Renowned Doctor on Why Some "Clinics" Are Scum

[HRTstudent]

I like this forum because, for the most part, we are all interested in actually treating low T in a medical, physician-supervised environment. However, I understand that there is a minority who simply do not share that ideology. Along these lines, the word clinic is often a tricky issue, and it's been brought up a few times more recently. Here's an interesting article I read from a real practicing US physician who treats hundreds of men treated poorly via some "clinics."



Source: Thomas O'Connor M.D.
March 2012 MD magazine
http://anabolicdoc.com/images/Anabol...012/1March.pdf

The federal government has been closing down many of the “anti-aging/rejuvenation clinics all over the U.S.! I’m no “pro-BIG BROTHER” guy, but honestly, thank GOD these places are getting smashed down! Here we go…

I’m about to RANT! I have a steady stream of patients coming to see me from these so-called “medical establishments” and it’s scary to see what they do/don’t do for their patients! Most of the patients I have from these “clinics” actually have never even spoken to a doctor while they received FedEx boxes of unlimited steroids ! God Bless America! And as for the “laboratory assessment” that was supposed to be done during their treatment period…what a ****in’ JOKE! Sorry, Mom! It’s not really rocket science, but if the doctor cannot address the following basics in androgen delivery to men, he should not be practicing medicine: simple polycythemia, differentiate true renal failure from a false-positive low estimated GFR, abnormalities in lipids, abnormalities related to basic urine analysis, prostate warnings, relevant issues
with key vital/clinical signs and symptoms indicating that something is going wrong!... and many more life-saving medical issues related to the safe delivery of testosterone to men. I’m so tired of so many men coming in to me with existing and avoidable diseases involving the heart and kidneys! These Docs are just selling compounded steroids through the U.S. mail system!

Another interesting comment I hear from my patients is that once I put them on real “pharmaceutical grade” testosterone from CVS and Walgreens, they feel much better! Not to mention, in many instances their insurance pays for their HRT! And to all of those whiny-ass SOBs who think I’m just bashing “compounding pharmacies”…Shut the **** UP! Some compounding pharmacies are OK, but the truth is these places can be making “gear” just like many of the “UG labs” do—with bulk “gear” powder from China! I swear I will kick the shit out of anybody who wants to argue me on this! It’s not time for political correctness, and that is not why Muscular Development has The Anabolic Doc as a writer! We have enough bullshit being thrown at us by the mainstream media today, and the hundreds of patients I have don’t lie! Enough said! Stop the medical madness and get a real Doc who understands testosterone therapy for men! It’s also not a bad idea to have a Doc who gets to know you and is there for you when you need him!

OK, thanks for letting me vent! I feel better now! I’m just so pissed off that so many people are getting shit medical care from these places! Maybe the standard Doc in the USA does not know how to deliver testosterone to you guys the way you would really like, but these Docs are good guys and have your health in mind! A lot of your regular Docs call me for advice, and that is really cool!


Hope you appreciate the sharing/information...

[Vettester]

Thanks for sharing this. It's actually kind of interesting coming from a doctor's perspective. IMO, what we need is more mainstream doctors to get up to speed with properly administering HRT to their patients. In my case, I started this journey with Kaiser, who is my PCP. Truthfully, I'd rather just stay there (1 stop shopping for all my health needs), but their ability to treat for HRT is (I'll be polite) not very good. One of their endos told me that E2 isn't an issue for men, and HCG is for Manny ... Enough to push me out the door and seek something better. Unfortunately, this is where and when a lot of guys end up landing with one of these "medical establishments" that Dr. O'Connor mentions.

So, yeah there are a lot of places cleaning house at the moment that are indeed basically selling compounded steroids via US mail. If somehow we can get mainstream medical up to speed with treating HRT properly, it would help keep some of this in check. JMO

[kelkel]

Very interesting. Many relevant points there HRT.

