Sunday, December 20, 2009

Is your IVF doctor taking you for a ride ?

Selecting the right doctor is one of the most difficult decisions an infertile couple needs to make. Most people use a hit and miss approach towards finding that doctor. They will ask friends for recommendations; family members who are in the medical profession for referrals; or go to the doctor whose name appeared in the latest newspaper article. Unfortunately , none of these are reliable methods for choosing the right doctor – and woe betide the poor infertile couple who stuck with the wrong doctor !

Even though there is no easy formula which works for everyone ,it always amazes me how patients continue going to a clinic even when they are not happy with it ! This is partly because patients perceive they are helpless; and partly because they underestimate their ability to judge the technical proficiency of a doctor.

Deciding which doctor to go is perhaps the only major medical decision which is under your control. Since this has such a huge impact on the outcome of your treatment, it is too important to leave this up to chance . You need to follow a systematic process , so you have peace of mind you made the right decision.
Here are some simple suggestions which will help you to make sure that the IVF doctor you select is not taking you for a ride.

The first visit will give you a lot of valuable information. Unfortunately patients are often so anxious and apprehensive during this visit, that they often fail to make the most of it. The first consultation is not just an opportunity for the doctor to make a diagnosis and formulate a treatment plan for you - it is also an occasion for you to judge whether this clinic is the right clinic for you.

First impressions are valuable –please learn to trust your gut feelings. Does the doctor make you wait for ever and ever before seeing you ? Do you get a chance to talk to the doctor or are you stuck speaking to his assistants ? Is the staff respectful towards you ? Do they appreciate that your time is valuable ? Are they empathetic ? Remember that the doctor’s personality rubs off onto his staff – and if his staff is rude and uncaring, it is quite likely that the doctor will be rude as well !

When you are a new patient, you are likely to be treated extremely well , because the doctor wants you to become his patient. Repeat visits are likely to be mirror images of the first visit. If the clinic is badly organized; if you are made to wait aimlessly without rhyme or reason; and if you get to talk to the doctor for only 4-5 minutes, these are all red flags which should alert you that you are in the wrong place. Yes, doctors can be extremely busy, but if they are so busy that they do not even have time to talk politely to you , then what value are such busy doctors to you ?

Does the doctor formulate a treatment plan for you ? Does he have a well -organized systematic approach , so that you know exactly what is happening ? Does he take the time and trouble to educate and inform you , so that that you are empowered to make your own decisions ? Is he empathetic ? Or does he talk down to you and interrupt you ? Does he take phone calls when doing a consultation ? Or does he give you his undivided attention ? How the doctor behaves during this first visit is going to be pretty much exactly how he is going to behave in all future visits - and if you are not happy with his personality or bedside manner please find another doctor.

The one thing which always perplexes me is why patients sign up to do a second IVF cycle in the same clinic even when they are not happy with the doctor ! Remember that no doctor has a monopoly. You are spending your hard earned money , and the least you can expect is good quality service . On the other hand, if your doctor provides poor quality services and you are willing to put up with it , then you really should not complain when this is what you get !

A lot of patients complain about the lack of transparency on the part of the doctor. They say that the doctor refuses to provide them with their medical records ; or to share information with them. I think any patient who accepts this behavior from their doctor deserves what he gets. You have a legal right to your medical records , and your doctor is obliged to give these to you . However , you may need to ask ! It takes two hands to clap - and if you do not ask , you are not likely to get what you want ! Blaming the doctor cannot justify your lack of initiative .

A good clinic will routinely provide you with a treatment summary of your IVF procedure ; as well as photographic documentation of your embryos . This is a tangible endpoint, which demonstrates the technical proficiency of the clinic, and assures you that the clinic is medically competent. If your doctor refuses to give you a treatment summary even when you request him for one, this is a major black mark against your doctor, and you need to be on your guard. Do not get fobbed off by silly excuses – for example, “ It is our clinic policy not to provide you with your records ! “ You have a legal right to your medical records , and your doctor is obliged to give these to you – he has no choice in the matter !

The other common excuse patients provide for putting up with poor quality treatment is – But I am not an expert ! What do I understand about the treatment ? I just believe everything the doctor tells me ! Unfortunately , ignorance is not bliss , and you cannot afford to take such a hands-off approach. While you don't need to become an IVF specialist yourself, you must take the time and trouble to become well informed about what your treatment involves. I feel enormous pity for patients who have been through an IVF cycle, and who do not even know how many cells their embryos had or what their quality was . If you allow your doctor to leave you in an information void, then why should you complain when he does so ?

Does this mean that you should be suspicious about your doctor and not trust him at all ? Of course not ! What it means is that you should trust your doctor - but only after you have determined that he deserves your trust. Trust is too important for you to just give away – your doctor needs to earn it !

In the final analysis, I feel patients get the doctors they deserve. The more the effort you put into selecting the right doctor, the better your chances are of finding the best doctor !

1 comment:

  1. Dr. Malpani

    As a patient I still went back to a dr even after he was nasty and rude. I cried every day when i left his office. Every day. I dont mean a couple tears either. I am coming to your clinic from the USA.
    I will meet you in early 2010.


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