Thursday, July 07, 2016

How can I be sure that my IVF doctor is not fooling me ?

I just received this email from a patient.

Hello doctor, can you please tell me how can I trust my IVF doctor - that he is not making a fool of me in the egg donor process. How do I know if he is showing me photos of a model , but is actually using her eggs or someone else's  ? How can I trust him ? Is there any rule or law that doctors cannot make a fool of their patients ?
This is an important question, and a difficult one to answer.  There are lots of stories about how IVF clinics have fooled their patients, and the truth is that if a crooked IVF doctor is out to cheat you, he will be able to, and this is why you need to be on your guard.
It's deplorable that the level of trust between doctors and patients in India has fallen to such abysmal levels that patients need to ask this kind of question. However, it's we doctors who have contributed to this sad state of affairs. Most doctors are straight-forward,  but we all know that there are some crooked ones as well. However, it's because the good doctors don't speak up about the mlapractices which the few bad doctors indulge in, that all doctors get tarred with the same brush. While lots of IVF doctors know very well which IVF clinics take their patients for a ride, sadly they will keep quiet about these clinics. This is partly out of a misplaced sense of professional courtesy, because they don't want to be ostracised by the medical community for pointing fingers at other doctors; and partly because they feel it's none of their business. After all, it's not a doctor's job to police other doctors, and they feel that as long as they are doing a good job in their own clinic, they don't have a duty to point out when other doctors are fooling their patients. Part of it is also out of a sense of fear - after all, they believe that people who live in glass houses shouldn't be throwing stones, and that it's not the pot's job  to call the kettle black.

I wish there was a list of certified IVF clinics in India who had met basic quality control standards; and that the Indian government would ask clinics to publish their success rates, so that patients could use this as a guide. Sadly, there isn't, which means you need to do your own spadework for yourself !
Most patients are not able to differentiate a good doctor and a bad doctor, and most will end up going to whichever IVF clinic their family doctor sends them to.  IVF patients are very vulnerable, and it's easy for doctors to take them for a ride , which sadly some of them do, because there is so much money at stake.

The good news is that there are lots of good clinics out there. However, there are plenty of bad ones as well, and you do need to put in some effort to find one you can trust.

Here's a secret. Try making friends with one of the IVF clinic staff. They know exactly what's going on, and they will be able to share insights into the modus operandi of the IVF clinic, and whether they indulge in dodgy practices.

It's a good idea to talk to other patients in the clinic while you are waiting ( and sadly, there will be a lot of waiting in most IVF clinics ). This can be a good opportunity to  share notes, so you can compare your experiences with others who have taken treatment in the clinic.

If your doctor refuses to answer your questions, or tries to put you in your place by reminding you  that he is the doctor, then this should be a red flag. A good doctor  will do his best to earn the patient's confidence, because he knows that patients have lots of queries and doubts, and he will try to allay these before starting the treatment.

You don't need to become a doctor when you're evaluating an IVF  doctor . However, it's a good idea to get a second opinion , so you can ask more intelligent questions and select the right doctor for yourself.

It's true that this takes time and trouble and effort. Isn't it just much easier to go to the first one who you pick or the one who's closest to you or the one you've read about in a newspaper article? Yes, it's easier but can often be the wrong decision, which can prove to be expensive.

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