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Finding the right IVF doctor can make a world
of a difference to your IVF treatment, which is why spending time, money
and energy hunting for the best IVF doctor in the best IVF clinic is
vitally important for you. Unfortunately, most IVF patients don’t know
how to go about looking for the best IVF doctor, and often end up
getting suboptimal treatment, because they are not taking treatment in a
good IVF clinic.
Who is the best IVF doctor ? For every
patient, their idea of the right IVF doctor will be different, which is
why you need to
invest time and energy in this pursuit. You need to have a plan of how
to go about finding the right IVF doctor for yourself. Step number one
is to start by preparing a short-list of possible candidates. You can
phone or email the IVF doctors on your list. “ Telephone shopping" can
provide you with a lot of useful information about an individual
doctor’s practice, including details of clinic timings, fees,
qualifications, hospital attachments, special interests. After all, if
you are willing to research which travel agent will give you the best
deal on a holiday trip, then isn't it worthwhile researching into whose
hands you are going to put your life in? You can learn a good deal about
the doctor and his practice, even before you actually meet him, by
merely telephoning and asking the right questions.
While it is true that
many mediocre doctors flaunt posh clinics, the setting in which the
doctor functions can reveal a lot about him. Is the clinic located in a
decent building? Is public access easy? Has the doctor bothered to
provide the basic amenities you need (e.g., drinking water,
comfortable seating)? What kind of reading material is kept in the
waiting area? (Old and torn magazines should qualify as a negative mark.
Patient educational literature and current issues of health magazines
indicate that the doctor respects your waiting time and wants to use it
to educate you). Are the office staff members helpful? How do they
answer the telephone? How do they treat other patients? You can learn a
lot about a doctor and his practice from the personality of his
employees: remember that efficient, caring physicians tend to hire
competent, friendly personnel!
While selecting a suitable doctor can be
difficult, try to find answers to the following questions.
- Credentials - training and qualifications.
- Skill and experience.
- Accessibility (locations; clinic timings).
- Affordability (fees).
- Professionalism.
Does he prepare for your appointment?
Explain records and test results?
Keeps appointments and values your time?
Manage an efficient clinic?
Review your status and progress periodically?
- Personality and style.
- Does he talk to you? Take time to listen to
what you have to say?
- Does he show empathy and compassion?
A good infertility doctor will usually:
- involve both husband and wife in
consultations, discussions and planning.
- offer recommendations and choices. Since
there are no "right" answers, he should allow you to choose your own
course of action..
- tailor testing and treatment to your
emotional needs and budget.
- have time to answer questions and offer
support.
- chalk out a treatment plan for you, with a
discussion of rationale, alternatives, costs, time limits and expected
success rates.
Many patients are still not very
sophisticated when it comes to selecting their doctor. Most Indians
follow a herd mentality, and believe that a busy doctor must be the best
– after all, if so many patients go to him, he must be good. However,
remember that you need to be more critical when making such a crucial
decision – after all, you have to trust that your doctor's skills will
provide you with the best treatment for your infertility. There is
little point in going to a doctor who is so busy that he has no time to
talk to you, or who cannot even remember your name!
Most gynecologists can provide basic
infertility workup and testing - but you may prefer to look for a
specialised infertility clinic which will provide all the services you
need under one roof, especially if you have a complex problem. Many
gynecologists are not really geared up to providing the care which an
infertile couple needs, and it’s not much fun sitting in a room with
pregnant women who have come for their obstetric care, if you are
infertile.
The risks of going to a general gynecologist
for treatment are:
1.
They may not have the expertise or specialised knowledge to treat
your problem, since they may not be aware of recent advances in this
field.
2.
They may not have access to the specialised tools needed to treat
you, with the result that you may have to run around from the doctor to
the lab to the ultrasound clinic for your treatment.
3.
They may not have a special interest in treating infertility, so
that you may end up getting "second class" treatment.
4.
A common mistake many gynecologists make is that they keep on
repeating the same treatment again and again – wasting valuable time and
money in the process.
We often find that by the time patients come
to us, they are so fed up and frustrated, since they have wasted so much
time and money on repeating ineffective treatments, that they have lost
confidence in doctors – and in themselves as well! Don’t let this happen
to you! While going to an infertility specialist can help you to ensure
you are on the right track, this does entail the risk of "overtreatment"
as well. Unfortunately, many infertility clinics are happy to do IVF for
all infertile patients who come to them, whether or not they really need
this!
