No investigation was conducted by the NSHA. No notice given to clinic patients of the closure – they only found out when Matsusaki, known by all his patients as Dr. Ron, updated them.
In the official letter sent by the health authority, Matsusaki was told he was “conducting research at the Digby General Hospital without approval,” and that he must immediately “cease all work associated.”
Matsusaki said what he was doing wasn’t research, but simply quality improvement, a recognized physician practice designed to read existing literature to improve practices.
“Patient treatment and quality improvement by looking into existing and recognized research – not conducting new research – was my main goal with this clinic. Had they investigated, they would have found that,” he said.
Why the clinic was started
Why did patients with hypothyroid symptoms have normal TSH levels?
This is the question Matsusaki pondered and was stumped by.
After seeing many doctors test only the levels of TSH, or thyroid-stimulating hormone, in their patients, Matsusaki began looking for a deeper problem, conducting what he called a ‘deep dive’ into the world literature on hypothyroidism starting in 2014.
He found documents that stated checking TSH levels alone is not enough to determine an accurate diagnosis of thyroid disease.
“The research I found stating TSH levels alone was insufficient dated back to the 1960’s,” he said.
“This has been around for longer than we think.”
Following points found in his literary deep dive, Matsusaki, who works as an emergency room doctor at the Digby General Hospital, began applying some of this knowledge to ER patients and saw immediate, positive results.
After this success, he used his one free weekday each Tuesday to work in what became the Thyroid Clinic at the hospital. He was also never paid for his time at the clinic, where he treated over 250 patients with hypothyroid symptoms.
“That didn’t matter to me so much,” he said.
“My patients and seeing real improvement are always my biggest priorities.”
He created a Thyroid Clinic Questionnaire to ascertain whether patients displayed hypothyroid symptoms or not. If they did, a test looking into other thyroid hormone components along with the TSH – free T4, free T3 and reverse T3 – that affect thyroid performance.
The results were then compared to patient symptoms, and a treatment plan devised.
In addition, most patients chose to be medicated with desiccated thyroid opposed to Synthroid, one of the most commonly used medications for hypothyroidism.
“The vast majority – ninety per cent – of my patients were prescribed desiccated thyroid. Many had taken Synthroid for decades and felt little change even as doses got higher and higher. Once their new treatment plan started, the change was almost immediate,” he said.
Why he believes it was shut down
Matsusaki highlights the literature he referenced, along with the medicine prescribed to his patients, were both existing and recognized before he began using them.
“Desiccated thyroid existed before Synthroid, but faded off the map after a very successful Synthroid marketing campaign,” he said.
He believes the success of his findings has frightened the medical profession which has stuck to one style of treatment for so long of just checking TSH levels.
“Thyroid disease is highly complex, and each case is unique. This is not a one-size-fits-all situation,” he said.
“Patient improvement stands at the root of the Hippocratic Oath. If this is working and clearly not hurting anyone, why can’t I continue?”
He sees this as but one more example of the medical profession choosing the easier route, dubbed by industry members as downstream, rather than a tougher, upstream approach that seeks the root issue rather than an easy fix.
His patients have created a support and advocacy group, The Orchid Cafe, named for the orchids Matsusaki has at his home and at his second home, the clinic.
The group was created and is still operating independently of Matsusaki.
His biggest worry now is what his patients, especially those with extreme hormonal imbalances, will do for treatment and prescriptions.
He is now in the process of creating an application for a research grant from the Nova Scotia Health Authority so he can continue treating his patients.
“I’ve always operated with complete transparency,” he said.
“Therefore what is my gain here? Nothing but helping my patients.”