Don't forget...some doctors cannot even interpret tests correctly...or ignore warning signs. A very common test often ignored is MCV in a CBC... Elevations in this test point to low B12, but doctors ignore it.

Doctors ignore low B12 values, and low Vit D values sometimes, too.

So it is not only the lab in question, IMO.

Yes, very true on interpreting the test. And so many do not look at trends and compare prior results to current results to see the changes that may give an indication to explore further.

We saw that with John....there was a definite shift in some of his blood work at an annual physical. We questioned it but were told the current numbers were still in a normal range. In hindsight, we should have pushed for retesting in 3 months but they were so convincing that there is nothing going on, we let it drop. Next time, I'll follow my intuition. Hope there's not a next time.

Could we have stopped or prevented what finally hit him? We'll never know. But I do know, we would have known about his problem before it became a crisis and been able to manage it better emotionally, and would not have been pressured to decide on treatment during all the confusion.

how true that is Marlene about not paying attention to trends. too many doctors just look at abnormal results even when a trend is pointed out to them by the patient. "yeah but its still normal range" but its dropped 35% in last month "yeah but its still normal range" ad nauseum.

Marlene we all do the best we can with the information and professional or otherwise expert advice proferred. sometimes information conflicts or isnt clear cut. At the end of the day all we can do is the best that we can.

So true.....

Thats big should though - realistically doctors, at least here in the uk , ive come across couldnt care less , they have budgets they have to manage under guidance plans thier given ( iornically called N.I.C.E ) with set prices that decided what you get before anything else.

And as I mentioend before even cancer patients arent getting the drugs they need , so all the nhs here have too is disagree with it - regardless of how effective it is - and simply say they cant afford it while allowing and paying for more polish and other folk to come here and abuse the system .

And if you go private you just end up paying the same amount for the same garabage resources / services because its usually the same doctors with the same amout of regard for your wellbeing , so where does that leave the patients ?

Id rather have honest doctor or one I knew was going to at least given me the right answer than one posing to help me while clearly being nothing more than expenditure manager for resources that already considered 3rd world as it is.

Until health care ethics is seperated from business and those it attracts the patients are always going to come last , and isnt thats whats happening now , not just in health , but everywhere - hence the economy woes ?

Mrs D I dont personally know you , but I know youve been here helping folk selflessly for years , if there was ever such a thing as co-op run health service Id trust you with my life before any doctor .

From my perspective i see the problem lies in education and the whole nature of money and payment.

Part of caring service is the fact is supposed to be about caring , but whats misleading is that most of these people doing do not care at all.

The main reasons i see for this are.

a ) Science and empathy do not mix unless its for something they believe in i.e. global warming , or greater ideals - not individual cases

b ) Doctors are being paid far too much for service they dont deliver ( simply referring you or giving you drugs does not justify 7 yrs in medical school )

c ) The payment attracts the wrong type of people ie.. the very sort who would happily have no qualms about selling out folk with bad care so they can get money

d ) No one seems to be checking to see if Doctors are " updating " their knowledge so they always have excues to refer you ( how convienient ) or give you passive care i.e. drugs.

e ) The whole emphais of health care in the uk at least is on passive care , not treating the problem but simply masking the pain , you dont need to be Einstein to see why ..

Just some of them IMO.

m

Ahhhh Melon, I didn't realise you were also from the UK and I agree with absolutely everything you have said, except you missed out the red carpet for those on methadone programmes which is a particular bugbear of mine.
I have been painfully languishing in the ether of NHS waiting lists snince Sept 2008 and have only ever had blood tests. My neurologist was pregnant at my first consultation and at this rate her baby will be at school before I get a diagnosis but hey ho NHS have made their targets, I have been seen within 12weeks of my referral yipeee!

I am a physician, a radiologist, so I do not know a lot about neuropathy. Sure I can spot masses, MS plaques, spinal disk disease, etc that can lead to neuropathy, but this is not the same a clinical diagnosis. Neuropathy may be easy to diagnose, but finding the cause and thus the treatment can be extremely difficult. I am idiopathic myself as all of my studies, except the skin biopsy proving I have a small fiber neuropathy, have been normal. Although, I just found out that my free T3 and free T4 are low normal. My TSH was about 1.1, so I'm not exactly sure what to think. Might have to get with an endocrinologist. In terms of education, I have 4 years undergraduate, 4 years medical school, 5 years residency, and 1 year of fellowship. I could have started at preschool and graduated from high school twice. In terms of "updating" knowledge, I have to document continuing medical education annually, as well as get re-certified every 10 years. These are all requirements in the states. Timing of re-certification will depend on specialty. I know that some doctors do not have good people skills or clinical skills or both. Please do not lump all of us with the few bad apples. Remember that the lowest person graduating from medical school is still called doctor. It is always best to research the physician and ask for referrals and then you can significantly limit your exposure to the bad ones.

Sorry for the rant.

All viewpoints are welcome here.

kwinkler.... I had rather borderline normal tests (but a higher TSH--5-6) for many years... before getting a radioactive technicium scan (I had a right sided goiter). That showed an abnormal gland (no uptake on the left lobe) . When I finally got the levothyroxine, my feet woke up from years of pain, and finally numbness. It took about a full year for me to get my feet back. It started around 30yrs with the hypo symptoms, became worse after I delivered my son, and was finally treated when I about 47-48.
I also had major issues (carpal tunnel) in my hands...with the low thyroid. I had carotene deposits in my hands and feet also.. which is common in hypo patients.

Thyroid problems can be confusing and often doctors will not deal with them, when borderline. There is a thing that is rather new, called reverse T3... this can be tested for. It is still controversial but some doctors call this inactive and a form of thyroid resistance. Keep that in mind when you go to the endo.
For what it is worth, most Endos toe a very strict line when tests are interpreted (old school). It is the holistic MDs that are more open to T3 supplementation.

I would like to add:
The Endo my PCP sent me to when she found my right sided enlargement, told me I was a neurotic medical professional....he was rude and demeaning (he was from S. America originally and I thought maybe it was his culture). He grudgingly ordered the scan, and when that came back very abnormal, he would not even look at me as I sat across from his desk. He made me wait 6 more months before giving me my needed medication...he withheld thyroid hormone from me! I went back and demanded it, and finally he gave it to me. You'd think it were a precious gem or something! So kwinkler, being a doctor or nurse or whatever, you may encounter jerks like this who like to play HOUSE (TVshow) and try to prove how smart they really are NOT!.
After all that I went back to my PCP and she monitors the levels with my yearly tests. I've been pretty stable at 75mcg/day.

Unfortunately these doctors are protected by other doctors and continue to mispractice for many decades. If it were any other profession besides politicians, they would have been drummed out forthwith. Until this changes, doctors have no right to complain if they are lumped in with the bad apples as a result. We hear about the push for tort reform to limit damages in medical malpractice suits but nothing about getting rid of the doctors who kill, maim, or overdose their patients. Not to mention the obnoxious, rude doctors, again who wouldnt be tolerated in other professions.