Getting a second opinion
Get a second opinion - this can never hurt
and is always helpful. If you find two experts saying the same thing
then you know you are on the right track! If, on the other hand, they
disagree, don't get upset - there are few black and white areas in
infertility, and doctors often have different ways of treating a
particular problem. Ask questions of both of them and then choose the
method which appeals to you - it's finally your decision!
What if you don't understand what the doctor
is saying and are getting confused? This is not your fault. If you do
not understand anything the doctor says - ask questions! If you still do
not understand the fault is his - he is not explaining in terms which
you can follow. Find another doctor!
Remember that you need to ask questions to
get answers - your doctor cannot read your mind! But also remember that
your doctor does not have all the answers - after all, medicine is still
an imperfect science, and your doctor is not a fortune-teller. If he
does not know the answer, he should tell you this as well.
How do we do a consultation in our practice?
We first ask the couple why they think they have not been able to
conceive, and how they expect us to be able to help them. The answers
give us a good idea of how much the couple understands about their
problem. It’s often heartbreaking when we see couples who have been
through 3 IVF cycles, and don’t even know how many eggs they grew or how
many embryos were transferred each time – or even why the IVF was done
in the first place. During a consultation, we first explain, using
models, how babies are made. We then review the medical records, and
explain to the patient what we feel their medical problem is. We then
explain to them what the treatment options are, and tell them to think
about these and then make up their mind. In our clinic, we do not charge
for a repeat consultation, in order to encourage patients to ask
questions, and to give them time to make up their own mind. We take
pride in the fact that our patients have a good understanding of their
medical problem, and realistic expectations of how we can help them!
Remember that the purpose of a consultation
is to get information. If you do your homework before going, you will be
able to make better use of your doctor’s time, since you can focus on
the issues which are important to you. You then need to go home and
process this information, so you can decide what to do. It’s very
difficult to think straight when you are sitting in front of the doctor,
so it’s usually a good idea to give yourself enough time to apply your
mind and assimilate the information, before making a decision. There is
usually no urgency, since infertility treatment is never an emergency.
Beware of a doctor who wants you to decide on the spot – it’s hard to do
so under pressure, and you may end up making a decision in haste, which
you may then repent at leisure.
As an infertile patient, you are very liable
to being exploited - and quacks in this field abound! Suspect your
doctor's credentials when:
1.
He promises too much.
2.
He says things like - "that's my secret."
3.
He doesn't explain clearly what he is doing during treatment.
4.
He advises too many tests and surgical procedures repeatedly.
When to Change Doctors
Because infertility is often a long drawn-out
process, anger is a natural result - and often this is transferred to
your doctor. However, constantly changing doctors or doctor-shopping can
be counterproductive! If the quality of care you are receiving is good,
be cautious about changing doctors - a doctor who knows you and your
infertility problem well can be of significant help to you.
·
Changing
doctors is never easy, because, over a period of time you do build up a
personal relationship with your doctor. However, you should consider
changing doctors if you feel that :
·
The doctor
is incompetent (i.e., he has ignored obvious symptoms, missed a
diagnosis, prescribed the wrong drug, or can't get to the bottom of your
problem);
·
The doctor
does not communicate with you effectively (i.e., his explanations are
not in lay person's language or no time is given to you to ask questions
and bring up related problems);
·
The doctor
does not pay attention to your needs and concerns;
·
You have
lost confidence in the doctor's skill and ability.
·
You find
the doctor is too inconsiderate (i.e., he makes you wait a long time for
an appointment, he fails to return your phone calls, he does not provide
clinic time during evening or weekend hours); and
·
Your
doctor is too expensive.
A common problem patients face is that when
they go to a new doctor, he insists on repeating all the tests all over
again. While this can be frustrating and expensive, it can be helpful as
well, because it allows the doctor to reassess your problem with a fresh
perspective. Please ask your doctor to explain why he needs to repeat
the tests, and how this will help in your treatment. If tests have
already been done, but are more than a year old, or if they have been
done from an unreliable lab, you may need to repeat some of these again.
It is all too common to find that infertility
clinics do not provide complete medical treatment details to their
patients. They often do this in order to make sure that the patient
remains with them, and does not go to another doctor. This is very
unfair – remember that your medical records are your property, and you
are entitled to a copy of them.
You may find that your new doctor criticises
the treatment your previous doctor provided. Remember that doctors do
have big egos, and they are often intensely competitive and critical of
each other. This can upset you, because you may start feeling that you
were given substandard medical care. As long as you have a clear
understanding of what was done to you and why, you should ignore this
criticism - don’t let it disturb you. Anyone can be wise with hindsight
– and do remember that all doctors will try to do their best to help you
to get pregnant!
