Thursday, November 03, 2016

IVF clinics need to learn to treat their patients more kindly


IVF treatment can be stressful, but the real tragedy is that IVF clinics often make it unnecessarily complex for their patients. They just add to their poor patient's stress levels by doing lots of superfluous stuff.

This starts even before the IVF cycle begins. For example, may clinics routinely subject all their patients to a battery of tests. Now these tests seem very sophisticated, but not only are they very expensive, they actually don't change the patient's treatment options.

These provide a lot of impressive numbers, but these are of no clinical use whatsoever. Unfortunately, patients are naïve . They believe that additional testing increases precision, but this is a false perception. They provide answers which look very impressive, but these answers may not be accurate, as a result of which the results are misleading or just plain wrong.

Also, many clinics make the actual IVF treatment cycle needlessly  stressful. A lot of clinics will insist that patients come in every single day. Some will do blood tests and  ultrasound scans daily; which means the poor patient spend her entire day in the clinic , waiting for the results, based on which the doctor will tell her what to do next. Blood tests are painful , and ultrasound scans are no fun - but the tragic reality is they are unnecessary  - there's really no need to do all these daily blood tests or scans.

Follicles only grow at 1 mm to 2 mm per day, so what's the point of scanning every day? E2 levels rise daily , but you don't need daily results in order to monitor the cycle intelligently. Not only is a lot of the patient's time wasted, since the senior doctor is hard to track down, all the treatment is planned on an ad hoc basis, which means the poor patient has no clue what is going to happen next. She needs to put her whole life on hold - and taking time off from work can be expensive !  The patient gets the blood tests done in the morning; the scans in the afternoon; and waits till the evening to talk to the doctor. Many end up spending nearly two or three weeks of their life in the clinic - waiting, waiting, waiting for something to happen.

If this was actually needed, then there wouldn't be a problem. The reality is that a lot of it is not necessary at all . It just makes the clinic appear very busy, so patients are impressed by how hard the doctor is working ! The reality is that most of this is just busy work , which doesn't add any clinical value. However, it's useful because it helps to impress the patient , who feels the doctor must be very good, because he is monitoring them so carefully.

What they don't realise is that all these test results don't really make a difference to the treatment decisions which the doctor makes for her.

In fact, the stress can get to be so much that patients refuse to repeat another IVF cycle , because they have such bad memories of their first IVF cycle.

Doctors need to learn to be kinder . They need to learn that it's not essential to call patients every day. Just because they've been doing it mindlessly for so many years  doesn't mean they need to continue doing this.

The only benefit is that the patients who are cycling together see each other on a daily basis, which means they often become friends .  They can share notes, and provide emotional support to each other. This is the only saving grace, because it can help them during their IVF journey.

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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