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At the end of a consultation, I usually ask my patients - So what have you decided ? What would you like to do next ? After all, IVF is an elective treatment; and infertile couples have many choices. These are very personal decisions, which are best made by the couple themselves, rather than the doctor.

Often, many patients will answer - Whatever you say, doctor !

While it may seem very flattering that they are willing to allow me to make the decision for them, this is actually not a good answer , and I am unhappy when I hear this !

I'd much rather have a patient who took the time and trouble to understand their options, so they could make the decision for themselves . The best decision is one you make yourself

I will not let them make the wrong decision - but when there are choices, patients need to use their best judgment and decide for themselves - they cannot leave everything upto God - or upto the doctor !

Many decisions are too important to leave upto anyone else. While a doctor can provide guidance ( for example, about success rates), his opinion should just be one of the variables you consider when making your final decision.

I agree it's much easier to let the doctor decide for you - but this is not in your best interests, or the doctor's ! After all, the outcome of any treatment is always uncertain, and if you do not get pregnant, you may be resentful. Making your own decision gives you peace of mind you did your best ! It also encourages you to seek out information and take a more active role in your treatment - actions which actually improve your chances of getting pregnant !

There are major disadvantages to the cut system. For one, this system increases the cost to the patient. It also promotes malpractice, because family physicians often pressurise specialists to do surgery in order to maximise their revenue, which means that procedures are done, which are not always in the patient's best interests. Because this practice is hidden, it's never discussed openly, and this creates a lot of resentment amongst patients.

The fact that doctors indulge in giving kickbacks is an open secret - and hiding this reality creates a lot of suspicion in the patient's mind. “This is one of the major reasons patients do not trust their doctors, and why the reputation of entire medical profession has taken such a beating in recent years,” says Dr. Malpani.