Horrible Practice

A friend in Florida sees her regular endocrinologist for hypothyroidism.  Ever since she was found to have impaired fasting glucose, her specialist insisted she check her fasting levels 3 times a week by glucometer, ongoing!  I, and other friends who have frank diabetes, told her it was stupid [we reserve the word for truly egregious instances].  The only rationale I can imagine is that the doc got tired of billing for mere hypothyroidism, & sought a more lucrative diagnosis.

And why see an endocrinologist for hypothyroidism, which happens to be the easiest chronic illness in the world for any primary provider to treat (just monitor TSH & adjust the L-thyroxine dose here & there)?  Florida apparently is a special state, with Medicare reimbursement for primary care low enough that providers simply refer out right and left.  The worst case scenario is to have an “interesting patient.”  See http://www.nytimes.com/2003/09/13/us/patients-in-florida-lining-up-for-all-that-medicare-covers.html [it’s a 2003 article; I’ve no idea if anything’s changed since].

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