
Originally Posted by
AnabolicDoc
I'm guessing you've been practicing for a longer time than me as I don't exactly agree with your last sentence, although I'm sure you're half kidding.
I agree with what you said about the long list of differentials and so forth. I think in conjunction with that, we've had such an exponential growth in medical knowledge in the past 20 years that is increasingly harder to stay current, especially for a PCP. There has been the development of completely new fields of medicine, such as medical genomics, which I admittedly know very little about. I think the average patient just isn't aware of how much there is to stay on top of. But I also think that too many doctors are unwilling to learn above what is required by continuing medical education mandates. The majority of the docs I know over 40 don't even use a PDA/smartphone for medical applications, which I think is essential and would result in an even more dramatic improvement in the quality of care provided if adopted by the older doctors.
On this forum alone we see too many stories of ppl out on TRT without an adequate work up, without consideration of hcg/AI/DHEA/pregnenolone and so forth. There are too many stories of young ppl who are put on TRT without the option of clomid and or HCG as treatment options which is done without regard to the person's fertility. At the very least before a young patient is placed on TRT, he should be counseled about impaired fertility, sperm storage, and alternative treatment options. This includes adequate supplementation with vit C, vit D, and a whole list of potentially useful supplements that won't impair fertility and MIGHT improve test production (and subsequently avoiding TRT), such as tongkat, DAA, tribulus, longjack root, ashwagandha, and more. Then the patient can mange an informed decision. Too many doctors are prescribing TRT without an appropriate knowledge base, but at the same time there is such a need for it and not enough capable doctors. I think this is even a bigger problem when it comes to female HRT, where there are many women seeking treatment but few doctors willing and able to do so. With all that said, I don't know if I have the right answer to these problems.