Endocrine Abstracts

Objective: A great number of patients are self-referred to endocrinologist. Most of these patients had some research of their symptoms and have a specific diagnosis that they want to investigate.

Methods: A retrospective chart review of 628 new consults conducted in one outpatient endocrine office at University of California, Los Angeles was conducted.

Results: Of the 628 new patients 326 were referred by another physician and were excluded from further review. Of 302 self-referred patients 248 patients had a preexisting endocrine diagnosis and were excluded. The remaining 54 patients were seeing endocrinologist for the first time and these patients were included in further study. Most common complaints were: weight gain (78% of patients), fatigue (72%), cold intolerance (46%), heat intolerance (31%), constipation (24%). Other common complaints observed were hair loss, low libido, erectile dysfunction, anxiety, palpitations, weight loss, hirsutism, acne, muscle weakness, stretch marks, buffalo hump and polydipsia. When asked if they had a specific hormone abnormality in mind most of the patients reported that their main concern is hypothyroidism (69%), high cortisol level (13%), low testosterone (10%), low cortisol (5%), hyperthyroidism (5%), diabetes insipidus (4%), diabetes mellitus (2%). After conducting endocrine studies based on presenting symptoms none of the 54 patients were found to have confirmation of suspected diagnosis. Four patients were found to have elevated TPO antibodies but thyroid functions tests were normal. Six patients were found to have diabetes mellitus that was previously not diagnosed or suspected. Two patients were found to have elevated cholesterol.

Discussion: Common problems lead to online research that offers a number of endocrine conditions as a possible underlying problem. With access to subspecialist care oftentimes unnecessary work-up is done.

Conclusion: A longer period of investigation would add valuable data in determining the impact of self-referrals on subspecialty practices as well as health care in United States in general.