Sunday, January 21, 2018

Are you fed up of going to disorganised IVF clinics ?

Because you are so desperate to have a baby, you will move heaven and earth to achieve your goal. You know that IVF is your best option, but you are completely confused as to which IVF clinic to select, because they all seem to be the same when you read their ads or visit their websites.

You start checking them out, and this is when you get disillusioned.

Most clinics are highly disorganised, and refuse to share any information . You are made to wait unnecessarily for hours on end; and finally only get to talk to a junior doctor, who seems to be completely clueless. You are offered a generic plan, and they refuse your answer your genuine questions, so you end up being disappointed and disheartened. Many will want you to sign up as soon as possible, because they seem to be more interested in extracting money from you, rather than on helping you to have a baby !

Sounds familiar ?

We are happy to provide you with a free treatment plan, customised to your needs, so that you know what the right action steps are. This will help you maximise your chances of having a baby - and will also help you to ensure that your doctor is offering you the right treatment, and being upfront and honest with you.

If you don't want to be taken for a ride, please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !




Why are couples so poorly informed about fertility ?

I just got this email .

I recently got married 2 months back on 26th November 2017 and we had intercourse and was eagerly waiting for a happy news as I’m 30 yrs and my wife is 25yrs old. Unfortunately she got her periods on time on 17th Jan and we consulted gynecologist on 18th. Doctor suggested to do semen analysis without having contact for 3 days.

It's disappointing that even well educated people have such a poor understanding how inefficient human reproduction can be. It takes time to make a baby, and it's sad to see them panicking needlessly when they don't get pregnant in a few months

What's even worse is that instead of educating them about the facts of life, their doctor is taking them for a ride by asking them to test their fertility !

Unnecessary tests lead to unnecessary expenses and useless "treatment" !

Saturday, January 20, 2018

Thursday, January 18, 2018

Using WhatsApp to improve Doctor patient communication.


WhatsApp is one of those apps which practically every doctor uses routinely in India. Most doctors use it for personal reasons , and many have also started utilising it to connect with their patients as well. Unfortunately, they do it in a disorganized and haphazard fashion, which means they are not making the best possible use of this very versatile platform !
Here's one way of making sure that WhatsApp can be used effectively to help improve medical care.
The doctor needs a dedicated mobile just for his clinic, which is used exclusively for this purpose , so he doesn't get troubled at all odd hours because of patients contacting him. The moment the patient contacts the clinic , the receptionist adds the patient's mobile as a new WhatsApp contact, and starts a conversation with that patient .  For example, this can be used to send a google map to the patient, so they can find the clinic easily !
When the patient comes for the first appointment, she adds a photo of the patient, as well as her demographic details as well . After the consultation, she ( or the doctor himself, or even the patient) can then take a picture of the consultation summary, as well as the prescription. Patients can continue adding the results of their lab reports and scans to this conversation, once they have done these, so the doctor can review them as needed. This way, he can interpret the results far more intelligently, because he has the clinical context he needs.
The beauty of WhatsApp is that all these documents are encrypted and secure, so you don't have to worry about confidentiality . You can thus create a  chain of conversations, which seamlessly provides a timeline of the patient's medical history, which both doctors and patients can refer to as needed. Because it's documented, there's no risk of miscommunication  ! Even better, patients don't need to keep on calling the clinic for every minor problem . The doctor can create lots of templates, which he can attach to the conversation as needed, to make sure the patient knows exactly what they need to do. If required, the doctor can even create WhatsApp groups of patients with similar problems ( for example, all patients with  diabetes). Not only can he educate them all at one time by sharing educational tips, they can also interact with each other, and thus help one another during their journey .
This is much better than a phone call, because the signal to noise ratio is far better . Doctors can now communicate with their patients in their own local language. Even if patients are illiterate, it's possible to leave messages for them using audio !
This will also empower patients. The WhatsApp trail will actually be far better than just the ordinary medical record, because it allows patients to provide their inputs and interpretation, rather than being only a medical document which doctors often refuse to share with patients ! Patients can also share their medical reports , and get a second opinion from another doctor anywhere in the world.
The beauty is that there is no incremental cost or friction for using WhatsApp for improving doctor-patient communication ! Doctors and patients use WhatsApp all the time, so there is no training needed - and it's free ! Patients are delighted , because this is not an additional communication channel they can use connecting with their doctor when they need to - no matter where in th world they are !   WhatsApp offers a direct and free backup of all communication including images and videos to the google drive, so you need not worry about what to do in case the phone crashes or goes dead (and they do).

While it's not great for an emergency, let's not forget that 90% of interaction with a doctor is for routine medical problems.  And the asynchronous nature of communication which WhatsApp allows means  that when the doctor is unable to pick up the phone, patients can use this channel to ask a query and/or send a photograph and get a response by a doctor when he gets free !
And if doctors want, they can always charge for these conversations, so that it's an additional source of revenue for them !

Also, once Whatsapp wants to start generating revenue, they will add lots of additional features which will help doctors to connect more effectively with their patients .  And there's no reason why they couldn't do this for other professionals as well - such as lawyers !

Tuesday, January 16, 2018

How do you differentiate between a good and bad IVF clinic ?

Why do IVF doctors lie to patients?

We often see IVF patients who are quite unhappy with the quality of information they've received from their doctors. The one thing which bothers them a lot is that doctors change what they tell them, and this is why they don't trust them anymore .

A common example is that at the time of the embryo transfer, the doctor is very optimistic and hopeful. He gushes about the high quality of the embryos he has created in the lab, and says things like, " Of course you will get pregnant ! You have a 90% chance, because your uterus is perfect, and your embryos are beautiful. These are  grade A embryos and because your transfer has gone off smoothly , you have a very high chance of success, so best of luck !"  He's trying to transmit a lot of hope and positivity and optimism to the patient, but unfortunately these are just empty words. He does not provide the patient with any documentation as to the embryo quality, and because he does not provide photos of the embryos, she's pretty much forced to believe everything the doctor says ! She's quite happy during the 2 ww, because the doctor is so positive and hopeful !

However, when the beta HCG comes back as negative and she goes for a followup visit to the doctor, he starts singing a completely different tune. He says things like, "Well, you didn't get pregnant because your embryo quality wasn't very good, and we will need to use donor eggs " . Or he may say - " Your uterus lining was not very good, and we will need to do additional tests to determine the reason for the failed implantation." The patient feels cheated and let down, because it now appears that the doctor wants to wash his hands off all responsibility for the failure !  She wonders - "Why did you tell me that my chances were very good at the time of the transfer ? Why are you now saying something so completely different?" She starts losing confidence, not only in that particular IVF doctor, but in all IVF doctors , because she thinks that all IVF doctors are pretty much the same.

This is why it's so important that patients demand that their IVF doctor provide photos of their embryos routinely to them . This is good for the doctor as well, because it inspires trust in the patient. They can see that the doctor is  very confident , and knows he doing a good job, which is why he is willing to be open and transparent . This simple step will help to keep IVF doctors honest, and will also ensure that the patient has realistic expectations from their IVF treatment.

 Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !







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