It started out bad. Then it got worse.
It took me years to get the right doctors. Through hard work, luck, determination, and some more luck, I finally managed it. My primary care physician (PCP) was kind, thoughtful, and smart. He knew a lot about how to treat thyroid conditions beyond the most common conventional approach. He knew how to treat adrenal insufficiency. He was fantastic. And then he announced his upcoming retirement.
It was 6 months away, and I was immediately worried. He promised that he would help me find someone, but we kept hitting dead ends. This doctor didn’t take my insurance. That doctor didn’t know much about thyroid treatments. That other doctor also didn’t take my insurance. Another doctor didn’t recognize adrenal insufficiency as a medical condition (WTF?!?) We hoped that his replacement could treat me, but they were having trouble finding someone to take his place.
Then my women’s health doctor left very suddenly. At my last appointment, we’d been talking about how she’d been at that practice for 25 years and planned to stay until retirement. Two months later, I got a letter that she’d had to leave due to a family emergency. She hoped to one day return to practicing medicine, but wasn’t sure when, or even if, that might happen.
Like my PCP, my women’s health doctor was fantastic. She always asked me questions about my entire body. She wanted to know all about what was going on with me. She was kind, caring, insightful, and smart. She knew how to properly treat with bioidentical hormones, and she also understood why those could be problematic for me, even though I still needed them at times. And she was gone.
Her letter included a list of doctors and practices to try. I called the first one on the list. They didn’t use bioidentical hormones at all. I called the next one. They didn’t take my insurance. And on it went.
My PCP officially retired. His replacement was a nurse practitioner (NP) fresh out of residency. She had no knowledge of thyroid or adrenal treatments. She agreed to keep writing my prescriptions, but was clear that she didn’t want that to be long term. And if I had questions, she wouldn’t be able to help me. Fuck. These are tricky conditions and the medications often need to be adjusted in ways that can be hard to determine. I’ll definitely have questions.
The hospital won’t let an NP be a PCP (insurances in the U.S. require everyone to have a PCP).) She’d suggested I speak to the administrative assistant about being assigned an official PCP in the office. The admin, who I’d spoken with more times than I can count, remembered me, and we had a chat. Another doctor had also left the practice. They had wanted to hire 2 or 3 new doctors and I asked how that search was going. She told me they were having trouble finding people, and that few were even applying. Then I asked if she knew how things were going to replace the women’s health practitioner I’d been seeing. She told me they weren’t even trying. They had wanted to replace her at first, but there are few in the country who do what she did, with her specialized knowledge, and they couldn’t even get applicants. So they stopped trying, and instead were focusing on the search for new doctors, which was also not getting very far. What’s going on here?
This isn’t any old office, you see. It’s an integrative medicine practice. Integrative medicine is even in the name. That’s why I wanted to go there to begin with, and it’s why I had liked these two practitioners so much. It’s also, without a doubt, why my health improved so much. I’ll let you read back over old posts for those details, but suffice it to say, I need an integrative approach. Alternative medicine helps, but only to some extent. Conventional medicine helps, but only to some extent. I need both, and they need to be combined, not separate.
For now I’ve found a doctor who, while not as great as my PCP, can help with my thyroid and adrenal stuff. He takes my primary insurance but not my secondary insurance, so I still need to get the new NP to order tests so I don’t have to pay a small fortune. I’m not exactly confident in how well that will work. And he appears to be in his 60s, so I’m not sure how long I can see him before he retires. And without these medications, I’m totally and completely screwed.
So my question is, what happened to all of the integrative practitioners? Are there any left? Are doctors no longer taking that approach, or maybe they are but they aren’t in Massachusetts? What are the patients who need them supposed to do? I’m scared, and I don’t know what to try next.
On the bright side, it’s autumn in Massachusetts and totally gorgeous, so here’s a picture of a tree for you. Enjoy! And if you can offer any tips for finding an integrative practitioner in Massachusetts who takes Medicare and MassHealth, and who has knowledge of Hashimoto’s and adrenal insufficiency, I would be INCREDIBLY grateful!