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Many IVF patients these days use acupuncture and will often ask me whether it's fine to do so or not . I advise patients to explore additional alternative medicines options such as yoga as well. Some of my patients think that the fact I am advising this stuff means I must be a quack. Others are happy that I have an open mind and am willing to explore alternatives with them.

I never want my patients to feel they have left any stone unturned. The truth is that many patients will explore alternative medicine without telling their doctor. I prefer taking a proactive approach, so they know I am on their side, and that they do not need to hide anything from me !

I am quite happy with this approach if the intervention is simple , harmless and inexpensive. I then feel that it's worth trying, even if there is no "evidence" that it works, provided the patient understands that this is not evidence based medicine and is willing to use themselves as a clinical trial, where n=1 ! I believe in Integrative Medicine and do not feel that Western medicine has all the answers. This is especially true when dealing with problems such as poor ovarian reserve, when we have very little which is useful to offer to the patient.

There are many intangible benefits to doing this. Most importantly, the patient feels that they have done everything humanly possible , and the peace of mind this can give them is invaluable ! It helps me to keep an open mind, and I learn from my patient's experiences. I am happy to share their successes and failures with other patients - and I feel Julia Indichova's book , Inconceiveable , is a great example of what the determined and motivated patient can achieve, even when the odds are against her. In fact, it is based on these "anecdotal successes" that we can learn newer techniques for treating our patients !

However, I do draw a line , especially when the treatments are expensive. Good examples of such useless treatments are Clear Passage Therapy and Proxeed. Patients need to be protected from quacks, and a good doctor will help them to do so.

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Many doctors underestimate their patient's intelligence. The truth is that most patients ( most of the time):
1. want to know as much as possible about their illness and their treatment options
and
2. are smart enough to understand their options

Patients want to be treated with respect. They look up to their doctor - and trust he will do a good job treating them. So why don't all doctors treat their patients as intelligent adults - someone who is capable of understanding what has gone wrong and what the doctor needs to do to fix the problem ?

Do doctors feel threatened by patients who ask questions ? Or is it that they do not have the time or energy to answer these questions ?

Some well-meaning doctors are worried that patients will not be able to understand the niceties of their medical problems. The nuances of medicine can be subtle, and few answers are black or white. Most are shades of gray, and these doctors are worried that providing additional information will just end up confusing the patient.

Others are not happy about sharing the uncertainty which is inherent in medicine with their patients. They want to be perceived by their patients as being the expert, and this is why they need to provide unequivocal answers. Others are concerned that discussing unclear issues with patients may cause them to lose confidence in the doctor. They believe that patients expect clear-cut answers - and that it's the doctor's job to provide these. Why add to the patient's confusion by talking about ifs and buts and maybes ? Doing so also runs the risk that the patient may end up selecting an option the doctor does not personally like - and this will just add to the tension.

I believe that if the patient cannot understand what the doctor is saying, the fault is the doctor's - he is not doing a good job explaining ! Most patients are quite sophisticated, and are used to handling uncertainty in their daily life. They want a doctor who will discuss their options with them, and provide guidance when asked for, rather than tell them what to do and expect them to blindly follow instructions.

I have found that sharing medical journal articles with patients will often them to come to terms with their disease, and help them to make the right decision for themselves.

Good doctors have a deep understanding of the technical minutiae of their specialty - and while they are capable of doing advanced research and publishing in medical journals, they are also capable of simplifying and explaining all the nitty gritty of their specialty to their patients !

Patients who are treated as idiots tend to behave like idiots !( Of course, sometimes patients do behave like idiots on their own as well , but thankfully this is a small minority !) Patients who are treated with respect will , in turn, respect the doctor and look upto him as a trusted professional , for guidance and wise counsel.

I treat many patients who are CEOs . They are very smart and teach me all the time ( if not about medicine , then about how to run my practise, for example !) If they are bright to run a company, I am sure they are smart enough to understand everything about IVF. Clever doctors will acknowledge the patient's expertise and make use of this !

Doctors need to take a proactive approach and understand that teaching their patients and treating them with respect is a great way of differentiating themselves from the competition.
The web is a great tool for patient education - and the nice thing about developing patient educational modules on the web is that once they have been developed, they can be used many times !

I have found this very rewarding, and you can see some of the patient educational modules we have developed at www.ivfindia.com. This is a "proof of concept" - and we hope that other doctors will use this as a model they can emulate !