Thursday, January 23, 2014

Why I enjoy teaching IVF patients

When doing an IVF cycle for my patients, I often ask them to point out their follicles during the ultrasound scans; or to tell me which of their embryos is of the best quality when we show them these in the IVF lab. Many  patients are quite taken aback when I ask them these questions. The knee jerk response is – How do I know ? I am not a doctor ! ( And I am sure some of them must be secretly worrying about my medical competence -  this doctor must be very confused if he needs to ask us for our opinion !)

I tell patients that I am not trying to make them IVF experts. I ask them these questions to try to engage them in their treatment. This way, they know exactly what's happening to them . Because they know I am going to question them, they do their homework and this make it much easier for me as well, because it’s much easier to explain medical minutiae to well-informed patients.

Not only do they feel in control of their treatment , a well-informed patient will always get better medical care, because she will make sure no inadvertent errors are made by any of the medical staff who are looking after her. After all, the patient is the most important member of the medical team !

Even better, these patients are much more satisfied with the quality of care they receive, no matter what the outcome , because they can see we are doing our best for them. Patients like this openness and transparency and are happy that we are respecting them as being intelligent adults.

Today, I had to prescribe the HCG trigger for a patient to schedule her egg retrieval. I asked her – Why don’t you write your prescription , and I will sign it. She looked at me as if I was crazy. Actually, this is a very effective tool to make sure patients understand exactly what’s going on. Most patients are quite intimidated by doctors and are very reluctant to ask questions . They will often nod their heads, even when they don’t have a clue what is happening. They will then try to fill in their knowledge gaps, by questioning the nurse .  This technique is called “teach-back” and ensure that patients know exactly what is going to happen. It’s a great quality control tool for me as well, because it allows me to check I am doing a good job with teaching my patients.

This way, I also get to learn a lot from them, because many of them will be able to explain technical details in terms which other patients find much easier to understand. The biggest pride for a teacher is having a bright student who outshines him – and when my patients are capable of  writing their prescriptions for themselves, I am happy that I have done a good job ! This helps to demystify the IVF process , and gives patients a lot more control of what's happening to them . It also makes my life a lot easier , because there's much less scope for errors and misunderstandings when patients are actively engaged in their treatment.

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