When Our Clinics Own Us

There are so many instances and situations at my various clinics where I have felt that I am completely powerless. When I have not been given choices or there are no choices. When we’ve had to just deal with the situation, accept it, and resort to the terrible phrase “it is what it is”. I’m not sure what the solution is. I think it would help for us all to share our clinic experiences - perhaps more transparency would do the trick. Like when you give a review on Yelp for a restaurant you just ate in.

There was a situation recently which made me feel awful. And it got me thinking about all the times that my clinics (and there have been a few) have complete power over me. I went online to pay my visa bill and saw that my clinic charged me $2,000. I was never made aware that I would be charged this amount for something so figured it was a mistake and called the clinic. Turns out that it was for a medical consult of our (hopefully) gestational carrier (GC). (good news, we have found someone amazing, but more on that soon, I want to focus on the topic at hand). This was a short chat between my doctor and our GC. And that’s what it costs for some reason I have yet to figure out. Do I have a choice in this? No. She has to speak with him and do all these tests. But the clinic doesn’t have to charge that exorbitant amount of money. And my doctor was running over an hour late and made our GC wait for his call. My fertility lawyer’s fees come nowhere close to what my clinic is charging for a short phone call. Neither do my accountant’s. It’s crazy. I think. So I made a huge stink about it. I spoke up. I emailed everyone necessary and unnecessary. Turns out that is was an error. And I will be completely refunded. Also turns out that there was supposed to be a charge for the appointment, but no one has yet told me what it is. Due to the huge stress this has caused me, I have demanded no charge at all for the appointment. This got me thinking of how easy it would have been for me to miss this charge. And to how many people must not realize things and perhaps pay for no reason.

I think part of the problem is that we’re seen as patients and not clients. These clinics are private here. As a client of a company offering services for my infertility, I am extremely disappointed. For any other company, we’d be going on Yelp and other sites and giving reviews and holding them accountable for a whole variety of things - just like we do for restaurants, our banks, stores we go to, and really anything these days. But for infertility, we stay silent. And this creates bad experiences for all of us. There's no real competition, so no one is really striving to do better. The clinics and doctors are simply not held accountable and don’t have to provide any transparency like everyone else.

Transparent Fence - Ice Storm at Blue Mountain, ON
(c) Rebecca Schwartz

In my first IVF round in Toronto after paying the giant lump sum for the surgery, I was smacked with an invoice mailed to my house for $900 for embryo freezing. Since this was my first time paying for treatment (new at the clinic and in Israel it’s free), I didn’t realize that it wasn’t included in the original price. When I went in to pay it I mentioned that I didn’t realize it was this much. The response was something like, well it would have been in the intro package. My response to that was, there’s so much that we have on our minds during an IVF cycle, so much to do, and remember, and also to pay for, a little reminder, especially for those of us who are new to the clinic, would go a long way.

Those who don’t deal with infertility don’t realize the financial strains this puts on us. With the clinic charging an arm and a leg for everything, we patients can end up bankrupt. And the clinic which is supposed to HELP us make a baby is making it way more stressful.

Not all situations are related to money. Sometimes it’s more technical. At one of my clinics our embryos were frozen in pairs. We came in to do the embryo transfer and op! They didn’t survive the thawing. So we waited around for them to thaw 2 more (luckily we had 2 more, but still). Now, I’m not in the lab, I don’t know why they didn’t survive thawing. Maybe it’s true and they really didn’t. But maybe somebody did it wrong. Or maybe they were dropped. Or maybe they were never frozen properly. Or maybe the oxygen levels were wrong. Or maybe a whole bunch of other things I’m not thinking of because I’m not actually a doctor and don’t work in a lab. More recently we did an IVF cycle and had 20 fertilized eggs. That’s 20 embryos dividing all nicely, looking all happy until day 3 when bam! They all stop. We don’t know why. Again, did something happen in the lab? Was there a sudden power outage? Were there other embryos on the same day that didn’t make it? Was it just us? I’m really skeptical, but I have to “trust” the clinic.

Sometimes it’s even simple things of having to wait forever. I once went in for an embryo transfer for which you need a full bladder. So the nurses told me to start drinking water. 3 hours later I was called in. 3 hours! The number of times I peed and drank and peed and drank was crazy. But they have the power and I can’t just walk in and demand whoever is in there to find our embryo and stick it in there! Although, that could make for a funny scene (in hindsight). If I go to a meeting at another office, nobody would make me wait 3 hours.

I’ve learned to never take things the way they are. To always question. Because you never know when there’s an error. Or when something can be better. Even if it’s through tears, or comes out a little bit rude, I’ve learned to speak up, otherwise I really am powerless.

In the United States, the whole system is private. This creates competition and better service. I recently had a consult with a doctor in Las Vegas and was immediately given the cell phone number of his Patient Concierge. Everything was made very clear. I knew exactly how much the 1-hour meeting would cost me. I filled out a form with my skype information. I signed that I knew what the meeting would entail and the cost. The meeting lasted 1-hour and the same day I received a follow-up email of everything we spoke about. The next day I received an electronic invoice to pay online and an email survey to rate their services and comment on how they can improve. When I didn’t complete the online survey, I received another email a few days later encouraging me to help them make themselves a better service.

It’s not a matter of the doctors, there are excellent doctors here. Mine included. But there’s something that the administration doesn’t understand. Clinics have to relate to themselves as a business.

At the end of the day, I like my clinic and love my doctor. I do wish things were more collaborative and more transparent. When I’m kept in the loop I’m a much happier patient. When I’m given options I feel less like I’m drowning. And for those of us living at clinics (it feels that way sometimes), we need to talk to each other more. Share our experiences. There’s definitely time in the waiting room! That way we can look out for each other more and we’ll know when there are red flags instead of just saying to ourselves “it is what it is”.