Actually, I found numerous doctors in my area who claimed to do "state of art"
TRT and who very openly discussed that "fact". Many bragged of the fact that they were already treating "many hypogonadal males".
Invariably, through further research (whether they were GPs, Endos, or Uros) I was dismayed to discover that they treated anywhere from a couple of hypogonadal patients - to maybe as many as ten. In every case the doctors thought that it was "a waste of time" to check for estrogens and estradiol levels or
DHT levels. Two doctors specifically said, "For what? I wouldn't know how to treat it if it was too high anyway". One doctor specifically said that there was no need to do that as males do not have a uterous so don't produce estrogens (yet he was a doctor who "claimed" to be a
TRT doctor).
And the
TRT protocols?
1. Compounded T creams - especially if they were "alternative medicine" oriented doctors. And universally not covered by my insurance and therefore much higher in cost.
2. AndroGel (and occasionally Testim). One doctor went so far as to say that 5 grams of AndoGel would "cure any known hypogonadal state". He was the doctor who first started me on
TRT and did so after testing ONLY Total T and PSA. No Free T. No LH and FSH. Etc. When asked about his regimen for follow-up, he stated he would check my Total T and PSA with my next annual physical (a year later).
3. IM Shots. Every doctor that I checked with but one used the protocol of 200 mg
Test Cyp every other week. The one exception used the even older protocol of 400 mg
Test Cyp once a month.
In every case (every one) the doctors not only declined to consider the use of HcG, but some expressed considerable concern that I was even asking about it. One doctor specifically referenced it being a medication strictly for female fertility.
So I think that it many cases it isn't a concern by the doctor that people will find out that they do HRT /
TRT or deal with treating hypogonadal males (after all, every major medical clinic / hospital in this country - John Hopkins, Mayo Clinic, etc., etc. recognizes Hypogonadism as a recognized medical disorder). Why would doctors be "embarrassed" that they are treating a legitimately recognized medical disorder? I don't think that the "really good"
TRT practitioners are "afraid that the word will get out", I think that most of the really good ones would like for the word to get out.
And I think that doctors who are actually doing legitimate "state of art"
TRT (like SWALE) are more than willing to let it be known who they are and what they offer.
The Yahoo H2 Hypogonadism forum has a file where members can openly post their doctor's information... with no apparent concern for legal entanglements. As long as the doctor isn't being bashed or slandered, what is the concern? The doctor is listed in the phone book (probably both in the business section and in the Yellow Pages) and is open for business and is treating hypogonadal males. What legal concerns are there? As far as I can see, posting a doctor's contact information on a forum is completely without legal concern (as long as there is no slander involved) simply because the member is doing nothing more than posting public information:
(A) If I can find the doctor's info in the phone book then it is a public listing
(B) If I call his office and ask if he treats hypogonadal males (before I would make an appointment), then that too is then public information
So what's the big deal?
Most medical forums that you would check (Thyroid Disorder Support Forums, Cushing's Disease Support Forums, Prostate Cancer Support Forums, etc., etc., etc.) almost universally have sections where recommended doctors can be posted with no concern (the Board simply announces that no bashing or slandering is allowed and refuses to post any postings that bash or slander). I am concerned here that a mountain is being made out of a molehill.
I think that a much bigger problem is that there will be relatively few doctors who end up getting posted simply as there are so few doctors that individuals are comfortable with recommending as being "really good"
TRT practitioners.
In my case, I personally dealt with four and had pre-appointment discussions with probably another 18 - 20, 22 doctors (before finally just giving up) in my area (NE Ohio). I finally gave in and made the drive up to see SWALE. As it stands right now, from my personal experiences (both direct and through phone calls), I could recommend only one doctor - and that would be SWALE.
Now don't get me wrong, I think that this project is a good idea - a very good idea. After all, it might turn out that there's a very progressive
TRT practitioner in my immediate area (and who is even on my insurance coverage!)...
Larry
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