Who should treat? Endocrinologists and radioiodine therapy

Endocrinologists were the first physicians to treat hyperthyroid patients with radioiodine. They performed the initial studies to determine dose requirements for treatment and devised the first diagnostic tests during radioiodine. Today very few endocrinologists use radioiodine in their practice, and most refer their patients to radiologists or nuclear medicine physicians for treatment. This policy poorly serves the patient and the public. It delays treatment, is inconvenient for patients, increases the cost of treatment (by adding another layer of specialty consultation), and potentially increases the possibility of error in administration of radioiodine--all undesirable effects. The actual administration of radioiodine is but a portion of the care of the patient, and it should be incorporated into the overall treatment of hyperthyroidism. Endocrinologists with their broad base of experience in all forms of thyroid disease and access to various forms of thyroid testing are in the best position to judge the timing and appropriateness of radioiodine treatment. The American Association of Clinical Endocrinologists has started an initiative with the aim of getting endocrinologists who are presently licensed to continue using radioiodine and helping other endocrinologists become licensed to treat their patients.