Doctors dealing with HRT are not always super-qualified. My HRT doctor is probably just as good at is as my former support group leader would be if she had access to being able to order blood tests...
She's just a GP that has read a couple things put out by a regional trans health program, and she's only been doing hormones since 2009 or something like that. Now, she's perfectly fine and all, besides having that fresh gatekeeper smell, but if there were a more qualified practitioner in the area... I would be very interested in seeing him/her.
That's just the thing, after all - she's the only well-known person in a region of ~200k people that does hormones. I'm sure there are some other GPs that do it, and I just haven't heard of anyone besides her... which is actually a feat since the group leader has tons of resources, and has ways to find information.
The best thing about her is that she has a wait list that's months long, and will likely never move to informed consent.
So yeah. As much as I would like to see someone else, I have to stick with her. She's a good enough person, and I do like her for who she is... but there is a degree of inflexibility and incompetance in this field of treatment that is mostly related to her limited experience and training, and since she's the only one, there's really no other option.
Sometimes standing up to your doctor, in a situation where you have one like mine, isn't the greatest idea... because it can go wrong, and if it does you're screwed. Telling my doctors what they want to hear, while slipping in the occasional honesty, is just a habit by now. If I didn't, my SRS coverage might be put on hold. :p