Monday, July 14, 2014

IVF process versus outcome


The outcome of an IVF cycle is always uncertain . When a cycle fails, the patient is never sure whether the failure was because the right process was not followed, or because of plain bad luck or an intrinsic  biological problem ( for example, women with poor quality eggs have a low chances of success, no matter how good the quality of medical care they receive)

How does the patient judge the quality of care provided – whether or not the doctor did a good job technically and followed all the right medical processes ?

Sadly, most patients are never certain whether she should change the doctor for her next cycle; or if sticking with the same clinic is her best choice.

This is the key difference between the expert patient and the uninformed patient .

The uniformed patient is clueless about the treatment details – they do not know what the right treatment involves, and they are not even aware of what was actually done. Bad clinics exacerbate this problem by keeping patients in the dark.  On the other hand, expert patients are sophisticated enough to demand openness and transparency and will refuse to go to a clinic which does not routinely provide photos of embryos.

Poorly informed patients have unrealistic expectations of IVF treatment . When the cycle fails, they will often blame the doctor for the failure . Their doctor, on the other hand, will blame them for the failure, by saying they did not follow instructions  properly !  This is why they lose confidence in themselves - and in their doctor as well. 

The expert patient has done her homework before the IVF cycle starts. She knows exactly what steps are involved in an IVF cycle, and takes an active interest in ensuring that the steps are being followed properly . When things go according to plan , she knows the process was performed properly , so even if the outcome is bad , they do not end up blaming the doctor – or themselves. They have peace  of mind that they received good-quality medical care ; and know that for them it's just a matter of time till they get pregnant . Doctors also find it much easier to manage these patients, because they have realistic expectations, and don’t go to pieces if the cycle fails.

Expert patients can proactively identify deviations and deficiencies in the treatment process . They are able to understand what can be done differently the next cycle , in case things don’t go according to plan. They can discuss with the doctor what changes can be made to the next treatment protocol , to increase the chances of achieving a pregnancy ; or they may decide to change the doctor.

A good analogy is investing in the share market. Both IVF and the share market have risks and uncertainties. No matter how expert your financial advisor is, the market can go up or down, for reasons which are beyond his ( or anyone’s) control. A sophisticated investor doesn't lose his cool just because his portfolio goes down . He takes things in his stride and is mature enough to take a long-term perspective, because he knows that historically the odds are in his favour.

The uninformed investor , on the other hand, panics when share prices drop . He doesn’t have enough confidence in himself , or in his financial advisor, to be able to manage the ups and downs of the share market ride, which can be very bumpy. He often ends up buying high and selling low, and consistently losing money in the process.

The average patient also ends up burning her fingers , partly because she is capable of identifying the right doctor; or making sure that the right medical treatment process was followed.

Some patients refuse to invest the time and energy which is required to allow them to become expert patients – and this can prove to be very expensive in the long run, both in the form of wasted opportunities and wasted money.

The good news is that it's no longer difficult to become an expert patients. There are tons of online resources available , including free e-learning courses and games, and you can check them out free at www.ivfindia.com.


So what are the possible combinations ?

Good process plus good outcome = happy patient - and happy doctor
Good process plus bad outcome = bad luck. Try again !
Bad process plus good outcome = dumb luck. Count your blessings !
Bad process plus bad outcome = every patient's nightmare. Information Therapy will help to prevent this toxic combination

A good doctor, just like a good financial investor, will spend time educating you about the risks and uncertainties involved in IVF, so that you have realistic expectations of the treatment, and can manage the IVF emotional roller coaster ride without losing your cool. Remember that we cannot control the outcome - but we can ensure the process followed was impeccable !

Want to make sure you are getting good quality medical care ? Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !


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