Managing patient complaints - Dr Malpani's guide for IVF specialists

The best way to manage complaints is to prevent them. This is why patient education becomes so important.


The trouble is that IVF doctors are very busy, and don't have time to sit and talk to their patients.



Also, for the first consultation, the IVF specialist is usually in "sell mode" and is trying to do his best to convince the infertile couple is that he is the best IVF doctor in town and that they should come to him for their IVF treatment.

He is very likely to overpromise - and fill the patient with lots of false hope, based on sweet talking them, or quoting highly inflated success rates.


While it's easy to fool gullible patients, it's not possible to fool all the patients all the time, and this kind of behaviour is very short-sighted because it comes back to haunt the doctor when the IVF cycle fails.

Patients feel cheated , and feel the IVF failure was a result of the doctor's negligence or incompetence. Even worse, lots of doctors refuse to see patients when the cycle fails. Because the doctor is too busy doing consultations for new patients, the old patients are fobbed off and handed over to an assistant or a nurse. Patients feel abandoned and are angry and vengeful.


It's important that patients have realistic expectations of IVF treatment - they need to understand that the outcome of an IVF cycle is always uncertain and not in anyone's control. If this is explained before the cycle starts, patients are much better able to come to terms with IVF failure, and are much less likely to complain unnecessarily.



This is why doctors need to be proactive, and educate patients, either using books to do so; or with the help or nurses, assistants and counsellors.


We use our IVF Comic book ( which you can download free); and the free IVF e-learning course at www.ivfindia.com to ensure that patients have realistic expectations of our treatment. The fact that we are willing to discuss failure openly actually helps mature IVF patients to increase their trust in us.

Have complaints about your IVF doctor ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better !

Helping patients make sense of their medications

It is difficult for patients to manage their medications. The elderly , among many others , tend to take several medications in different doses at varying times of the day. There are often complaints of numerous side effects of these medicines, some of the complications a result of cross reactions between these medicines.

The law mandates pharmaceutical companies provide information about the medicine on its package. The purpose of these leaflets is to help patients understand their medicines , so they take them properly . But there are numerous complaints against these leaflets, for instance, tiny or cramped text, bad printing, hard to understand warning symbols, incoherent instructions, complicated language etc. 

Dr. Malpani speculates how many people even bother to read these leaflets, let alone understand them.

These leaflets are not patient-friendly. They are apparently designed to be compliant with the law alone. The attitude of pharmaceutical companies by publishing information in this manner seems to be self-protection against potential lawsuits by aggrieved patients than to actually prevent a health risk for patients. Since the leaflets are barely readable at best, a chance at patient education is lost. Thus, patients are oblivious to the side effects and complications of the drugs they are consuming. Read more about health literacy at http://blog.drmalpani.com/2012/11/how-promoting-health-literacy-can-help.html

Choosing a good IVF doctor

A good doctor can assure you good medical care. Almost all patients blindly believe their personal doctor to be highly capable. But in truth, it is hard to gauge the competency of your doctor.

Patients lack the technical expertise to judge the ability of the doctor. Therefore, they use secondary sourced of information and surrogate markers to select a doctor. Recommendations about the doctor from a friend or a family member or another doctor as considered acceptable reviews about the doctor’s competence. Apart from this, people judge their doctor by his bedside manner, the ambience of his clinic, his professional reputation or any newspaper articles about him. Sadly, these reviews are not sufficient and are unreliable at best.

To ensure the best medical care from a competent doctor, it is essential to spend your time and energy to do your homework. Information Therapy can be used to evaluate the most important criteria of technical competence for your treatment of concern. Contrary to popular belief, is is a simple task thanks to technology. For instance, at an IVF clinic, always insist on seeing photographs of your embryos. Good IVF clinics have the clinical expertise to create good embryos and they will have photographs to this effect, which they will be glad to show to a patient. It might not be wise to trust an IVF doctor, if he hesitates to show you the photographs of your embryos.

Get to know more here http://blog.drmalpani.com/2012/11/how-to-keep-your-doctor-honest.html

How the wrong infertility treatments can reduce your fertility

Infertility doctors, sometimes, act illogically. A patient whose burning wish is to have a baby is often subjected to meaningless treatment procedures. This can take up a lot of time and can possibly cause pregnancy to be delayed. There are complaints against the hostility of these procedures towards the patients and that these processes are capable of wasting their fertile years.

Here are some instances of infertility doctors improperly treating patients, which result in a decline in the patient’s fertility instead of a successful pregnancy.

Earlier, for a couple having complaints of infertility, the woman would be examined for anti-sperm antibodies. Anti-sperm antibodies were thought to kill the sperm, thus causing immunological infertility. This condition was treated by prescribing the use of condoms to the couple during intercourse. This was based on the assumption that continual exposure to sperm prompted the woman’s body to create anti-sperm antibodies, so the use of condoms for at least 6 months would shield the immune system from the foreign antigens present on the sperm. Conjecturing that this would help reduce the anti-sperm antibody levels in the woman, it was believed she could conceive immediately after condoms were discontinued. Malpani Fertility Clinic reveals that it is improbable for anti-sperm antibodies to play a major role in causing infertility as these are very commonly found in fertile women too. Malpani Fertility Clinic suggests that it is a waste trying to “treat” these antibodies. Read more at http://blog.drmalpani.com/2012/12/infertility-doctors-and-irrational.html

More than meets the eye at free medical camps

From free fertility camps of IVF clinics for aspiring mothers to urology hospitals offering free screening for prostate cancer, free medical specialty camps offered by several hospitals are widely conducted everywhere.

Be it cataract surgery or family planning, there is no doubt as to the popularity of medical camps in India. Initially intended to provide medical services to poor patients residing in remote areas, medical camps made it possible for rural citizens to avail of health care services without having to travel far to a city. Run by philanthropists and charitable organizations, most of these camps were relatively inexpensive methods of ensuring that healthcare services were available even to the poor.

It appears that medical camps are more of a promotional campaign for hospitals these days. Needless to say, free camps offered by hospitals generate a lot of public attention, bringing to emphasis their dedication to community service. Beware though, that many of these medical camps might be cheating gullible patients with their ulterior motive of helping hospitals build a database of potential patients to whom they can sell their services. Many complaints have been received about their misdiagnosis and profit mongering over-treatment for a health condition that was better off untouched. More facts revealed at http://blog.drmalpani.com/2012/12/why-free-medical-camps-can-be-bad-for.html

Why do patients hesitate to change IVF doctors when they are dissatisfied ?

It is common for a patient to experience failures with IVF not just once but several times. In addition, many patients are also dissatisfied with the kind of medical services provided by their clinic of choice. What is astonishing is that nevertheless, they choose to continue with the same clinic.
Many patients are stuck because they do not have any alternatives. For instance, when they are undergoing a government aided treatment procedure, they have to necessarily go to a particular clinic mandated by the government. However, when patients are paying a hefty fee for IVF treatments at private clinic, they do have the option of switching clinics, which, surprisingly, they do no avail of.

Patients may feel they are cheating their chosen doctor by discontinuing with him, even though they may be discontented with him. Some believe that the doctor who has already done one IVF cycle for them might have got considerable insight into their case and thus, may be successful the next time. Many patients simply refuse to consider better clinics either because of their false generalized perception that all IVF clinics offer the same quality of treatment; or due to their reluctance to take the effort to search for a better choice. Their reluctance may stem both from a lack of awareness and lethargy. It is possible that they may not know how and where to look.

Take a deeper look into this issue at http://blog.drmalpani.com/2012/12/why-dont-patients-fire-their-ivf-doctor.html.