How Integrated Are You?
Posted on March 3, 2009
Later this month I’ll be interviewing Evelina Sterling and Angie Best-Boss about their new book, Budgeting for Infertility where we will discuss many of the patient advocacy concepts in their book. As I prepared for this interview I started to think about the things that my husband and I did as we started our infertility journey.
Our first step was to get the basic tests run. For him that meant a semen analysis. For me that meant basic blood work-up to check my hormones. Once we received his results back that confirmed my fear, his sperm was poor in all 3 categories (quality, quantity, and movement), we researched what our options were for family building. We searched online for resources that discussed male factor infertility and the types of treatments available, which lead us to consider in vitro fertilization (IVF). My results showed that I had elevated prolactin. A little bit of online research confirmed that prolactin can cause irregular cycles.
With the information about our medical issues in hand, we decided to make an appointment with a Reproductive Endocrinologist as first steps in our journey to become parents. I asked everyone I knew for recommendations. In addition, I researched doctors who were in our local area using an online directory. Once I had a few names and websites in hand, I dove into learning about each doctor’s pricing structure.
We interviewed 3 doctors before deciding which one to use for our fertility treatments. We figured if we were paying out of pocket we were going to find a doctor we “clicked” with. When we interviewed the first doctor he confirmed all of the information we had already researched. He was nice and seemed very competent, yet he lacked the confidence we were looking for. The second RE we went to interview was more than 60 minutes late for our appointment and his office didn’t bother to inform of this when we first arrived. We walked out. While I realize this may seem dramatic, our logic was that if this was how the office was going to communicate with us when we were a “prospective” patient, we doubted they’d make much more effort once we handed them $12,000 or more. We are sticklers about customer service. The third doctor wasn’t local and my husband wasn’t too excited about that idea. However, doctor #3 diagnosed my pituitary tumor over the phone just by looking at my paperwork and said that he was sure he would get us pregnant during our first IVF cycle. I was hooked.
I was looking for a doctor with a God-like complex – which is interesting because I don’t generally do well around people who are arrogant. I wanted him (or her) to ooze confidence. Doctor #1 didn’t fit that profile, but doctor #3 did. However, it wasn’t just the confidence they possessed that lead us to doctor #3 – it was our perception of his competence too. I was impressed that he diagnosed my tumor over the phone, which the other doctor hadn’t even mentioned and when I did pose it as a possibility he dismissed it’s importance during a treatment cycle. Since doctor #3 was going to treat my tumor as part of our IVF cycle, I felt like he was more interested in helping us get pregnant and have a baby.
Most importantly, though, was the difference between how doctor #1 and #3 defined success. With doctor #1 success was defined as a 24 week pregnancy. With doctor #3 it was a live birth. We were more interested in having a live baby than just a pregnacy. All items ended up leading to us using doctor #3 for our IVF cycle.
My husband and I probably asked more questions during the initial interviews than we did once our IVF cycle started. Our infertility has taught us great lessons that have carried over to help us become more active participants in our health care.
What is important to you in a doctor? How much research did you do before you hired your doctor? Are you happy with your decision? If not, it’s best to find another doc than to carry on with your health plan (or fertility cycle) with someone you don’t trust or don’t like.
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3 Responses to “How Integrated Are You?”
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My first fertility specialist I was referred to by my ob/gyn (who felt she had taken me as far as she could after my 5th miscarriage and almost 2 cumulative years worth of clomid). He was HORRIBLE! I hated him. He belittled me, the exam was rough and without care for my sense of modesty or dignity. He doubted my history (though it was clearly documented in the files I delivered to him), told me I wasn’t his typical fertility patient and outright told me he couldn’t understand why I would want another child (I had two living children and had had 5 miscarriages). At the end of being humiliating in more than few ways by this man, he told me to “go home, have all the sex I wanted and come back to see him in the fall and he would talk about getting me pregnant then”. I cried the entire 2 hour ride home and never went back. I was fortunate to find a group called PARINTS in St. Louis run by a nurse with over 20 years experience working in infertility. This group of nurses matched patients with doctors suited to personality, need and medical history. They coordinated your care with the doctor’s office and made sure you had all your questions and concerns addressed quickly and completely. They were wonderful to me and matched me with an excellent doctor whom I continue to see even though I live over 100 miles from her office. She was not an RE and not anything at all like the awful man I had just been to. I have been a patient of hers since 1999 and each time I visit her office we are just as likely to start chatting about the shoe sale at the mall as my most recent pap smear. She never talked down to me or just at me. She treated me as an intelligent, informed woman and as a partner in MY care.
I never needed a hand holder. I certainly didn’t want a doctor with a “god complex” or an attitude of “I’m the doctor, don’t you go worrying your pretty little head about it . . .” I didn’t have to have a good bedside manner – in fact, some of my past doctors that I liked had the personalities of well, a brick! However, all my best doctors had one main thing in common – they listened to me, answered my questions (appreciated them even) and respected the fact that even though they were experts in their field, it was MY body and therefore knew a little bit about this particular model.
My current doctor is caring, but doesn’t beat around the bush or sugarcoat things. She doesn’t browbeat me with a bunch of medical speak and our conversations are just that – conversations, two ways. I would trust her with my life and have in fact, numerous times!
A good doctor is gold, a good doctor for YOU is priceless.
Julia,
Thank you for your always thought-provoking comments. I agree, a good doctor for me is priceless! Glad you found a doctor that works well with you and cares about what is important to YOU.
Kelly
[...] to see patients leave for better care or more caring doctors. See Julia’s comment on the How Integrated Are You? post. Truly, if you lack compassion for your patients you are in the wrong [...]