being understanding and work with them. |
| range. Her doctor was just reading the range the | | | | Some doctors have a time during the day when |
| laboratory provided instead of following the new | | | | they are more easily able to speak with patients |
| guidelines. | | | | by phone or some will even communicate with |
| Sarah's situation is just one example of a doctor | | | | patients via e-mail. The best solution is to find a |
| not knowing the latest information. In case you | | | | way to get your questions answered that works |
| find yourself in a similar situation, here are some | | | | for both you and your doctor. |
| helpful tips when educating your doctor: | | | | |