Several months ago, I had a conversation with a reporter from a major media outlet. She wanted to know if David Kreiner, MD ,would go on the record with many of his viewpoints on the treatment of infertility. You see – it can be hard to go on the record when some of your view points may be counter intuitive to the fertility pharmaceutical industry (funding), annoy patient organizations (referrals), and may make life harder for IVF Centers and other reproductive endocrinologists around the country who may be your friends and colleagues. You see, Dr. Kreiner is one of the few reproductive endocrinologists that feels that regulation may not necessary be a bad thing if done right – and is willing to say it – out loud and in writing on his blog thefertilitydoc.com.
It takes ah…..what is the word? Balls.
I love that about Dr. Kreiner. He is not this big personalty – he is actually a gentle soft spoken guy. He has the training that sets him apart from many of his colleagues, but many would not even know his background because until recently he didn’t talk about it much. He is this incredibly reputable fertility specialist that has quietly been offering for years programs that support patients in making the choice not to have higher order multiple births such as The Single Embryo Transfer Program. A program that encourages patients to only transfer one embryo at a time by not charging them for the freezing, storage and subsequent transfers of their embryos until there is a live birth. And he wants everyone to stop doing intrauterine inseminations (IUI’s) and move on to newer techniques such as Micro IVF that requires less fertility medication and brings down the cost and risk to the patients tremendously. And he is willing to see patients are no cost to them through a free consultation program. Saint Dave? Hardly – but he is willing to put his money and his reputation where his heart and mouth is – and he doesn’t care about being popular among his cronies.
You know – in talking about all of this with this reporter – the issue of conflict of interests in the field of reproductive medicine kept coming up again and again. I guess that the field of reproductive medicine is not the only field in medicine that has to deal with these issues. But sometimes as I look around at our talking heads I wonder if we really see ourselves?
I am lucky – I am finally in the position with this blog (which I own and is controlled by no one but me) to be able to say what I want to say and need to say about the treatment of infertility, the protection of fertility and the intersection of sexuality with complete freedom. No one looks at my writing before I push the publish button (can’t you tell that there is no copy editor?). And I often do not know what I am going to write about until I sit at my computer at 5am with my coffee.
My blog has gained attention because I say what I believe to be so – and I say it the way I always have -with plain language and a frankness that many people find startling (you should meet my mother – you would understand). You might not always agree with me – but I say it. Mostly. And it is that mostly that I am really interested in – in myself and others.
Do I really have the complete freedom that I claim that I have?
There is this internal button inside of all of us that worries about offending and hurting our colleagues. No one wants to make funding sources or referral sources angry right? And there lies the rub. If we don’t bite the hands that feed us – we are as useless as a Jenny Craig frozen dinner at a Chocolate Fair.
But by speaking the truth about what we know is wrong – we risk being left out of the fertility club of associations, organizations and being “unfriended” on Face book! Are we still stuck in high school and worried about being left out of the cliques? If we say what we believe to be so – and do what we know in our hearts is right – will people stop having lunch with us?
I often talk about issues that are important such as the marketing of patient education to infertility patients. It took courage for me to write that – because I didn’t want to upset people. And yet – I only scratched the surface of that issue. But publishing what I put out there made my stomach crawl all day.
What I found interesting – is that my phone burned up all day with people wanting to talk about my patient education blog privately. “Thanks God Pam you are talking about this stuff” and the conversation would go on from there. But these were private conversations. They did not happen in the comments section of the blog or on my very active Face Book or Twitter account. Oh yes – people wanted to talk about all of this – but no one wanted to comment or show support publically. I am not criticizing – and I get it. I am just saying…..
It’s time for all of us to look at the emperors in our kingdom of infertility and be like that kid in the Hans Christian Anderson Tale – “The Emperor’s New Clothes” – where the kid didn’t know that he was suppose to see the clothes and spoke the truth without fear.
It’s time for us to stand up too – and not be frightened of all the various kings in the fertility kingdom. The time has come – and I have been so lucky to work with a doctor that has guts.