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One of the major worries most IVF patients have is about the competence of their IVF doctor. While most patients select an IVF clinic based on its reputation, the sad truth is that there is not much correlation with the actual quality of the medical treatment they receive and the brand name of the clinic. Many "big name" clinics are very impersonal and are run like assembly lines. The patient rarely gets to meet the doctor and most of the care is provided either by the nurses of the assistants. Patients feel they are helpless and passively put up with poor quality care, because they do not know what else they can do.

A much bigger problem is the lack of transparency and documentation . Most IVF clinics do not even bother to provide patients with a simple treatment summary ! Patients are clueless about basics, such as the number of follicles seen on the ultrasound scans; the number of eggs collected; the number of embryos formed ; and the quality of their embryos .

Patients are forced to blindly trust their doctor - and those who dare to ask questions are rudely put in their place !

What's worse is that it's well known that some IVF clinics will use your eggs ( without your permission) and gift them to someone else ! Not only is this plain unethical and wrong - it also significantly reduces your chances of getting pregnant !

How can you protect yourself ?

The answer is simple ! Ask questions - it's your body and your treatment ! You are paying a lot of money and you need the answers.

Please learn to ask intelligent questions ! Do your homework, so you do not have to bother the staff with basic questions to which you can find the answers yourself by going online. However, you need to find out details about your own treatment and how it is progressing. Ask for prints of your ultrasound scans and photos of your embryos. This is basic documentation, which every clinic should routinely provide !

If they do not answer your questions , this should be a red flag - beware ! A good doctor will share information - why should they hide anything ?

IVF treatment is too important for you to leave everything upto your doctor
you need to take an intelligent interest in your treatment. Taking treatment at a world-class clinic will maximise your chances of success and give you peace of mind you did your best !

Not sure about what questions to ask ? Get a free second opinion at www.drmalpani.com !

We treat patients from all over the world and many of them want to do a phone consultation with me before coming to our clinic for an IVF treatment.

I can understand why they want to do so - after all, going half way across the world to get treated by a doctor you've never seen or met is a major leap of faith - and talking to the doctor can help to reduce some of this anxiety !

While it's true that the human touch is very important in providing good medical care, the truth is that it's not humanly possible for me to do so. This is true for many reasons.

For one, because of time zone differences, it's quite difficult to find a time slot which suits both the patient and me. We often end up playing phone tag - causing even more frustration ! Also, phone connections in certain countries ( such as Africa) are not of good quality, so that it's hard to hear each other. Also, sometimes patients forget some of their questions ( not all of them are well organised enough to prepare a list of their questions) , which means they often need to call twice or thrice ! Also, sometimes they do not understand what I am saying , because I may use a medical term they are not familiar with and it can be hard to explain everything in detail on a phone call . Another problem is that the husband calls me ; and after I finish answering his queries , his wife calls in another 5 minutes for additional clarifications, because he could not explain to her what I told him ! And when I am busy seeing patients in the clinic , it's hard for me to spend time on the phone . This means that my phone conversations are often short , which gives patients the wrong idea that I am curt or rude !

However, my major argument against a phone consultation is that it is not a very efficient means of communication ! There is no documentation , and too much scope for confusion and errors. This is why I prefer email, where everything is written down. I can answer as many questions as the patient has - and the patient can share this information with friends or family members who are doctors or nurses , to make sure I am providing sensible advise. They can also cc their spouse, to make sure everyone is on the same page. Because we can store and refer later on to this email conversation trail, there is no scope for ambiguity; and no confusion about medications or their dosages .

It's also much easier for me to answer more complex questions in case more clarity is needed, because the patient can ask for more details in his reply, in case he does not understand something I have said. Moreover, the advise I can provide by email is far more sophisticated and reliable as compared to a phone call, because I can think carefully before sending the email ! Email also allows the patient to send me all their medical records, so I have all the medical details I need to provide intelligent answers , customised to the patient's medical history !

A major benefit with email is that I can provide links to the relevant pages on our website, so they can get even more detailed information about their specific problem. While some patients email is much more impersonal than a phone call, I believe email is much more efficient, when used intelligently !

This is why I request patients who want to talk to me to send me their medical details by filling in the free second opinion form instead, so I can guide them properly. Some get upset with me because I refuse to talk to them on the phone - while others understand that I am doing so in

Doctors are usually quite smart. They are academically bright , as proven by the fact that they managed to get into medical college inspite of intense competition; and have successfully graduated from a demanding course. Also, while not all doctors are brain surgeons, most are intelligent and have a high opinion of their own intellectual abilities.

However, some of them are quite badly behaved. They are rude to their patients - and make them wait interminably in their waiting rooms, for no good reason. Since doctors are in the business of saving lives , some of them start behaving as if they were demiGods. It's quite easy for them to delude themselves into having a very high opinion of their worth. This is often bolstered by their patients, who look upto doctors and often worship them. ( As a pithy saying goes, the reason doctors are on pedestals is because patients are on their knees !)

There are many reasons which contribute to this inflated opinion doctors have of themselves. For one thing, many doctors interact primarily only with their patients . Because they have a very limited worldview, they view themselves as being masters of their ( little) world. Also, they are top guns in the hospital hierarchy, and are used to having nurses and assistants obey their every little whim - something which reinforces their view that they are the best !

Also, not only does a big ego seem to be an occupational hazard, it also seems to be a contagious disorder. Residents learn to acquire their "high and mighty" style from their bosses in the hospital during their rounds - and this is a trait which seems to run in certain departments ( for example, heart surgeons). It's also much commoner in doctors who work in hospitals ( as compared to those who own their own clinics).

However, I think the real reason some doctors have such an inflated ego is because they have low self esteem - and an inferiority complex, which they try to hide . Many of them earn much less than their peers - and it's well known that MD postgraduates earn a fraction of their MBA colleagues. This burns many doctors up - especially when they recollect that these same MBA grads did much worse than they did in school. This is why some doctors need to primp and preen to show their patients who is the boss !

Good doctors, who have high self-esteem, do not need to put on these false airs and waste their time in posturing !

But talking about doctors and egos does remind me of this old joke.

A man dies & goes to Heaven.

Upon arriving at the Pearly Gates he is told "Welcome to Heaven, everyone is equal here."

The man is then given a tour of Heaven and finds that it is indeed true.

The man decides he's just got to try the food & goes & stands in the cafeteria line.

While waiting ,a man in green scrubs goes rushing to the front of the line & gets his food ahead of all the others.

"Hey, I thought everyone is equal here. Why did he jump the line?"

"Oh, him?" says St Peter, "That's God, he is just playing at being a Doctor ."