Be Willing to Pay if You Can, If NeededIf you are covered by an HMO, or participate in medical insurance, or have medical coverage from the US military, or you live outside the US and have access to government-sponsored health care, like the National Health Service in the United Kingdom, there are some pros and cons for the thyroid care you're likely to receive.
If you need the services of a conventional endocrinologist, you should be fine, because these sorts of health care systems typically have qualified specialists who can capably treat you.
If you have subclinical or autoimmune thyroid disease, or you do not do well on a standard levothyroxine treatment, however, you may be frustrated by the limited choice of doctors you have, and the level of attention those doctors give to thyroid diagnosis and treatment.
You will find that doctors in these sorts of systems are rarely allowed to use innovative or controversial tests and treatments, such as Free T3 tests, Reverse T3 tests, T3 drugs, and natural desiccated thyroid medications, and usually can't spend the time to help identify, test for, diagnose and treat complex autoimmune and hormonal imbalances.
Doctors who are part of HMOs, reimbursed by insurance companies, or who are part of government-run health care programs, must follow official guidelines set up by those companies or governments that carefully outline which diagnostic tests and treatments are the standard of care, and impose time limits for office visits. HMOs, insurers and government health-care programs typically require doctors to follow narrow and conventional guidelines, such as relying on TSH tests for diagnosis and management, and using only levothyroxine drugs like Synthroid for thyroid hormone replacement.
When you need more personalized thyroid care, you can decide to fight the system, yes. But it can a long, hard fight, and you may not win. Sometimes you may encounter a more open-minded practitioner who is willing to think outside the box on your behalf. If you do, take advantage of that relationship, and hope that the practitioner doesn't move or leave or get fired! Frequently, however, the best solution is to pay out of pocket to see a great "private" practitioner.
I've heard patients say that it's not fair, and they refuse to pay extra for something they feel they should be getting as part of their existing service. Believe me, I understand the frustration, and it isn't fair, and it does seem ridiculous to have to pay extra for something that you're already paying for. But the reality is, if you can afford it, even several visits with a truly knowledgeable practitioner could mean returning to wellness, versus years of fighting with sub-par doctors, while coping with chronic illness.
Know When It's Time for a Second Opinion or a New DoctorFinally, I think it's important to know when it's time to look for fresh ideas and new perspectives.
Sometimes, when you feel like your practitioner could use an additional pair of eyes to look at the situation, a second opinion can be a terrific addition to your care. It's important to know when it's time as a thyroid patient to seek a second opinion. In other situations, however, a second opinion is not enough, and it's really time for a new doctor. Many of us are reluctant to "fire" a doctor, but it's often the most important first step toward wellness. Learn about the 10 signs that you need a new thyroid doctor. And if you're still wondering if it's time, listen to what other patients have to say about it. More than 130 thyroid patients have shared their own stories about how they knew it was time for a new thyroid doctor. You may recognize your own situation, or feel compelled to tell your own story about how you knew it was time to look for a new practitioner for your thyroid care.