Tuesday, July 21, 2015

Why is it so Hard to Change IVF Doctors ?

Patients find it surprisingly hard to change their IVF doctor , even when they are not happy with him.
When patients  are choosing an IVF  clinic for the first time, they’re pretty clueless and naive , and are not sure how to differentiate a good clinic from a bad one. This is why they sign up, often with the one who’s closest to them; or the one who’s the cheapest ; or the one who has the biggest ads.
However, after going through an IVF cycle, lots of patients are extremely unhappy with the way they’ve been treated.  They find the doctor’s usually not available; they are made to wait for hours on end; they are treated with disrespect; there is no standard treatment protocol and everything seems to be done on an adhoc basis; there is no transparency or openness ; and they keep on being asked to pay extra for additional services, often in cash, as a result of which the total bill comes up to much more than what they’d originally budgeted for.  So when the first cycle fails, you’d logically expect them to search for a better IVF clinic, where they'll hopefully have a better experience . However, a lot of patients, even though they are extremely unhappy with their present IVF doctor, continue staying with him and do a second cycle in the same clinic.

I find this extremely hard to understand.  I can forgive making a mistake once, but why would you compound the mistake by repeating it again ?  I think, there are many reasons for this.

The first is one of denial.  No one wants to accept the fact that they’ve made a mistake so they'd rather stick with the known devil, than hunt for someone else. After all, what's the certainty that the next IVF doctor will be any better ? Also, they’re hopeful that the doctor will improve or will do a better job now that it’s their second cycle . Their naive hope is that he will have a soft corner for them, or will try harder, since it’s their second cycle,  and they have a relationship with him.

A second problem is one of attitude.  Lots of patients would rather behave as passive victims and blame the doctor and still continue with him, rather than take the effort and the energy involved in finding a new doctor. This can be hard work , and they don't want to do that.  And a lot of them justify this be saying that they are worried that they could end up going from the frying pan to the fire. It's much easier to stay, so this becomes their default option.

Thirdly, a lot of them aren’t confident enough that they’re going to be able to make the switch . When they try to do so, the existing clinic creates a lot of hurdles in their way ! They provide both a carrot as well as a stick. The barrier is - “Sorry , we will not give you your records, because this is our clinic policy that the records are our property” ; and the carrot is, “Fine, we give you a 20% discount if you stick with us and don’t go anywhere else”.

Part of the reason for this reluctance to switch comes from what psychologists call cognitive dissonance.  Patients think of themselves as being smart , and when they are then confronted with the reality that they weren’t smart enough to choose a good IVF doctor , rather than accept the fact that they made a mistake, it’s much easier to rationalise their choice by saying, “ Well maybe the doctor is good and it's my fault that I can’t see his finer points and that’s why I’m better off sticking with him."
 The other problem is what is called loss chasing behaviour, which often means that when we make a mistake , we have a natural human tendency to compound the mistake even further by trying to reduce its impact.  Ironically, this has exactly the opposite effect and we dig a deeper grave for ourselves by throwing even more good money after bad.

Patients need to be aware of these psychological traps which affect our ability to learn from our mistakes . In order to improve , they need to step outside themselves , and understand that the first cycle cost is a sunk cost.  There’s nothing they can do to recover this. Rather than make a bad situation worse, they need to learn from the mistakes which they made in the first cycle , and do a better job in their second cycle . One of the most effective ways of doing this, is to analyse your learning and then convert this into action by finding a better IVF clinic, who can do a better job.
It’s much more likely that your second clinic will be better than your first ! This is because you are now a smarter and better patient , and because you know exactly what problems you had with your first clinic , you can ask far more intelligent questions in order to make sure that you will not encounter the same problems.

I agree, this is a hard earned lesson, but it should be put to good use because this is the only way you will be able to maximise your chances of having a baby !

Need help in finding a better IVF clinic ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better !

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