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Old 24.12.2017, 23:36
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How to handle underactive thyroid in Switzerland?

Hi,

I have medical condition called underactive thyroid. I need medicine handle it. My supplies will eventually run out and I will have to buy more. From what I understand I need prescription to buy it. And have to see doctor to get prescription...

I have Swiss insurance, but have never seen any doctor here. How should I approach this problem? As I understand I have to make appointment with some Endocrinologist. But what then? How this visit will look? What should I tell and what's going to happen during visit? I managed to restore my hormones to, more or less, normal levels so that blood examination will not reveal the issue.
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Old 24.12.2017, 23:44
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Re: How to handle underactive thyroid in Switzerland?

It's very common here- so the doc will do a blood test to test T3 and TSH- and then prescribe. They might agree to put you on same drugs, and same dosage- if those are avaialble here, and if they consider your dosage to be correct- or discuss with you any changes they think woud be appropriate. Go to a GP first (family doctor) and if necessary, get referred to a specialist this may not be required at all.

Ask colleagues for recommendations for your area.
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Old 24.12.2017, 23:51
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Re: How to handle underactive thyroid in Switzerland?

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Hi,

I have medical condition called underactive thyroid. I need medicine handle it. My supplies will eventually run out and I will have to buy more. From what I understand I need prescription to buy it. And have to see doctor to get prescription...

I have Swiss insurance, but have never seen any doctor here. How should I approach this problem? As I understand I have to make appointment with some Endocrinologist. But what then? How this visit will look? What should I tell and what's going to happen during visit? I managed to restore my hormones to, more or less, normal levels so that blood examination will not reveal the issue.
Well, if you have Swiss medical insurance it will be no problem at all to examine the previous prescriptions, and further prescribe.

Is your question on how to find a GP in Switzerland or something else? Just ask your insurance.
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Old 25.12.2017, 01:50
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Re: How to handle underactive thyroid in Switzerland?

What is GP? I don't have any medical record in Switzerland so examining previous prescriptions is probably impossible. If doc decide to do T3/TSH, results will be just fine (I did myself a few days ago) - this probably won't help to convince the doc that I need medicine. I'm mostly concerned about the visit. What should I tell (I'm not sure how revealing "prior" medical issues will work Swiss insurance...). Should I prepare myself for extensive physical examination? Also other thing is that this illness cannot be cured. I will have to take pills for the rest of life. I prefer not to visit doc every month (and pay for it) just to get next prescription. Can I request some form of "persistent" prescription (and visit doc from time to time only to do examinations)?
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Old 25.12.2017, 02:18
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Re: How to handle underactive thyroid in Switzerland?

There is no lock-out for pre-existing conditions on basic medical insurance.

GP = General Practitioner or “Hausarzt”.

Go to a doctor and ask to be prescribed thyroid pills suitable for your condition - the doctor will probably want to do a blood test to establish your hormone levels before prescribing a dosage.

Some doctors can setup a longterm prescription - so you don’t need a consultation appointment to get a repeat. My doctor uses the “Zur Rose” system - I just need to phone the surgery receptionist to order more pills. Others will setup a “dauerrezept” at a nearby pharmacy so you can just go straight to the pharmacy. A doctor who is any good will do blood tests every year or so to monitor your situation.

Depending on your “franchise” it is unlikely the cost of thyroid pills will be reimbursed by the medical insurance company as they are unlikely to exceed your franchise.
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Old 25.12.2017, 06:02
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Re: How to handle underactive thyroid in Switzerland?

My experience, YMMV:

I would strongly recommend that you be initially evaluated by an endocrinologist. The Endo would review your current treatment plan, do whatever tests are needed, and recommend a treatment p,an going forward.

What ongoing treatment would look like, frequency of monitoring, etc. will depend on your individual case.

You will likely need a GP to refer you to an Endo, as many specialists only see patients via referral. Complex endocrinological issues seem to be beyond the scope of some GPs, or at least that was the case with the GPs I have seen, hence my recommendation to see the Endo to establish a treatment plan.

Be aware that in some areas it can be difficult to get a first appointment with an Endo, and a fairly long wait for an appointment is not unusual. A non-emergency appointment with my Endo will usually mean a wait of 4 - 6 months, an urgent appointment might still have a wait of more than a month.

Basically, I make my control appointments a year in advance. If results show the need for more frequent monitoring then the practice does it's best to fit that in. My Endo's practice might be busier than some, perhaps you will not run into this issue. But best to be prepared.

Once you are stable it is possible that your GP could do the blood tests, but I'd still want the results reviewed by the Endo.


Bring all your medical records with you, including copies of tests results. A good Endo will want to understand your treatment history to date.




All the best.
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Old 25.12.2017, 09:01
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Re: How to handle underactive thyroid in Switzerland?

