I hear ya. It's so frustrating to find a good doc. I even work in the field and it took me a long time to finally find a doc who was sensitive to my needs.
My opinion on docs who don't want to do agressive HRT, they are more old school....this boils down oftentimes to their being conservative in prescribing HRT so that some people will be in "normal" ranges but still be symptomatic for low hormone levels. That being said, some of the younger Endocrinologists will prescribe based less upon lab tests, that may cite "normal" hormonal levels based upon standard lab ranges...but will rather prescribe to effect per each individual. There are also some really great, new/younger Internists/Family practice docs who love Geriatrics....they may be a great start as a PMD and may be able to refer grandpa to a more progressive Endocrinologist.
It can sometimes be tough to find a good Endocrinologist because many docs are trained to see inside the box and look at hard facts- lab results, doses, calculations- and by necessity because they're seeing quantities of patients, may sometimes overlook the response by the whole individual person or not be present to witness their response. But there are many truly gifted docs out there who are able to see this whole picture.
Me and my Soap Box. I'm going through this "On my soap box" phase right now. Thank you for putting up with me.
Anyway, I wish you and Grandpa all the luck in the world and hope you find a doctor for him who's a good match. And again, how sweet you care for him so much, he is lucky to have such a caring family member!!