Anyone else with a team-based IVF clinic? Got a problem.

pblge

*loss mentioned briefly*

The good thing about my clinic is that they're open every day, every weekend, every holiday--you could probably get blood tests on Christmas there. The bad thing is that they achieve this because the doctors essentially "go zone." There are three doctors in charge of IVF, and they rotate months. (This is why we chose Feb for IVF #2--to be with our regular doc.) But they take the weekends off during their month, so one of the other doctors will step in. The problem is that one of the three doctors, we'll call him Dr. C, is terrible (Dr. A is mine and I love him, Dr. B is the most senior and is extremely competent). For one thing he has a terrible bedside manner. Lots of sports jokes (does he KNOW who his clients are??????), kinda of a good ol boy type, and just really a jackass. He's also been wrong many times in what he's told me. For example, when he told me to prepare to trigger that night for IVF #1, but then called later to say he was wrong and it was too early. He "found" 20 mm follies that the other doctor the next day said weren't there. The worst thing, however, is that he made a really bad call with my meds that nearly had my cycle cancelled. We knew going in that I'm an extremely "brittle" and sensitive responder. He decided, against all of what the other doctors had said would be good practice for me, to "coast" my meds (Dr. B had been very carefully regulating mine and things were going great). My E2 was less than half (went from about 4500 to 2000) by the next test, and about two thirds of the follies fell out. Moreover, it's possible that the bad stims might have caused the m/c (stim problems can cause aneuploidy and other genetic abnormalities), and although I don't necessarily blame him for the m/c, I don't want him anywhere near my future treatment. 

So I just found out that he'll be in charge the weekend before my ER, which is exactly the time he was in charge of me when he f*cked up my last cycle. I've asked the nurse to speak to my regular doctor to see if someone else can make my med decisions, but I'm kind of freaking out and wondering what I'll do if they tell me he's got to be involved.

Has anyone else dealt with a situation like this? Am I justified in insisting he stays away from my meds? I don't want to overreact, but I also don't want to go through this if I think there's a good chance he's going to swoop in and ruin another cycle. Any advice??? 

pblge

IFinTN said:

Personally, I think it's within your rights to say that you don't want this guy calling the shots (literally!) is there a patient advocate you can speak to in their office?

Um, I don't know. Is having one typical for these clinics?

pblge

Not really--there are two IVF nurses who seem very overworked. It was one of those two to whom I expressed my concerns and she's supposed to talk to my regular doc. 

missmarypoppins

My clinic seems to function similar to yours. It's kind of a you get who you get situation. At the start of this cycle I specifically asked that my doctor be the one to look at all my monitoring results and make all medication decisions. Not that anything was done wrong last cycle but I wanted the same person looking at my results every day. They didnt seem to think I was crazy to ask for this, so hopefully you'll have no problem!

Milagros315

My clinic is sort of like this. I've seen three different doctors and my regular doctor didn't do the ER or ET. However, my regular doctor is always the one who reviews my progress and makes the decisions so I haven't had any problems.

I'm so sorry that it hasn't been that way for you. I agree with the others - you should absolutely call and request that your regular doctor review your reports and approve any changes to your treatment. I hope that they're willing and able to find a way to work with you and make you feel comfortable.

chucktgirl

I've had two experiences like this. In the first, the one doctor made sure I never had to come into contact with the other one, even so far as having a different RE from an hour away contact us to discuss our issue instead of the other (bad) in-house RE.

The second experience was different. The RE basically said FU, you get who you get.

I hope your clinic is more like the first I experienced!

jaztastic

My clinic is similar, and so is my OBGYN office so I wasn't surprised, especially given you need constant monitoring. I don't have the same experience as you though. All our doctors seem to be on the same page even from office to office. I would suggest letting your RE know how you feel. But I understand that's an uncomfortable situation to be in, since it's not that many of them and they rotate the way they do. Wishing you all the best, but my mom always say a closed mouth will not be fed. good luck!

berries555

I have a similar clinic...whatever dr is available will assign meds at the time.   However, I do have one nurse for each cycle.  Which is very nice!!  So I will raise questions with the nurse at each appt if I have any.  I am sorry you have a difficult clinic.  BOO!!  

The unfortunate thing is, I bet most clinics are similar since they need to have someone available every day of the week.  

Manada

We dealt with this with our clinic. The docs at our clinic work in teams of two and have a regular RE who subs in when any of the others are on holiday.

The doc our RE works with is senior in the clinic but he made a super bad call for us on our first cycle, his approach doesn't always jive with our doc's, and we don't really like his communication style. We have made this gently clear to our doc and she makes a point now to write her instructions and protocols clearly in our charts - if he ever wants to deviate from it - and she is in town - he calls her to discuss and we wait for that to happen. It makes us feel less
Caught between an RE we know and one we don't trust as much....

JasmineTea2013

My clinic has 3 REs. Honestly I have never talked to my RE directly except for the first setup appointment. The ER and ET were done by 2 other docs that I had never met before. I got all my meds instruction and lab/us reports from nurses.

keziah23

My clinic has 3 docs as well and my REs regular office is actually at a different location from the clinic. I see a doctor at the clinic for ultrasounds then my doc does the ER and ET.  They are good about keeping in close contact and I make sure to keep in touch with my RE too. I asked for more monitoring earlier in the cycle this time because of the cancel last time and they have no issue with that. 

I am sorry that you are going through this, do you have the same nurse throughout that can help you advocate?

pblge

Thanks, ladies. It's good to hear that this is a common set up, and that some of you have successfully dealt with problems like this before. I'm really hoping my doc will call to say that someone else can make my meds decisions. I honestly might cancel the cycle if they tell me he'll be in charge.

Fingers crossed!!!