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Showing posts with label Therapy. Show all posts
Showing posts with label Therapy. Show all posts

Who should you go to - Gynecologist ? Or Infertility Specialist

Posted by nurul Thursday, December 30, 2010 0 comments
Infertile couples are often confused whom they should visit when they need medical assistance. Even though infertility always affects a couple , it's usually the woman who takes the initiative in seeking medical care . Most will bypass their family physician , but are unsure whether to go to a gynecologist or an infertility specialist. Both options have advantages and disadvantages , and it's worth examining these.

The gynecologist is a logical first choice. Most women have a long-standing relationship with their gynecologist , and are comfortable with him. Since gynecologists are specialists in tackling women's health problems , most can competently diagnose the cause of infertility ; and provide basic medical treatment. They are usually quite conservative; and would be the first choice for simple problems . However , they are often poorly equipped to deal with complex infertility problems.

Since a man with a hammer only sees nails, they will often subject the patient to unnecessary surgical procedures , such as a laparoscopy; or perform intrauterine inseminations for men with low sperm counts , simply because they do not have anything else to offer. They are often extremely poor at handling male infertility problems , and will usually refer these to their friendly urologist. This often means that care gets fragmented; and ends up of being poor quality.

Most gynecologists are also not aggressive enough when dealing with older women. Since most of their women are fertile, they often forget to remember the impact which aging has on the ovarian reserve of infertile women.

Also since they rarely have a special interest in treating infertility , waiting rooms are often quite infertile-patient unfriendly. There are often full of expectant mothers , and this can cause unnecessary emotional distress. Also some of them are not compassionate or empathetic enough when dealing with the impact which infertility has on the woman's psyche.

Infertility specialists would be the first choice, if you have a complex problem. Not only are they experts at dealing with infertility they have a lot of experience; and are armed with the advanced reproductive technology to solve most problems. However they are often quite expensive ; and some of them will often resort to unnecessary , complex costly treatment, even to tackle simple problems.

This means the patient has to choose between the risk of wasted time with the gynecologist, versus overtreatment with the infertility specialist. Since the infertile couple doesn't know how simple or complex their medical problem is , this often leaves them in a quandary.

What we do in our clinic ? If I am the first doctor the infertile couple is seeing, I will complete the workup for them , so we have an idea as to what the reason for the infertility is. This takes about 7 days and costs about US $ 200 only. If it's a simple problem , we will suggest that they find a gynecologist for their treatment. This allows us to concentrate on infertile couples who have complex problems , so that we can provide them with a higher quality of service, without diluting our focus.

In the best of all possible worlds , gynecologists with take care of the simple problems ; and if they have failed to achieve a pregnancy within 6 months , they would refer these patients onto an infertility specialist. Unfortunately, since most doctors have a proprietary attitude towards their patients , they are often reluctant to refer these patients to infertility specialists , because they do not want to lose them. This often means that they waste the patient's time , money and energy in pursuing ineffective treatments.

One useful tip is to create a clear plan of action with a well defined timeframe in partnership with your doctor , so you have a clear sense of what your treatment options are. This way, you retain control of your medical treatments as well as your life so you have peace of mind you did your best.

Want to make sure you are on the right track ? Please send me your medical details by filling in the Free Second Opinion Form and I'll be happy to help !

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Libraries, doctors, patients and information therapy

Posted by nurul Tuesday, August 31, 2010 0 comments


In an ideal world, doctors would be able spend as much time with the patient as he needed. They would understand the patient's personal beliefs and preferences; empathise with his worries and concerns; educate and inform the patient about his treatment option; and draw up a treatment plan which the patient was happy with.

Sadly, in real life, the only kind of people who are going to get this type of care today are billionaires who own their own hospitals. Today, most doctors are just too busy to be able to even talk to their patients for an uninterrupted ten minutes ! When they are young, they are rushing from clinic to clinic , trying to grow their practise . When they are senior, they have so many patients who have lined up to see them, that they just cannot devote the time needed.

As a result of this busyness, the first casualty is often patient education. Because doctors are not able to spend enough time with the patient, they are often not able to explain how they plan to fix the medical problem. As a result of this breakdown in doctor-patient communication, patients often have unrealistic expectations from their medical care - and if something goes wrong, the doctor is the one who bears the brunt of the patient's anger and resentment.

This is why patients now often spend hours on the internet, trying to educate themselves and learn as much as they can about their medical problems. While this is very good, the reality is that the quality of information on the net leaves a lot to be desired - and patients often get confused or misled by unreliable websites, making a bad situation even worse !

This is why librarians can be such a useful source of Information Therapy ! Librarians are information specialists, who have been trained to search for and retrieve high quality information.

In fact there are many reasons why librarians can do a better job at dispensing information therapy than doctors can !

They are trained professionals, who are expert at taking an interview with the patient, to determine what his information needs are. Because they are not medical professionals, they are able to provide objective, reliable information with no vested interest ! In fact, the information provided by an expert medical librarian is often better than that provided by a doctor. Unlike a surgeon who is quite likely to push for surgery, a librarian has no conflict of interest or hidden agenda and is quite happy to present all possible options, without any bias !

Equally importantly, patients are often more comfortable talking to librarians, who are seen to be non-threatening peers who encourage questions and take delight in providing high quality answers ! Doctors, on the other hand, can be quite intimidating - and most patients are very reluctant to ask their doctors questions, even when they are completely confused and do not understand what is going on !

Even better, librarians can help patients to make sense of the information they retrieve, because they are taught how to rate the quality of information. While patients will often get lost on the net, librarians can help them to judge how good the quality of the information is, based on a number of objective criteria. Of course, whether this information then can be applied to the individual patient is something which only the patient ( and his doctor) can decide ! Thus, while a surgeon may pooh-pooh a medical treatment option ( because he would rather do surgery than prescribe medicines !), a librarian can help the patient to explore all the available alternatives, with an open mind. Also, librarians do not use medical jargon to obfuscate the information they provide. They ensure that the patient understands the information - and because librarians are also lay-people, they are often much better at speaking the same language the patient does ( unlike doctors, many of whom do not seem to be able to communicate with their patients in simple English !)

There are many advantages of using this combination approach !

It fosters and encourages team work in medicine, and allows patients to get the benefit of multiple perspectives !
It keeps doctors honest, as they know that patients will be counter-checking the information they give them
The information is provided by information specialists, which means it is reliable, and current
Interestingly, doctors can also learn from the information which librarians provide. It's not going to teach them about medicine, but will teach them how to explain complicated medical concepts to their patients , and help them improve their communication skills
It can also help doctors to keep updated, if they have an open mind. Thus, these information searches are likely to teach them about alternative medicine options , which they would not otherwise be aware of
This kind of partnership can save the doctor time. He can focus on providing the medical care, because he is confident that the information needs of his patients are being met by trained professionals
It also helps the patient to be more confident that they are getting the best care , and will help them develop more trust in their doctor, because they have verified the information he has provided using independent sources provided by the librarian.
This approach will also help to reduce the difficulty patients often encounter when they search for medical information on the internet, because the librarian will make sure the information is authentic and current !


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