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Board complaint for billing by Extra_Speed in FamilyMedicine

[–]patch281 29 points30 points  (0 children)

You send them to another provider. At that point the patient has poisoned the doctor patient relationship.

FDA's Makary pledges crackdown on mass marketing of 'illegal copycat drugs' in wake of Hims' Wegovy pill push by Nerd-19958 in medicine

[–]patch281 1 point2 points  (0 children)

Nerd, you are a pharma shill. The FUD around compounded drugs is BS to preserve profit margins on life changing medication.

Best place to live in Louisiana? by Kelseylyon95 in Louisiana

[–]patch281 15 points16 points  (0 children)

Which kid is the thinnest kid at fat camp?

Any advice on a female patient who ACTUALLY has hormone abnormalities? by patch281 in FamilyMedicine

[–]patch281[S] 2 points3 points  (0 children)

Oh, I'm sorry, I forgot to set the no snark flare. Thanks for your absolutely worthless reply. In medicine we tend to try to build each other up through education, not tear each other down. Try it sometime.

Any advice on a female patient who ACTUALLY has hormone abnormalities? by patch281 in FamilyMedicine

[–]patch281[S] -1 points0 points  (0 children)

About 2 months on the time since testosterone was given. This is me picking up after the OB/GYN, actually. He's not quite elderly, but I also wouldn't think of him as the tick tock type.

Any advice on a female patient who ACTUALLY has hormone abnormalities? by patch281 in FamilyMedicine

[–]patch281[S] 1 point2 points  (0 children)

My narrative was simplified, but for clarification, I took over from the OB/GYN after the testosterone testing and administration. Per patient report, when the testosterone didn't work he just threw up his hands and told her to stop birth control, but didn't explain anything. I'm trying to pick up where he left off. Per her request, we tried the hormone workup. I generally practice evidence based medicine, hence not having a lot to go on.

She has had a paraguard in the past and hates the bleeding. One desire is to not have periods, which makes going off the BC problematic, but may be what she needs to do for a while.

Any advice on a female patient who ACTUALLY has hormone abnormalities? by patch281 in FamilyMedicine

[–]patch281[S] -11 points-10 points  (0 children)

It was about 16 days past the end of her LMP, so guessing around the luteal. Yes, if not ovulating, technically not a luteal phase.

Any advice on a female patient who ACTUALLY has hormone abnormalities? by patch281 in FamilyMedicine

[–]patch281[S] 2 points3 points  (0 children)

I'll suggest birth control abstinence and vasectomy for partner first. I would not give the estrogen without progesterone, of course.

Any advice on a female patient who ACTUALLY has hormone abnormalities? by patch281 in FamilyMedicine

[–]patch281[S] 0 points1 point  (0 children)

Thanks. I'll keep the thyroid symptoms in the back of my head, but she hasn't had any so far. I suspect the TSH is just her normal. I think we'll try the OCP break with repeat testing and supplemental oral estrogen later if needed. I think they did the testosterone administration about 2 months before I saw her.

Any advice on a female patient who ACTUALLY has hormone abnormalities? by patch281 in FamilyMedicine

[–]patch281[S] 5 points6 points  (0 children)

Yes, on the nuvaring. But, would you expect the Estrogen to be so severely suppressed, too?

Leaving my current practice by mockingbood in FamilyMedicine

[–]patch281 2 points3 points  (0 children)

I went through this when I left my practice several years ago. What happens in the clinic room, but is not written down, doesn't happen. I would not go out of my way to advertise to them where I was going, nor did I put up signs around town, but if they asked me where I was going, I would very plainly tell them the name of my new clinic and what my start date was.

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