UCSF Endocrine Metabolism Group

I had a multinodular goiter on half my thyroid and was referred to UCSF Endocrinology Faculty Practice. I had many appointments over several years and saw several UCSF specialists (some of which were «world reknown»). I found them to be very aggressive with treatment. They put me on a high dosage of synthroid for a long time (studies show that this is a questionable long term treatment for goiters because it is not effective). They strongly urged me to have my entire thyroid removed or radiated. Why? (1) To make sure there was no cancer (despite the fact that 3 FNABs showed the goiter to be benign). (2) They said a goiter on one half was usually an indication that the other half wasn’t functioning. They wanted me to continue getting yearly FNABs (although studies show this isn’t necessary when a FNAB comes back with benign results). I stopped the FNABs after 3.
I resisted the high dosage of synthroid and was condescendingly told «Well I guess you know better than the doctors.» UCSF wanted to monkey around with my system in other respects as well. They wanted to test me for Graves Disease, even though I had no symptoms. The world reknown endocrinologist said «I can see the disease in your eyes.» I went home and looked in the mirror and thought my eyes looked the same way they always have. They recommended that I should be placed on estrogen replacement therapy (pre-​menopausal) supposedly to help me through menopause when I got there, even though I had no symptoms and did not have any complaints which would have merited this treatment. I said no to the Graves Disease test and no to the ERT.
I finally decided to get the goiter out, but UCSF strongly resisted my desire to have only half my thyroid taken out. I did not want to be on synthroid for the rest of my life. UCSF said (a) being on synthroid is no big deal (excuse me but I think being reliant on a medication for survival for the rest of one’s life is a big deal — why intentionally invite that when it can be avoided??), and (b) even if half was taken out, UCSF told me I would still have to be on synthroid for the rest of my life. (I challenged them on this, but of course, they knew better.) I even said to the UCSF surgeon «I’m telling you that I only want half my thyroid taken out. When I am on the operating table and under general anesthesia, will you honor that request, even if it is against your better judgment?» His answer was «I don’t think you want to tie your surgeon’s hands like that.» Sorry, but that was the wrong answer.
I ended up choosing a non-​UCSF surgeon (one who had privileges at California Pacific) who believed it was necessary only to remove the bad half of my thyroid and expected I would not have to take synthroid. In him, I found my kindred spirit on this issue. He did the operation and removed only half.
That was 5 years ago. I have not taken any synthroid since my days of being a UCSF patient, nor do I need it. I never took EHT. I do not have Graves Disease. I did not develop thyroid cancer. None of the horrible things has happened to me that was predicted by UCSF if I did not get all of my thyroid removed. My remaining half-​thyroid functions perfectly. I do not rely on medication to help me live an active life. What’s more, I feel much better than I did when UCSF had me on that synthroid.
It is easy to be bedazzled by UCSF Endocrinology Practice’s pedigree. It is even easier to be swayed by this notion that you are getting the latest and greatest and cutting edge level of care. But there is more to the highest level of health care than that.
In my case, UCSF Endocrinology Practice was consistently wrong in prescribing treatment. They repeatedly refused to treat any of my requests as valid. I found their arrogance to be disconcerting. I did not feel that the endocrinologists and I were a team mutually agreeing on a course of treatment. Instead, I felt that I had to watch out for my own interests, make my own decisions, and consequently was patronized in doing so.
Each individual needs to do what he or she thinks is best. For someone who has a life threatening illness, wants a practice who will pull out all the stops for treatment, whether proven to be effective or not, and is willing to trust the doctors to make decisions for him or her this might be the right place. As for me, I would never go back there.

I wish I could be seen here… but they won’t take me, because they’re ‘at capacity’. I found this out after 3 months of sending refereals, faxing and re-​faxing their number of requirements for patients to be seen, hundreds of dollars of out-​of-​pocket lab costs.
So, no they won’t see me after all of that, and it took me 16 phone calls to try and get somebody to talk to me where the entire staff wasn’t out to lunch. Apparently, somebody messaged my primary care physician this information months ago, but she never recieved it, and she gets an A+ for reliability.
Hypothyroidism runs in my family. Hypothyroidism has shown up on a number of my lab results, and I have a ‘mystery disease’ known as polycystic ovarian syndrome. It would be nice to have the option to work with an endocrinologist to further examine my extremely high cholesterol counts, high testosterone, random TSH/​T4 levels as well as non-​existant period, but all of it gets lumped into the category of ‘PCOS’ where the OBGYNS push synthetic hormones on me.
I would like to get to the root of the problem, but my case won’t be seen by this office.

I’ve been an Type 1 Diabetic for the past 15 years, and spent the first 8 years getting treatment at the Joselyn Diabetes Clinic in Syracuse, NY. Their treatment was comprehensive and fantastic. I had a hard time finding a comparable practice after I moved to the Bay Area — most diabetes/​endocrine practices (out here?) don’t include additional services like diabetes educators or have practitioners who are up to date with the latest technology. I use an insulin pump, so it was essential for me to visit a clinic that would a) understand how to help manage that and b) be able to prescribe new treatments involving newer technology.
Pros: I’ve been very happy with my experience at UCSF. I visit Dr. Umesh Masharani once per quarter, and he consistently manages to spend enough time with me to answer all of my questions. Their educator, Gloria Yee, is very experienced with insulin pumps and helps to run a monthly class specifically for people using a pump. The combination of a doctor and educator definitely improves the overall quality of care. Finally, their recently renovated office space is on the 6^th floor at 400 Parnasus and has panoramic views over Golden Gate Park, SF, and the Sunset — its awesome.
Cons: The only downside of the UCSF practice is that they can’t do the common lab work in-​house. At the Joselyn Clinic in NY I was able to have my Hemoglobin A1C checked using just a finger stick each time I visited the clinic — the whole process took about 2 minutes. At UCSF I have to have blood drawn just to have this test done. I think this is basically because insurance doesn’t cover the in-​office version of the test, and I think you’d run into this issue at any practice in CA. Still, its a bummer.
Overall: Definitely recommended.