[HRTstudent]

Thanks for sharing this. It's actually kind of interesting coming from a doctor's perspective. IMO, what we need is more mainstream doctors to get up to speed with properly administering HRT to their patients. In my case, I started this journey with Kaiser, who is my PCP. Truthfully, I'd rather just stay there (1 stop shopping for all my health needs), but their ability to treat for HRT is (I'll be polite) not very good. One of their endos told me that E2 isn't an issue for men, and HCG is for Manny ... Enough to push me out the door and seek something better. Unfortunately, this is where and when a lot of guys end up landing with one of these "medical establishments" that Dr. O'Connor mentions.

So, yeah there are a lot of places cleaning house at the moment that are indeed basically selling compounded steroids via US mail. If somehow we can get mainstream medical up to speed with treating HRT properly, it would help keep some of this in check. JMO

You hit the nail on the head.

This is the dream right here...

if only our doctors could be as trained in male hormones as they are in diabetes.

Like you, my doctors had no interest in checking estradiol. It's a shame that so many patients actually feel forced to self medicate or play doctor themselves. It's hurting individuals like just us to have these doctors prescribe things they are ill-informed about.

[kelkel]

It's definitely scary. The first doc I had sent me to an Endo where we discovered the adenoma. Ok, fine. Problem located. Now fix me. He had no clue about TRT and should have stuck to diabetes. I started educating myself (mostly here) and it became painfully obvious to me in a short period of time that he really had no clue what he was doing. Classic statements such as "you don't have to worry about estrogen" and "there's nothing you can do about testicular shrinkage as it's not a proper use for HCG and it won't help!" After a short period of this I basically told him he should stick to diabetes and metabolic diseases and not treat people for TRT as he is clueless. He was literally amazed that I argued with him and told him he was wrong. He and his staff subsequently called as they could not believe I was "leaving" his practice.

[Vettester]

Kelk, I envy the fact that you got to walk out of there on your own terms. Unfortunately, my endo fired me as a patient. After he gave me the spiel about HCG is only for Manny, I dug up and sent him an article from the Journals of Endocrinology, which clearly supported clinical evidence with the effectiveness of HCG. Honest to God, my intentions were only to raise his awareness, and I figured he would relate better with information coming directly from his colleagues. LOL, how naive of me at that time not to realize just how fragile his little ego was. It infuriated him, and he immediately sent me a letter of dismal, claiming I was unwilling to cooperate with his sound medical advise.

Again, to reiterate, I would suspect that a big portion of the clients that end up at these clinics that are mentioned by Dr. O'Connor are just guys like us, who just tried to get a fair shake with their PCP's, but ended up elsewhere when they got neglected and mistreated. Places like Kaiser and other PCP's will slowly but surely get on board with this, as they are seeing the $$ opportunities that are getting passed up. After several years of working with HRT clinics and doctors, my PCP is starting to take notice to all the positive changes I have gone through. She is now running my E2 in her labs!!! This is a huge step, as this would have never happened with team Kaiser in years past. She is now asking me questions regarding my HCG protocol, and how I manage my regiment. I suspect that she has seen an increase of 40 something patients over the past few years, and the discussions at their meetings are probably starting to take a different tone.

And like many of you guys, I found this forum when I was down and out with my medical team. If memory serves correct, it was just right after the fiasco with that nazi endo that I mentioned above. It's been an interesting and productive journey ever since. Just remember, there's going to be clinics and doctors that will give a guy any and all of the gear he wants, and there's going to be places that will give you next to nothing; maybe one pump of gel if you're lucky. However, in the end, we are ultimately responsible for our lives and what we do with our bodies. Just because I have a script for 250mg/wk of cyp doesn't mean I take it. Optimal health is a little different for each individual. Resources like this forum will give each person the tools to discover their own sense of optimal well being ... It's just a matter if each person will take ownership of their program.

[GotNoBlueMilk]

Based on comments on this board, in general the private doctors are no better than the clinics . . . knowledge wise. The clinics just exploit better.

