we are all feeling it
The practice of infertility has really changed over the past decade. Dramatic changes in our understanding of embryo health, genetics, endometrial function, ovarian stimulation, etc. means the more and more people are getting pregnant than ever before. Infertility treatment is really expensive, but for the science involved for the number of highly educated people needed to administer these treatments, it is actually less expensive than it certainly could be.
The pandemic has also changed infertility care, well not the science but the people.
I graduated medical school in 1998. Since that time I’ve trained to be a family doctor, then an obstetrician and gynaecologist and then a fertility specialist (REI). I’ve practiced in each of these three areas but none as long as I have in infertility.
When I first started practice I felt the system of doctor-centred care where in-person appointments were made for every single patient concern or test felt inefficient. I saw people suffering with anxiety with questions that could be answered with a quick phone call or email. I saw people lose precious reproductive time waiting for appointments when electronic communication could speed things up dramatically. We needed a shift to patient-centred care.
I was among the first group of doctors who tried to solve these communication issues by emailing and phoning patients far more than our predecessors. We moved to electronic records so patients could see their own results immediately. I believe rapid access to results and a doctor or nurse improves the patient experience.
The pandemic has caused another shift in patient care as we move to virtual/phone/video interactions. I think it is good, but not great shift.
One significant change I have seen in the past year is the temperament of some patients. It’s been a hard year on everyone but now more than ever we are seeing patients let out their anger and frustration on us.
Not one day goes by that our front receptionist isn’t set to tears by a partner angry we cannot allow them into the clinic. Not a week goes by a nurse doesn’t come into my office considering quitting because of an abusive phone call from a patient. On-line we used to see about one negative review a month. Today alone I answered three such reviews: one was complaining about a doctor who hasn’t even worked here in a few years, the others accused us of being greedy, others questioned our integrity, and the list goes on. One of the negative reviewers conceived on her second IUI with us and complained that we encouraged IVF. Why so many negative, hateful, angry posts? If I am remembering pre-pandemic days, the person who conceived on their second IUI sent a thank you note, not any angry Facebook review!
Last year we helped over 4000 people. We did our best. We cried for patients, we cheered for patients, we answer scared phone calls from bleeding women at 1am, we stayed late and came early. We did everything we could to keep our prices low and our pregnancy rates high.
Personally, I think the majority of patients are happy with the care we provide and forgive our imperfections as they would hope to be forgiven in their lives, too. I think 95% of patients lead with kindness and understanding, but those 5% are either increasing in number or becoming more vocal.
It is really disheartening and I am honestly worried that if these negative voices keep propagating it will get harder to keep people working in the area of infertility.
Me? I am going to keep going. I love this work. I’m 47 and have lots of years left to practice, improve pregnancy rates and help 100% of the people who reach out for care… the highest quality of care. Perhaps once the pandemic settles, and our communal stress decreases, there will be more peace and less anger. For now I will keep hoping the good reviews outweigh the bad, the good feelings and good outcomes outweigh the bad, and that kindness and patience will become the dominant emotions we all lead with……
If I can help please email me firstname.lastname@example.org
Reproductive Endocrinology & Infertility