What is your health insurance plan? In addition to the deductible/franchise, you had to choose between traditional (free choice), HMO, family doctor and Telemed. In the first case, you can start by contacting essentially any doctor in Switzerland. In my experience, even specialists who normally expect referrals will see patients directly if the situation is unambiguous. A polite email or phone call to their office explaining the situation and asking for advice is never really wrong.

In the case of other health insurance models, you'll need to start according to that model's rules. e.g. with Telemed you'd start with a phone call to a nurse who would advise on what to do next.

In my experience a "Hausarzt" (GP/family doctor) will help manage chronic problems, but will issue referrals to specialists to devise treatment plans as soon as there is any uncertainty. If your condition is well controlled by standard medication, and especially if you can bring in medical records showing this, I'd expect a GP to be willing to prescribe more of the same in the short term. However it is very possible that they'd want you to see a local specialist to confirm the long term program.

When they feel it is appropriate, any doctor can issue a "Dauerrezept" (long term prescription) which you take to a pharmacy to be kept on file for a year.
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Old 25.12.2017, 18:55
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Re: How to handle underactive thyroid in Switzerland?

I have standard model.

Does it mean that even though I have standard model, I still need to get referral from GP in order to make appointment with most Endocrinologists? I have to hurry up, I'm not sure if I have supplies for 6 months...

Who is a GP? Is this just any doctor with specialization in "FMH Innere Medizin"/"FMH Allgemein Medizin"?

What is the difference between urgent and non-urgent appointments? When situation is eligible for urgent appointment?
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Old 25.12.2017, 19:45
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Re: How to handle underactive thyroid in Switzerland?

Someone with a stable thyroïd function is not likely to be considered urgent - here, there or anywhere.

In most cases, specilaists to not accept direct contact, and in any case, it is normally much faster if you go through your GP (family doctor).
Best wait anyhow until January, as your franchise is per calendar year.

Without knowing where you are from and what sort of system you are used to - difficult to comment more than that.

If your concern is because your dosage or your type of thyroxine/treatment is unconventional - then you have to realise the doctor, be it your GP or endo will discuss things with you but will not agree to be dictated his/her prescribing. Are you on synthe thyroxine, or something else.

Last edited by Odile; 25.12.2017 at 20:02.
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Old 25.12.2017, 20:47
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Re: How to handle underactive thyroid in Switzerland?

What is likely to happen with the prescription is you'll get one for maybe a few months just so your new doctor/endocrinologist can be sure the medication is working correctly. After that the prescription will probably be for a year so you can just go to a pharmacy to stock up when your supply runs low.

As Meloncollie said appointments with your endocrinologist may just be annual ones with more frequent checks done by your GP, but this will be decided once you've met with your specialist and they've assessed you.

As for what you tell them - as much as you possibly can about your condition, how you've handled it in the past, etc. Full disclosure in other words. If you have any of your medical records with you then bring those to the initial GP/endocrinologist appointments too.
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Old 25.12.2017, 21:06
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Re: How to handle underactive thyroid in Switzerland?

Yeah, I was just wondering what if I were going to run out of medicine on 1st April, but had appointment on 1st May? I come from system where it is necessary to have referral from internist in order to make first appointment in endocrinologist. Waiting time is 1-1.5 year (no matter if it is first visit or follow-up). It means that treatment in practice looks different: I make blood tests out-of-system (pure my expense in private laboratories) every two months. In most cases I have to make adjustments in dosage after receiving results. I visit(ed) (my) internist to get prescriptions. These prescriptions are basically dictated by me. Internist is not going to send me to any blood tests or make any other examination. And I'm not going to see endocrinologists more than once a year. There is no such thing as "permanent prescription". Before I moved to Switzerland I moved within country to different city and lived there for a year. Within this time I didn't see endocrinologist - it is just impossible in such a short time. Given this, system has two options: give me prescription for what I want without examinations or let me die. My dosage is not unconventional, however unconventional is the fact that I have this disease - I'm living opposite of risk factors. I have some medical records, but not in English (nor German).
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Old 25.12.2017, 21:45
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Re: How to handle underactive thyroid in Switzerland?

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what if I were going to run out of medicine on 1st April, but had appointment on 1st May?

My dosage is not unconventional, however unconventional is the fact that I have this disease - I'm living opposite of risk factors. I have some medical records, but not in English (nor German).
Make an appointment with your GP before that time. He/she will do some blood tests to check your T3 and T4 levels. And can prescribe medication.

I have Hashimoto and just go once a year now, just have to phone every quarter to pick up my meds for the next quarter.

You can ask your GP if it is necessary to go to an endocrinologist.
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Old 25.12.2017, 21:51
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Re: How to handle underactive thyroid in Switzerland?

