What to do when you know your doctor is uninformed or biased

Question_Mark

Summary: I clearly have some varicose veins in my scrotum; it's known as a varicocele. It causes a dull ache, and the medical literature strongly suggests that it lowers testosterone levels. I've studied it in depth for months, from legitimate sources.

My GP referred me to a radiologist for an ultrasound. Though by all accounts the radiologist was a nice guy, he didn't know anything about the link between varicoceles and low testosterone, and he said not to worry that varicoceles are harmless. I disagree. Without throwing credentials around, I want to establish that I'm educated in medical literature and statistics and research and I know more than this man about the condition.

I can clearly see it, and my left testicle appears to have gotten slightly smaller since the varicocele first appeared. But he said it was nothing to be concerned with, that it's barely noticeable (its size varies day to day and on this day, unfortunately, it wasn't as inflamed-looking as most days), and he wrote a letter to my doc saying that everything was cosure.

Now, my doc doesn't seem to know much about varicoceles either. How on earth do I approach him about this? I don't want to appear arrogant, like I'm telling him what he doesn't know, and I don't want to sound confrontational about the radiologist who was very biased and on the ignorant side. I want this taken care of (there's a minimally invasive surgery that's very effective and very low risk), and I don't know what to do. How do I approach my doc, and how do I convey that the radiologist wasn't up to scratch on this topic.

I took photos of the varicocele and am planning to bring them in, and perhaps I should bring in some research showing the importance of treating them early?

(Clearly I'm not looking for medical advice)

2Scoops

I think you've answered your own question. Return to your doctor and explain your concerns and findings in a non-judgmental non-confrontational way.

username123

Go back to your doc, tell him you are not happy and you want a second opinion. If your doc doesnt like it, go to another doc.

Chrisita

Find a Dr who practices functional medicine.

Xeyn

Could you link the accredited literature that links varicocoele with low testosterone?
There is definitely literature to suggest prominent varicocoele are linked (but not necessarily with causality) to sub fertility but many studies have shown surgical correction won't effectively treat this sub fertility.

There is no definitive consensus as far as I'm aware of to treat varicocoele's. And those that are treated are done so for significant pain or infertility - but again many studies have shown little improvement in outcome.

Secondly, your radiologist will give an objective report on what was noted at ultrasound, bias does not come into it. He may have offered informal advise but it is up to your doctor to interpret the results and refer you to a urologist or interventional radiologist if he/she feels this is warranted.

Drained_Empty

try and get a referral from GP to a urologist

ergo

your GP is a generalist - not possible for a GP to be up to date on the latest literature on every possible medical condition - but a quick search might inform him or her and your GP may have already done that

- ask for a referral to a specialist ie. a Urologist - be prepared for the specialist to have a different opinion to yourself (or maybe he or she will agree)

some basic but useful info here, some of it based on a couple of Cochrane reviews it seems
http://www.patient.co.uk/health/varicocele-leaflet

gctest50

Question_Mark wrote: »

Summary: I clearly have some varicose veins in my scrotum; it's known as a varicocele. It causes a dull ache, and the medical literature strongly suggests that it lowers testosterone levels. I've studied it in depth for months, from legitimate sources.

Go to (another) doctor

steddyeddy

Go to another doc. When I'm prescribed antibiotics I always ask my doctor what sort of bacteria they are effective against. If he doesn't know I change.

HeadPig

10-25% of men have varicocoeles. They are of no significance unless you feel they are affecting your fertility. It's not an issue.