Many doctors will repeat exactly the same
treatment the previous doctor has administered – often because they have
nothing better to offer! However, remember that even though you have
changed your doctor, you have remained the same – and the purpose of
changing doctors should be to allow you to progress further with your
treatment.
Choosing an Infertility Clinic
Many couples ask us whether they should
travel abroad for treatment. Fortunately, the quality of medical care
available in leading IVF clinics in India today is easily on par with
the world’s best clinics, since they use exactly the same equipment, and
the same techniques. In fact, IVF treatment in India is an excellent
bargain by international standards, since you are getting exactly the
same quality of treatment you would get anywhere else in the world – at
a fraction of the cost. This is why so many IVF clinics in India
routinely treat infertile couples from overseas.
How does the quality of care in the smaller
towns in India compare with that available in the metropolises? Do you
always have to travel to a clinic in a large city for treatment? Since
there are no standards or regulations (IVF clinics in India today do not
need to meet any quality control criteria) you need to be an educated
shopper! While the quality of care can be quite good in smaller towns,
most of the reputed clinics are in the larger cities. These bigger
programmes are usually better, because they are busier, and more
experienced, and busy IVF programmes (which perform more than 150
treatment cycles per year) have been shown to have higher pregnancy
rates. However, very busy clinics may not be able to provide you with
the personalized care you need, and some can be quite uncaring, so that
they make you feel that you are just a cog in a machine. For simpler
treatment such as IUI, it is best to look for a good clinic in your own
town. However, for advanced treatments, you may be better off going to
an established clinic. While travelling can add to your stress and
expense, many infertile couples actually prefer not having to take
treatment in the city which they live, as they would like to protect
their privacy.
The Need for Active Participation
Remember, you are in charge of your own
medical care! Medicine, as both a science and art, often requires
choices and there are no "right" answers - you need to make your own
decisions. After all, it's your body and your life!
You have a vital interest in treatment
decisions and outcomes but lack the medical knowledge and skill to
decide alone. The concept of a team - the medical caregivers ( doctors,
nurses, specialists) and you (the couple), working together, allows each
to contribute to a successful outcome and offers you a sense of control
over your infertility care.
Your role on the medical team is multifaceted
- you need to wear many hats when you are an infertile patient!
Emotional Care
When confronted by infertility, you need more
than just medical care – and a good doctor will help to provide you with
emotional support as well. Unfortunately, doctors often end up
amplifying the stress infertile patients find themselves having to cope
with. Many doctors make patients long hours, for no good reason; and
others are often insensitive to their emotional needs. Others may be
quite thoughtless, and instead of trying to provide special attention to
the needs of infertile couples, make them wait with pregnant mothers in
the clinic. A good clinic, on the other hand, can help to alleviate your
stress, by recognizing it; teaching patients that this is normal; and
showing them how to cope with it. A good doctor will be able to
establish a relationship with the couple, based on understanding and
respect, to help them maintain and rebuild their self-esteem.
Questions to Ask Your Doctor
·
Do you have experience in
fertility treatment? When do you consult with an infertility specialist?
·
Will you refer me to an
obstetrician when I get pregnant or will you deliver the baby?
·
Will you send me to any other
physicians or laboratories for treatments or tests?
·
Will you treat my spouse? If
not, who will?
·
Do you arrange for adoptions?
·
Do you document surgeries with
photographs or videotapes so I can see your findings for myself or
provide them to other doctors?
·
Which hospital(s) do you use?
Questions to ask about Tests, Surgery and
Treatments
·
What kind of procedure is it?
·
What will the procedure tell
you?
·
What results do you expect?
·
How long will it take?
·
What will it cost? Does
insurance cover it?
·
Will it hurt? How will it make
me feel afterward?
·
Can you do it in your office?
As a hospital outpatient?
·
Will I be incapacitated? For
how long? Will I miss work?
·
Will my spouse be involved?
How? Will he/she miss work?
·
Will it interfere with our sex
life? How?
Questions to ask about Medications
·
How long will I take it?
·
What will it cost? Does
insurance cover it?
·
Will it hurt or have side
effects?
·
Do I take it at home or at your
office?
Remember that just
finding a good IVF doctor is not enough. For an infertile couple, the
doctor-patient relationship is the ultimate one-to-one relationship, in
which you confide fully in your doctor and trust him to help you to
conceive. You need to form
a partnership with your IVF doctor, so that you can make the most of his
skills and abilities.
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