No doctor worth the name should give you a prescription without first examining you, sorry. And you're not in whatever country you come from or have lived in before. This is Switzerland, things are done differently. Find a GP and register with them, make an appointment to see them and get a referral to an endocrinologist. If you let them know how long your supply will last they will get things organised so you can be seen by the specialist before your supply runs out.
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Old 25.12.2017, 21:55
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Re: How to handle underactive thyroid in Switzerland?

Right, you will not get any meds before a check up. I only got some because I had a referral with medical data from my previous GP when I moved to Switzerland.

And that was only to cover a short period until my new GP had all the tests done
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Old 25.12.2017, 22:01
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Re: How to handle underactive thyroid in Switzerland?

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Yeah, I was just wondering what if I were going to run out of medicine on 1st April, but had appointment on 1st May? I come from system where it is necessary to have referral from internist in order to make first appointment in endocrinologist. Waiting time is 1-1.5 year (no matter if it is first visit or follow-up). It means that treatment in practice looks different: I make blood tests out-of-system (pure my expense in private laboratories) every two months. In most cases I have to make adjustments in dosage after receiving results. I visit(ed) (my) internist to get prescriptions. These prescriptions are basically dictated by me. Internist is not going to send me to any blood tests or make any other examination. And I'm not going to see endocrinologists more than once a year. There is no such thing as "permanent prescription". Before I moved to Switzerland I moved within country to different city and lived there for a year. Within this time I didn't see endocrinologist - it is just impossible in such a short time. Given this, system has two options: give me prescription for what I want without examinations or let me die. My dosage is not unconventional, however unconventional is the fact that I have this disease - I'm living opposite of risk factors. I have some medical records, but not in English (nor German).
Look, I'm sorry but I still do not understand why you don't just go to a doctor here? As you can see from this thread, most of us women seem to have been diagnosed with an under active thyroid. Me since years as well.

It's a very common condition.
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Old 25.12.2017, 22:01
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Re: How to handle underactive thyroid in Switzerland?

Call your insurance provider helpline, they all have one.
Take it from there. I doubt they'll let you die.

If you are with Swica, they have clinics, I've never waited more than 3 days for a non-urgent appointment.
Swica also allow 2 'walk-ins' per year to the hospital without a referral.
I found this out after going direct to the hospital.

My friend has no thyroid, and is on Tirosint. No dramas, yearly checkup, waiting time 4-8 weeks for the appointment and a few days for test results.
Make sure you tell them you are available for cancellations.
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Old 25.12.2017, 22:15
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Re: How to handle underactive thyroid in Switzerland?

It's fairly straight forwards, google "hausarzt" in your local city - this is a family Dr / GP. It is required in general to have this main doctor and any specialists like an endocrinologist will ask if you have one. Make an appointment, show up and tell them your medical history and prescription needs. If you have medical records bring them, even if in another language.

In order to help you, the "hausarzt" will either prescribe you your existing medicine, conduct tests or refer you to a specialist if needed. You simply have to go...it's the only way. If you urgently need a prescription refill, make sure you explain this to the Dr. & from experience, they will do their best to help you.
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Old 25.12.2017, 22:35
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Re: How to handle underactive thyroid in Switzerland?

OK. Thanks all. Now I have much better overview of Swiss medical system. I'll Google for "hausarzt" and try to make appointment.
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Old 25.12.2017, 22:43
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Re: How to handle underactive thyroid in Switzerland?

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OK. Thanks all. Now I have much better overview of Swiss medical system. I'll Google for "hausarzt" and try to make appointment.
Don't even need to do that. Just go to www.local.ch, type in "harusarzt" and the city and it'll call up all the ones in you area.
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Old 26.12.2017, 05:07
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Re: How to handle underactive thyroid in Switzerland?

Matt, if you are in danger of running out of your meds soon-ish, as others have said, see a GP.

If you have not yet found a GP here, or are having trouble getting a timely appointment with your GP, there is always the option of going to one of the walk-in clinics (Permanence at the HB, Aerzthaus, etc.) to at least get temporary meds.

You don't need an appointment at the Permanence, you can just show up - but there is generally a wait to be seen. You can make an appointment at thr Aerztehaus and likely should, as this is really a routine appointment, not an emergency. I do not personally know this clinic, but have been told one can generally get an appointment quickly.

http://arzthaus.ch/
http://permanence.ch

(Check to see if your insurance covers Permanence.)

Either clinic can refer you to an endocrinologist as well.

But you should make establishing a relationship with a GP a priority. The GP cannot do everything, but nonetheless is often the gateway to getting you in to see other doctors. This irrespective of insurance type, as some specialists will not see self-referred patients.

All the best...
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