IVF can be an emotionally taxing treatment. Not only is it very expensive, there is a lot riding on the outcome. Patients know that the success rate depends on how good the doctor is, which is why they have very high expectations from their doctor. They will spend a lot of time hunting for Dr Right - an IVF expert who is approachable and affordable; who will design their treatment plan and personalize it specifically for them; and who will be available to answer their questions.

When they go the clinic for their scans and monitoring, they want to be able to talk to their doctor, so he can check their treatment is progressing as expected, and that there are no unexpected surprises. They want a doctor who knows their name; who cares for them; and who is available to hold their hand and provide a shoulder to cry on when things don't go well.

It's very frustrating for patients to find that the doctor is never accessible. He is either travelling; or giving a lecture; or is away at a conference; or is treating patients at another clinic. Even when he is in the clinic, he is so busy doing consultations with new patients, that he is not free to answer queries. When the patient is not sure if things are going well, or why the doctor has made a change to the protocol, they are forced to direct their queries either to the nurses or the assistants. The juniors are often clueless as to what is going on, because they are inexperienced or have been told that all patient's questions have to be answered only by the Doctor - they just have to carry out his orders ! When patients don't get a chance to get their queries clarified, they feel upset and abandoned.

This lack of information and transparency can become a major sore point for the patient. This is especially true when the cycle fails, and at this point the patient feels cheated. She is very likely to complain that she did not get good medical care, because the Doctor was not available.

Not only do patients need a lot of handholding - they expect their treatment to be personalized. When their care gets fragmented between the sonographer, the nurses, and the andrologist , they are understandably upset - especially when it seems that the left hand has no clue as to what the right hand is doing ! When the patient needs clarifications, the standard answer is - we are doing what the doctor has advised. Only he can answer your questions.

They would much rather have one person whom they could talk to - one person who was responsible for coordinating their care - and obviously they want this person to their doctor ! They want the doctor to be available to carry out all their procedures for them - including the scans, the egg collection and the embryo transfer. It's very frustrating when they find that they have to deal with a new doctor everytime they come to the clinic - someone who knows nothing about them and someone with whom they have no personal relationship.

They are always unsure if the new doctor knows what's happening - and it's very difficult to establish a rapport every time with a new doctor who happens to be on duty on that particular day. While these may seem to be relatively minor issues from a doctors point of view (because doctors are focused on providing high quality medical care), the fact still remains that IVF treatment is very highly emotionally charged, and IVF patients require a lot more attention and pampering as compared to the average patient !

Successful IVF clinics will develop processes to ensure sure that the patient's personal doctor is always available to take care of his patient throughout their entire IVF cycle. Not only does this ensure that the medical treatment is being carried out properly , it also allows him to provide the patient with continuity and emotional support. He can provide a shoulder to cry on - or serve as a trusted sounding board , when patients are not sure what the next step should be, or if the cycle needs to be cancelled.

Patients also want documentation and openness about how the cycle is progressing. They need to know whether the follicles are growing well ; and if their treatment is progressing according to plan. When the protocol is changed, they need to know why this change was made - and what they can expect. It's very frustrating for them when they have to wait for hours before they get a chance to talk to the Doctor.

The doctor should be accessible, so he can answer queries by email - or will ensure that calls are returned promptly by the end of the day. Patients want photos of their ultrasound scans and their embryos, so they have documentation that the treatment was carried our properly.

Before starting treatment, they need clarity about what the treatment plan is going to ; how often they will need to visit the clinic; and how much it is going to cost them. They also need to know when they need to make payments - and what is included in the treatment cost, and what is not.

If there is an emergency or complication, they need to know whom to contact - and need to be sure there doctor is available to take care of them. Finally, they expect a caring doctor, who will followup after the cycle, when the beta HCG test negative, so they know what their next action steps are, and don't feel abandoned just because they cycle failed.

All this requires a lot of coordination and care on the part of the doctor and a good IVF clinic will make sure that the doctor, who is the face of the clinic as far as the patient is concerned, is always available for his patient, when the patient wants and needs him.

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

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