IVF patients versus IVF doctors

When patients come to an IVF clinic, they expect to be treated by an IVF expert. Having spent many years in medical school, we have mastered technical skills such as egg collection and embryo transfer. However, some patients want only the doctor’s technical help , and not their professional advice. This includes carrying out laboratory procedures that the patients cannot do by themselves at home.

Such patients are normally familiar with the whole IVF process and may only want the doctor’s technical help. However, in such cases where patients are interested only in the doctor’s technical expertise , they may end up clashing with the doctor's professional views. For example, older women may insist that the doctor do IVF with their own eggs, instead of choosing egg donation , even when they know that their ovarian reserve is low and that their chances of getting pregnant are very slim. 

They do not want a doctor's advise - they have already made up their mind. They get upset when their doctor insists on offering them alternative options they are not emotionally prepared to explore.

If they do not accept the doctor's advise, he may feel that the patient is questioning his competence and authority and may consequently get annoyed.

The best approach is for both the patient and the doctor to agree on the kind of help the patient will be offered; whether technical or professional. Most importantly, patients should be open to diverse medical views as opposed to prematurely choosing only those options that seem appealing to them initially. They need to make well-informed decisions , based on a wide knowledge base. Equally, IVF doctors needs to be supportive and not judgmental - after all, patients and doctors are on the same side !

The second IVF baby

Upon having their first child via IVF, most infertile couples are understandably relieved and are filled with so much happiness that they feel their family is complete. They find their first child completely fulfilling, and do not even dream of having another baby.

However, about five or six years later, the very couple that successfully had their first child via IVF will walk into a clinic and give IVF another try, this time more enthusiastic and confident of their chances of success. Mostly, they explain that their first child is lonely and needs company.

Such patients need to understand that as much as their chances of their second IVF succeeding are normally high following the success of the first cycle, it does not mean that the second cycle has a 100% chance of succeeding. Dr. Malpani says the best approach would be to always plan for the future just after the successful completion of the first cycle by asking your IVF doctor to safely store the frozen embryos for you if you had arranged for them to be frozen. Those embryos are from the cohort that succeeded during the first cycle and therefore their chances of getting you a baby are high.

The most encouraging element of the IVF cycle however is that you will have established a good rapport with your doctor and you will know how to get him/her to adequately respond to your complaints and questions. Moreover, you will have lots of IVF knowledge carried over from the previous experience.

Why aren’t infertile patients better informed?

It is disheartening to see how ill-informed infertile patients are concerning their medical condition, especially in this new world order, where lots of information is available online and can be accessed 24/7 via smartphones. It is even more disturbing when most of these patients happen to be the elite who spend a lot of time surfing the internet , but never bother to do medical research.

Doctors certainly aren’t omnipresent and will therefore never be able to answer all the questions and complaints of patients all the time. Dr. Malpani says this is an opportunity that infertile clinics should make the most of. Even though the information available online today online is of large volume and potentially confusing, IVF clinics should invest money and energy in developing straightforward patient educational materials, so that patients have realistic expectations of their treatment, and do not feel cheated just because their IVF cycle fails.

Providing reliable educational information helps IVF clinics, as their doctors and IVF specialists don't need to spend as much time in educating patients about the procedures. This information can be provided much more effectively through online video, which is a much more engaging medium and ensures patients will remember that they see. They can review this many times as well , to reinforce their learning; and share it with their spouse and family members , if they need to.

Why clinics need to reach out to patients directly

Doctors who run clinics are intelligent and recognize that reaching out to patients directly is the best way to attract patients to their practise. The traditional way which involved offering incentives to family physicians and other doctors to refer patients to their clinic can be very expensive and unsustainable because it reduced their profits by over 25 % ! Even worse, they are not able to build a direct relationship with their patients. This means that the patient may feel cheated if the outcome is not good, and he may complain about the clinic. Even worse, there is never a guarantee that these referring doctors will be retained if they get better offers elsewhere from other competing hospitals.

It is therefore vital that doctors and clinic managers do their best to delight their patients. Improving service delivery will attract more patients and increase profitability, and is very cost effective. Service delivery in clinics should be broadened to cater for visitors and friends and relatives accompanying patients . These are all potential future customers after all ! Which hospital they will select when they fall ill will depend on how they were attended to during their initial visit. It is therefore important that hospital visitors are made to feel valued and treated with dignity.

Doctors should therefore not just concentrate on filling their clinics and improving technical care, but they should also ensure that visitors are well attended to , because they could serve as ambassadors of the hospital  and help attract more patients to the facility! Word of mouth marketing is a cheap and effective way to market a clinic!