Can anyone suggest any decent thyroid resources for patients that aren't websites from mad, single-issue pressure groups?

It's not a popular thing to say, but increasing access to GPs just lowers the threshold to present, leading to capacity being further taken up by the trivial and self limiting. Particularly if "free". There's a lot to be said for a therapeutic wait and soft barriers to access.

I keep seeing GP trainees sat with EMIS/S1 on one screen and NICE CKS on the other. In plain view of patients. Don't do this, kids.

Don’t take paracetamol then…? 🤷 Sit with a headache, pain, and fever if you want. I don’t mind.

This post partly came about because our registrars were complaining they had to stay late to sort out all the vitamin D and B12 results they’d generated…

Anyone also noticed that clinicians are far more judicious in their requesting if they have to deal with the result?

My first time formally taking on medical students today. Tiring and actually a bit harder than the day job, but I enjoyed it. Young (oh, so young!), keen, enthusiastic and professional. We’re going to be in good hands, I’m sure 👌

As doctors we absolutely need to recognise and respect expert patients or carers when it comes to chronic and complex disease. The doctor mustn't dictate and assume they know best. But the patient or carer must not expect the doctor to do everything they say. Seems obvious.

Heartbreaking for the family but not an easy diagnosis to make in the early stages. My sympathy for the Paeds ED Reg who assessed and managed the risk. Sometimes we get it wrong. There is also harm in doing everything for everyone every time. https://t.co/8Hspz37hU6

Strikes me as fairly typical knee-jerk policy, and the reported outcomes seem a bit suspect. The road to hell is paved with good intentions. BBC News - Martha's rule rolled out to all acute hospitals in England - BBC News https://t.co/Lb2J1nZopv

The grass in my garden right now:

Sat in Soho Gardens. Lots of Instagrammers farting about this morning. Expect to see me in the background of various reels slumped on a bench stuffing a banana and looking disapproving.

Late Friday. Cases of cold sweat-inducing clinical risk kept out of hospital. Just me, taking it on the chin. All far beyond my remit because other services say no. If something happens they’ll throw me to the wolves. Nobody would help. You’ll miss us. #buckstopshere #justaGP

Loving how the thyroid loonies have descended on this thread.

Complaint from son. Upset at situation and feels wrong treatment given, delaying Dx. States symptoms of fatigue, thinning hair and weight loss were wrongly attributed to thyroid under-treatment by GPs. Feels they’ve been negligent. Considering legal action. 8/8

BT done. TSH unchanged; mildly suppressed. New IDA on 🩸 done at same time. Urgent call to patient and son. Results relayed, need for further testing to exclude malignancy explained. 2ww colorectal - malignancy found on colonoscopy. 7/n

F2F appt with senior partner. Son brings 📑 again. Patient looks thin and pale. GP mentions LT4 might be too high, needs new TSH. Declines raising LT4 until this is checked. Pt and son angry, threaten complaint. BT arranged 1w hence. 6/n

2m later pt and son request call from senior partner - refuse appts with other clinicians. 3w later ☎️ with senior partner. Pt feels no better, unhappy higher LT4 hasn’t helped. Asking for ⬆️ dose. GP partner hesitant w/o seeing F2F. Son unhappy. F2F arranged in 2w. 5/n

2 months go by and the new TSH arrives. Mildly suppressed. Patient sent message checking for any symptoms of over treatment - denied by patient. New dose established. Plan to rpt TSH in 3m. 4/n

Complaint responded to, ☎️ with senior GP partner offered. Brief discussion had, apologies offered for miscommunication. LT4 issued. Partner reasons TSH higher end of normal. Complaint closed. 3/n