Wednesday, December 26, 2012

Why don't patients fire their IVF doctor if they are not happy with him ?

I see a number of patients who have undergone multiple failed IVF cycles in a single clinic . While it is true that most IVF cycles will fail , what amazes me is that these patients are very unhappy with the quality of medical care which they have received in their clinic. However, in spite of the fact that they are  dissatisfied with their doctor , they continue to take treatment at the same IVF clinic , even though they have failed multiple times. This always amazes me and I am still trying to make sense of why this happens.
It’s true that some patients don’t have a choice. For example, if your treatment is being funded by the government, then you have to go to the clinic which the  government selects for you. However, most IVF patients pay a fat fee for their IVF treatment, and do have the option to change clinics ! Why don’t they do so ?

Some people feel that once they have chosen a doctor , they need to be faithful to that doctor and continue sticking with them , even if they're not happy. Others feel that now that they've done one IVF cycle with this particular doctor , he knows and understands their case , and will hopefully do a better job the next time around. Others are just not willing to explore other options. Some naively believe that all IVF clinics are created the same , and that there really is no point in looking for an alternative , because most doctors provide exactly the same kind and quality of medical care , so why not continue with the same one? Others will stick with the same clinic purely as a matter of inertia because they're not willing to take the time and trouble to look for an alternative option. They are lazy and poorly informed and prefer sticking with the known devil . Many don't know how to look for alternatives.

Now just because one IVF cycle fails doesn't mean that you need to go looking for a new clinic for your second cycle. However, if you are not happy with the quality of care you have received, I think patients need to learn to vote with their feet !  Not only should they be articulate and express their displeasure , so that their doctor can fix the problem ( if he is willing to do this); or they need to look for alternative solutions if their clinic cannot provide what they need.

IVF treatment is expensive and patients pay for it out of their own pocket. They rightfully have certain expectations , and not only do they expect to receive good high quality medical care, they also expect that the medical team will provide them with personalized attention as well as emotional support. However a lots of patients are dissatisfied because they find that it is difficult for them to talk to their doctor . They often feel abandoned. Their biggest complaint is that they have very little information about the actual medical details of the treatment. There is very little documentation , and they are often poorly informed and clueless as to what happened and why.

Now while I'm not trying to provide excuses for IVF doctors who do not provide good quality medical care , I also think it is the patient's responsibility to work towards getting good medical care. Patients cannot continue to afford to think of themselves as being passive recipients of attention from medical professionals. They need to take an active part in their medical care if they want to make sure they get good quality treatment. This does involve some effort on their part , but this can pay rich dividends !

Before their first IVF cycle, many patients can be quite naïve and poorly informed ; they select a particular clinic simply because they don't know any better. However, after they have experienced one failed IVF cycle , if they continue to put up with such poor quality medical care , I think they are to blame as much as the clinic. After all, if patients are willing to accept poor medical care; and if they continue going back to the same clinic , even though the care was poor, then there is no incentive for a rational IVF doctor to make any changes whatsoever in the care they provide !

It's high time patients stopped complaining about how uncaring doctors are; or how inaccessible they have become. They need to understand that there is a lot which they can do in order to solve the problem , and they cannot afford to leave everything up to the doctor. Patients need to learn to become well-informed and engage actively in their medical care. Not only is this good for them, it’s actually good for their medical care team as well , because well informed patients will ensure that the team is on its toes and will provide high quality treatment , tailored to the patient's needs . This approach also helps to reduce the risk of medical errors and mixups !

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