Just went through this same ordeal with mine, except it would run in the 220 deg range and sometimes higher even in 50 deg. weather. After a new radiator, 5 fan clutches, and multiple thermostats some with holes drilled the heat was still their. I could never hear or feal the fan kick in. Some said I couldn't hear it because of the straight pipe. On my 2500 I could always hear it and even feel it kick in, so I swapped fans. Now the 3500 stays cool, I can hear and feel the fan kick in. It will barley climb over 190 at 80 deg. outside with a load on a good hill before it starts to cool down. As others have said 200 is not all that hot but mine started the same way about 7 years ago and gradually got worse. Thankfully i figured it out and can now roll on with a load.
Brian