[doc w]

IMO one of the biggest issues is the timeframe we live in. Although test has been around since 1940's, TRT protocols are fairly new. Imagine being one of the first diabetics to be treated. The knowledge is out there, but since the media has stigmatized aas. Doctors are usually unwilling to treat with the necessary amounts, or they are greedy and don't give a sh@t, or the lack the knowledge. I think we will see a huge change in the next ten years as better protocols are developed and as the evidence mounts that low t is a detrimental condition

[GotNoBlueMilk]

I was fortunate that I found a clinic that was excellent; however, the big benefit of this clinic is the doctor in my area. He really knows his stuff! He also started me out subq 2x/week. This was way before Dr. Crissler relented on his subq position and finally came over. My clinic also doesn't sell any meds. They write a script. So the temptation to line the pockets with more money by writing more scripts is gone.

The only down side to my clinic is the headquarters seems to have some internal problems. Getting my first appointment setup was difficult. Had the same thing when I tried to get my wife in to see this doctor.

So in the end it really comes down to the doctor. A good doc isn't going to work for a pill mill. He/She will have both knowledge and morals.

[fit2bOld]

^^^^ So well said guys, Having been told by the female GP Viagra and Vitamin water would be a good idea and no interest in blood work I ended up at a clinic. Now searching for a new GP came across a great PA that was totally educated, been with him over a year we do regular blood work and he is truly interested in how I feel.

Were all looking for quality care funny how we find it or don't with all the so called professionals.

[zaggahamma]

i wonder what is the main contributing factor that is getting them closed down

too large of doses, not enough bloodwork to show the need, too many "strains" of hormones ie: anavar , deca , etc.?

i for one like the idea that if i can ever afford to get on growth and maybe run some deca a few times a year for joint relief that its not impossible

[APIs]

i wonder what is the main contributing factor that is getting them closed down

I would think their biggest snafu is lack of face-to-face care & a proficient paper trail showing medical necessity for each & every patient.

[zaggahamma]

I would think their biggest snafu is lack of face-to-face care & a proficient paper trail showing medical necessity for each & every patient.

yeh
seems as if they would know what would be required to stay in business if others are still running...idk..

maybe some are contibuting to obamas re-election and some arent

[LFH40]

It's definitely scary. The first doc I had sent me to an Endo where we discovered the adenoma. Ok, fine. Problem located. Now fix me. He had no clue about TRT and should have stuck to diabetes. I started educating myself (mostly here) and it became painfully obvious to me in a short period of time that he really had no clue what he was doing. Classic statements such as "you don't have to worry about estrogen" and "there's nothing you can do about testicular shrinkage as it's not a proper use for HCG and it won't help!" After a short period of this I basically told him he should stick to diabetes and metabolic diseases and not treat people for TRT as he is clueless. He was literally amazed that I argued with him and told him he was wrong. He and his staff subsequently called as they could not believe I was "leaving" his practice.

Wow, sitting here after the wife and baby went to bed and trying to educate myself by reading through old threads and realized after reading this, Kelkel, sounds like we had the same endo! Haha! I got the same response. She told me, "shrunken testicles are something I guess you'll have to learn to live with," and "don't worry about estrogen, the dose I'm giving you won't affect it," and "hcg ? Oh god, I don't know about that... Your insurance won't cover that and we don't know enough about that for use for men."

Garbage! All of it. I walked out never to return. I too have a 10cm adenoma and at least I know why I have low t. Going through Low T . com was the best thing I ever did. Wednesday will be two full weeks since starting and albeit slowly, I'm feeling changes going on. Subtle, but nice changes. Guess around three full weeks is when things really start to shape up?

Damn those endos!

[dreadnok89]

yeh
seems as if they would know what would be required to stay in business if others are still running...idk..

maybe some are contibuting to obamas re-election and some arent

Yikes, awful political joke alert

[Low Testosterone]

i wonder what is the main contributing factor that is getting them closed down

too large of doses, not enough bloodwork to show the need, too many "strains" of hormones ie: anavar , deca , etc.?

i for one like the idea that if i can ever afford to get on growth and maybe run some deca a few times a year for joint relief that its not impossible

Interesting thread. Old, but still a good one. As for the answer to the above, several things:

1. No face to face visit with a doctor.

2. Filling prescriptions early and repeatedly for a controlled substance. I don't think a lot of people realize how big of a deal this is.

