Thursday, September 06, 2012

Family doctors and IVF

In these days of superspecialistion, does the family doctor have a role to play in IVF treatment ? In fact, many infertile couples today will directly go to a gynecologist or an infertility specialist and will bypass the general physician / family doctor altogether.

In countries like the NHS, where GPs act as gatekeepers , patients need a referral from their GP to go to an IVF specialist.  This means that they cannot do IVF until their GP is convinced that they need this. However, even in India and the USA, where patients usually pay for their own IVF treatment (fee for service ) and can self-refer themselves to an IVF specialist, GPs still have a significant role to play.

A good family doctor will :
counsel patients, so they understand the basics of baby making;
 explain their fertility treatment options;
will discuss the alternative of adoption;
set realistic expectations;
do an efficient basic workup for infertile couples;
and refer patients with complex problems early to a specialist , so they do not waste time

A good doctor will continue holding the patient’s hand during the IVF treatment ; and will also help them with the treatment ( for example, by giving them the shots they need).

He will also help to prevent overtreatment, by telling them what not to do; so they don’t end up wasting their time on money on unnecessary laparoscopies.

Perhaps the most important role of a GP is to refer his patients to the right specialist – the IVF clinic which has the best success rates; and can treat patients well.

Unfortunately, because of the entrenched system of cuts and kick backs, GPs will often refer patients to second class IVF clinics for extraneous financial considerations. This can actually end up hurting you, so make sure you do your own homework when you need to select an IVF clinic !

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