Should Doctors talk about money?

One of the most distressing things I face in practice is when I get negative feedback from a referring physician. Fortunately, it happens rarely but recently I was shocked about the complaint. Apparently, his patient was offended that I discussed the finances involved with her treatment. Her Ob Gyn agreed with her that it was inappropriate for me to discuss the cost of her options. He told me, “I like you and think East Coast Fertility is an excellent program but I never talk about money directly to patients! It’s not – I don’t know…seemly!” “Money issues are discussed with the business office, the doctor only discusses the medicine”.

Perhaps it’s unfortunate that fertility doctors have to be so concerned about their patient’s pocket books unlike other fields of medicine that are usually covered by some measure of insurance. But in the case of infertility with only a handful of states having some kind of mandated coverage – not everybody in the United States - mandate or no mandate for infertility -even has health insurance! Many fertility patients are in some form or another “cash pay” patients. One of the most popular places that patients visit when they go to any fertility clinic’s website is the finance page. This is simply a fact of life.

For this reason I have developed many programs that will create access to fertility care for as many people as possible. But here is the catch! One program does not fit all. These are simply not over sized tee shirts – each of these programs represent a certain course of medical care – and each individual and couple needs the assistance of a caring doctor to help them choose the right program that will fit their own particular medical history. In addition to the NY State DOH Grant Program and our own East Coast Fertility Grant Program, we have the Micro-IVF Program, The Money Back Guarantee Program, and The Single Embryo Transfer Program. The most effective treatment and the most efficient is always a full stimulation IVF. However, if someone has insurance coverage for IUI and meds but not IVF then they may prefer to do IUI. If they do not have coverage for IUI either then it may be more cost effective to do the Micro-IVF Program or minimal stimulation IVF at 2-3 x the success of IUI with less risk than gonadotropin IUI and less cost per pregnancy. Yet at a price of $3900 it may be more attractive than a full stimulated IVF. There is also The Single Embryo Transfer Program where we reward patients transferring one embryo at a time by making their cryo, embryo storage and unlimited frozen embryo transfers for free. Others prefer the insurance of The Money Back Guarantee Program where patients are offered six IVF retrievals and frozen embryo transfers for a fixed fee that is refunded if they do not result in a live birth. In order to inform patients about our success and programs that make IVF more available to them we offer free consultations.

In today’s world of fertility care – a good doctor will help a patient find not only the right treatment but how to access that care. In order to do that – a doctor may have to do what some may think is unseemly – and that is to talk about money.