3. Not displaying consistency with who they treat and how they treat them, i.e. denying one man and accepting another who's virtually identical to the denied man because one was willing to pay more.

4. Prescribing controlled substances for the purpose of TRT that are not approved for the purpose of TRT. This one doesn't happen as often anymore but it still happens.

The one thing about the rant of Dr. O'Connor that I have to disagree with completely is what he said about compounding pharmacies, it's not that black and white. There are compounding pharmacies that use the same USP powders that every big name/label pharmacy uses and who have labs that are every bit as clean. To imply otherwise is ignorant or motivated by some other desire. It borderline discredits him in many ways, in my opinion.

[imnotnatty]

Dude I understand your rant, however, I've had horrible experiences with a few doctors and only got treated properly with an anti aging clinic, first doctor thought 190 test level was ok for my age, the other wanted to give me androgel and refused to give me test cyp, the third was a cocky asshole and said to excersice and I was too young to take trt. Then I want to an anti aging clinic and got what I needed.

So....

[APIs]

The one thing about the rant of Dr. O'Connor that I have to disagree with completely is what he said about compounding pharmacies, it's not that black and white. There are compounding pharmacies that use the same USP powders that every big name/label pharmacy uses and who have labs that are every bit as clean. To imply otherwise is ignorant or motivated by some other desire. It borderline discredits him in many ways, in my opinion.

I would agree that good compounding firms do exist & I have utilized the service myself. However, inherent quality can sometimes be lacking in the Compounding Industry.

While I agree it would be incorrect to label "everyone" in this manner, I can say from first-hand experience that the compounding industry's adherence with true cGMPs (Current Good Manufacturing Practices) is generally not as thorough & traceable as it is with Big Pharma. Federal oversight & enforcement in the two industries is very different. Whereas Big Pharma must utilize raw material sources manufactured by FDA inspected & approved facilities with efficacy data that is further validated through DMFs (Drug Master Files), NDAs (New Drug Applications) or ANDAs (Abbreviated New Drug Applications), the Compounding Industry does not. It’s not by choice, but the two industries operate under very different laws & regulations.

The Compounding Industry sometimes operates under the general premise that as long as a raw material or API (Active Pharmaceutical Ingredient) meets simple USP Specifications that it's OK for compounding purposes. Just because an API meets USP Specifications, does not necessarily mean it was produced under cGMP (Current Good Manufacturing Practices) which is the basis in determining whether an API meets minimum quality standards. This is a grey area in the industry that is exploited by some compounding firms to obtain their raw materials at the cheapest cost possible. As a result, it’s not uncommon for some Compounders to purchase APIs from U.S. Distributors or from other sources that are not on the same quality level as APIs (raw materials) being utilized by Big Pharma.

While this approach is not illegal, it is well known this practice by default can sometimes lead to quality & efficacy issues. Of course, this only surfaces when something major goes wrong with a drug being produced by a bad Compounder & we hear about it on the news.

In the end though, the Compounding Industry plays an important role in our healthcare system filling voids not addressed by large pharmaceutical producers.

[Juced_porkchop]

It's definitely scary. The first doc I had sent me to an Endo where we discovered the adenoma. Ok, fine. Problem located. Now fix me. He had no clue about TRT and should have stuck to diabetes. I started educating myself (mostly here) and it became painfully obvious to me in a short period of time that he really had no clue what he was doing. Classic statements such as "you don't have to worry about estrogen" and "there's nothing you can do about testicular shrinkage as it's not a proper use for HCG and it won't help!" After a short period of this I basically told him he should stick to diabetes and metabolic diseases and not treat people for TRT as he is clueless. He was literally amazed that I argued with him and told him he was wrong. He and his staff subsequently called as they could not believe I was "leaving" his practice.

thats F-ing awesome! that you told him straight up he is clueless! hahaha