Many patients who come in for a consultation walk in with fat medical files in tow. These have copies of their previous test results, and there could be summaries of the treatment cycles they have already been through. They place these on my table, wait for me to go through their records and then pronounce my verdict. Sure, I will be predictable and do that eventually; but I will also be a little unpredictable and first ask my patient- “Not Getting Pregnant- Why is that?What exactly have you learned from all the previous medical encounters?”

There is nothing complex in this question and it’s easy enough to understand, but most patients get thrown by it. In their opinion, it’s the doctor’s job to figure out why they aren’t getting pregnant. At  this point I can see very clearly that some of them become pretty uncomfortable as they feel  I’m not competent enough and  they doubt whether I would be able to provide  them the treatment they need.

They wonder what kind of doctor asks them about why they are infertile; they feel it’s something he should be explaining to them.  The next thought that crosses their mind is – “Isn’t this what I am paying him to do? Still others feel a glance at their medical files should give me the answer to that question. But there is a simple logic to asking my patients this question. It gives me the chance to ascertain how much they know about their own problem.

Identifying where the problem lies

Only when I understand what their current level of understanding is when I would be able to start at the right point and then take them up to the point they should be at. If any of my patients are puzzled and aren’t too sure about what they should be saying, I just tell them that this question isn’t very difficult to answer. It’s simple really as the only things required to make a baby are eggs, sperm, a uterus and tubes.

And if they aren’t getting pregnant, the problem must lie with one of these. In some cases, unidentified fertility may be causing the issue. Since this is an extremely basic question, if they don’t have the answer to it, I know that I just need to counsel them further. This is a far more efficient & effective approach; it helps ensure that the patient and I are on the same page.

It’s a matter of teamwork

Once I begin going through all the records, I also ask the patient to explain all the key test results. It’s not like I’m trying to test them. It’s just the way I try to figure out whether they are able to successfully wade through all this complex jargon that shows up in their reports. While they are talking, in case they come up against a stumbling block, I quickly explain and help them move forward.

This approach also lets them know that they are being treated like a mature and thinking human being and that everything needn’t be left up to the doctor. This gives our patients the confidence that we would be able to function as a team.

Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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