How can we know what we don’t know?
I asked an amazingly brilliant GP, who has been one of my long time mentors, why he had had a few patients with a TSH <0.05 for many years. He replied that he titrated to T3/T4 levels as he always does. He was horrified when I showed him that best practice is to titrate to TSH not to T3/T4 and that his patients were possibly at increased health risks. He couldn’t believe it! How could he have been practicing for such a long time and never come across this!! In reality, his patients felt fine, and therefore there was no opportunity for feedback. And this doctor is brilliant! It is SO easy to keep doing what we have always done and not know if it is best practice!
“Makes you think – what might you be doing in not the best way?…
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