Thyroid Nodules and Cancer 101: The age of your primary physician knowing whats right for you about nodules and thyroid cancer is over.

Thyroid Nodules and Cancer 101: The age of your primary physician knowing whats right for you about nodules and thyroid cancer is over.

Thyroid Nodules and Cancer 101: The age of your primary physician knowing whats right for you about nodules and thyroid cancer is over.

Thyroid Nodules and Cancer 101: The age of  your primary physician knowing whats right for you about nodules and thyroid cancer is over.

 

The New Age of Patient Autonomy

The Gatekeeper Role of the Primary Physician Must Change in 2018

doctor-patient-relationship

JAMA 320(19) Novenber 2018

Kilbride et al

Dr.Guttler’s Comments on the viewpoint article.

  1. In 2018 the patient takes control of their care when it comes to difficult decisions about thyroid nodules and cancer.
  2. Old assumptions that your physician was the best source of needed information about thyroid care is over.
  3. What does it mean for the patient with thyroid nodules and cancer?
  4. The patient can obtain needed information on thyroid nodules and cancer from the internet or social media.
  5. The patient must seek outside opinions if their primary will not allow them to go outside their insurance plan.
  6. The patient in order to be informed must go outside the opinion of  just of their primary physician and collect needed information for qualified thyroid websites.
  7. Old primary physician gatekeeper is out and a new version must be a consultant not a dictator.
  8. They must listen to the patient when they found surgery alternative treatment options such as ethanol PEI or radiofrequency ablation RFA.
  9. The old gatekeeper function is now modified to include opening the gate to new ideas brought to them from the patient.
  10. Many alternative services that save unnecessary thyroid surgery must be brought to the primary physician’s attention and request they study the request before declining it. Saying surgery is the only answer and these alternatives or PEI and RFA are painful and dangerous just is not truthful in  2018.
  11. Last resort is for the patient to assert their right of autonomy when it comes to their health and go against advice and seek care on their own.
  12. Call 310-393-8860 or email to thyroid.manager@protonmail.com for outside opinion before you go to surgery.
  13. DR.G.
2 Comments
  • Pam LiVecchi January 1, 2019 4:28 am

    I have a 1.0 cm nodule on my Isthmus that affirms said was suspicious ROM 50% the description is: the cytology and cell block preparations are markedly cellular and consist predominately of Hürthle cells in trabocular arrangements and singly, with scant/absent colloid. I also have 2 other nodules in my lower right 1.0 cm that are marked benign. My endocrine doctor recommends a full removal of my thyroid.

    • Dr Guttler January 2, 2019 8:42 am

      Pam,
      Before you have removal of the thyroid get expert second opinions.
      Send me the path reports and the slides.
      There is a $450 charge to review the slides.
      Alicia at 310-393-8860 or thyroid.manager@protonmail.com will
      send you a medical records release slip after you send the report first.
      Secure email you can use credit card.
      It is too late once you have it removed.
      Some 1 cm don’t need to removed and others only half of the thyroid.
      Send a check if you wish to me at
      1328 16 th street
      Santa Monica CA 90904

      Dr.G.

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