Thursday, January 02, 2014

What IVF patients need to know about the known unknowns

Information therapy is a very valuable tool to resolve a lot of problems in medicine. One of the major issues today is the trust deficit , and information therapy can arm the patient with reliable information. Knowledge is power, and reliable , updated evidence-based information can prove to be extremely valuable for them , and for the doctor who is treating them .

Our knowledge falls into four groups– and Information Therapy cannot provide solutions to problems in all these areas. The first group is the “Known Knowns”. This consists of the basic background information which most people have about their body and about illness and medicine in general, and which we take for granted. This is the knowledge we update on a regular basis, by reading newspapers or watching TV.

Second is the unknown knowns. This is the quadrant in which Information Therapy shines.  This is the stuff which doctors and experts know a lot about , but which most patients don’t , because they don’t need to bother about it when they are well. However, when they fall ill, they can use information therapy can fill in the gaps in their knowledge base , so that they are well-informed about their treatment options.

The third quadrant are the known unknowns . These are questions which we know we don’t have the answers to. These are at the heart of the cutting-edge of research , where labs spend a lot of money trying to advance medical science. An example is – Why do men have a low sperm count ? While it’s easy for patients to ask these questions as well, these are of little utility to them, as there is not much their doctor can do to answer them in clinical practise.  The fact is that medicine still does not have all the answers – and when the doctor says – I do not know, this does not mean that the doctor is incompetent or outdated – it simply means medicine still has lots of grey areas! Sadly, many doctors will not share the truth with their patients.  Because they want to be seen as being omniscient, they will subject their patients to a battery of tests and treatments, which are of unproven value. While is this is fine in the contest of a controlled clinical trial,  I don’t think it’s ethically acceptable to use patients as guinea pigs in clinical practice!

Finally, we have the unknown unknowns . These are the areas which lie beyond our perspective, because no one has thought about asking these questions ; or because we do not have the tools to be able to answer them intelligently. This is the stuff which belongs to the research agenda of future generations !

An extremely important segment consists of information which the patient knows that they know , but where the information they have is incorrect . This is actually the biggest danger of all ! Because the patient thinks they know, they don’t bother to check their facts or do their homework . As a result of these preconceived notions and misconceptions, they often end up getting poor quality treatment. As Mark Twain once said , "It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so."

This is why, if you are a patient and even if you think you are well-informed, it's always a good idea to use information therapy to check that what you know is correct ! Medical knowledge advances all the time – and outdated or incorrect information can have a lot of harmful side-effects.The key is to focus on the process - this is in your control, even though the final outcome is not.

If you would like to to learn more about the IVF unknowns and check you are on the right track , please send me your medical details by filling in the form at so that I can guide you better !

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