So in case you didn’t know what I did to earn my daily Jenny Craig, I am the Director of Patient Education and Marketing at East Coast Fertility (ECF).
What that means is that I help develop all of ECF’s patient education and marketing materials such as our patient packet, develop content for the new upcoming website, talk to patients, and visit ob/gyns offices to talk to them about the programs that East Coast Fertility provides. I do lots of other things too – but that those are the highlights. I love my job – and I am passionate about the programs that East Coast Fertility offers. To me – that is what sets East Coast Fertility apart from all of the other IVF Centers.
Let’s face it – in most parts of the country – these fertility doctors pretty much have this stuff down. It isn’t hard to find good, even great success rates – and in most parts of the country there are a lot of choices. On the east coast and west coast it’s hard to cross the street and not find a good IVF center when it comes to “the numbers”. And small percentage points in success rates are really meaningless – I know that fertility patients measure every possible point on that CDC or SART report – but really? Those success rates have to be really different in order for those numbers to be statistically meaningful and impact outcome.
For an old bird like me (wanna know more about me click here!) that has been a patient advocate in the field of fertility since some of these doctors were residents – it is the programs that make access to safe fertility care affordable that sets an IVF Center apart. And that is what I like to talk about when I talk to anybody about fertility care in today’s world.
So, the other day I was having lunch with a group of ob/gyns on Long Island. Dr. David Kreiner (the director of East Coast Fertility) was late (he was doing transfers), so I had some private time with the some of the staff and the doctors in this office over wraps and potato salad. And one the doctors – a very nicely dressed man with a great tie that he was trying not to spill mayo on – said to me – “You know, I like Dr. Kreiner – and I send him patients – but it has gotten back to me that Dr. Kreiner actually talks about money directly to the patients! I have to tell you that I never do that – and I am not sure how I feel about doctors talking about money to patients! It’s not – I don’t know seemly!”
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 a “cash pay” patient. 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.
Dr. Kreiner understand this – and has a deep commitment to creating access to care for all patients. To that end – he has developed many programs that will create access to fertility care for as many people as possible such as the Micro-IVF Program, The Money Back Guarantee Program, and The Single Embryo Transfer Program. East Coast Fertility also participates in the NY State DOH Grant Program, and if you don’t qualify for that Dr. Kreiner has created his own East Coast Fertility Grant Program. Patient’s can even participate in studies and receive discounts!
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 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.
You know – I wish we lived in a world where patients did not have to worry about finances in order to receive medical care. I am proud to work for a team of fertility doctors who understand the real life issues of fertility patients – and are not frightened to speak about it. Not only that – but they have worked completely out of the box to create programs that open the doors to prospective parents who might be otherwise shut out. They even offer free consultations!
And that is what I told the Ob/Gyn with the really nice tie.
What do you think? Is it impolite for doctors to talk about money?
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Amy Demma
March 18, 2010
In my experience, folks who reach the stage of accessing ART for family building desperately want to know three things: can you help me to become a parent, how long is this going to take and how much will this cost. Patients are, whether we are comfortable with this view or not, consumers and consumers need to understand “how much”….how much success can I expect from my investment, how much time and how much money. The fact that Dr. Kreiner speaks about cost (I am assuming, in his initial consult) speaks to what I have come to know so well about this physician, his compassion and empathy. Dr. Kreiner clearly understands the vulnerable consumer who sits across his desk, one with rent or a mortgage to pay, likely some other consumer debt, perhaps a diminished 401K and a broken heart from not being able to achieve the dream of parenting. Not only is it appropriate for the physician to address their patient (the consumer) holistically, acknowledging all of their worries and concerns…but, I think it served the patient well and fosters a better dynamic between the two. And yet another round of Kudos to Dr. David Kreiner and the entire team at East Coast Fertility.
Evelina Sterling
March 18, 2010
Of course being the co-author of Budgeting for Infertility: How to Bring Home a Baby without Breaking the Bank, I’m all for discussing money as openly and honestly as possible when it comes to fertility care. I truly wish this was not necessary. But, as you mentioned, the truth of the matter is that most patients are financially responsible for at least some (if not all) the cost of their fertility treatments. We all wish we could say money doesn’t matter and the sky’s the limit when it comes to family building, but this is not the case for the vast majorities of families experiencing infertility. It’s the truth, and it should not something about which any of us should be ashamed.
I’ve come across way too many patients who go into a fertility clinic not knowing at all what to expect in terms of costs and are too afraid to ask. They desperately want to be “agreeable” and “good” patients so they just go along with what the doctor recommends….tests, appointments, medications, procedures, whatever! Before they know it, they are bombarded with bills often in excess of thousands of dollars…thousands of dollars they cannot afford. Imagine the heartbreak of these families…struggling with infertility and now thousands of dollars in debt and still no baby. Not a good situation for any family to say the least.
I’m so glad to hear about innovative programs like East Coast Fertility that is trying to help more families successfully overcome these financial barriers. And fortunately, more and more clinics are realizing this major impediment as well (especially given our current economic crisis). However, there are still clinics that do not want to mention money, and many patients feel very uncomfortable bringing up what they can and cannot realistically afford to their health care providers. Everyone has a different view on money so one should not assume what works for one family will work for others.
Money is indeed a difficult topic in any situation. Overall, we need to figure out a better system so all families are given similar opportunities to understand their treatments and all the costs involved. This way they can make informed decisions about their family building options, as well as recognize how these decisions will affect their lives (and the lives of their loved ones) in the long run. This is true with any other type of “big ticket” item we consider (a house, a car, college, a vacation, etc.), so why shouldn’t we have the same expectations when it comes to expensive infertility treatments? This field is not only about making babies, but also building strong, healthy families all the way around. Whether we like it or not, money and our family’s financial stability is an important piece of this.
Stephanie Fry
March 18, 2010
It is great that East Coast Fertility is so involved with and offering multiple options for financing. It is a huge aspect of infertility for most patients and our doctors and clinics are usually the best source of information to help us understand, plan and often times actually finance treatment. I believe one of the marks of a good RE is one who understands and can explain costs and options to a patient in order to help them make treatment decisions.
Terri Davidson
March 18, 2010
You have touched upon a “teachable” moment for OB/GYN’s and their patients. For if one OB/GYN made a comment, there are probably more who are thinking the same thing but never mentioning it. Fertility clinics’ physician education efforts have rightly focused on clinical aspects of care, but referring physicians also need to learn about the financial realities of infertility treatment in order to optimally help their patients. I am sure East Coast Fertility will be on the forefront of doing just that.
Sharon LaMothe
March 18, 2010
Pam…you bring up the best topics!
In the Surrogacy world, talking about money can not be avoided no matter how uncomfortable it is. We (consultants and agency owners) talk about the cost up front and the Intended Parents are often shocked at how much ‘more’ they have to invest in a situation that is not guaranteed to give them what they want, a baby. When we ask Intended Parents if they have talked to their clinic about the additional cost of Egg Donation or Surrogacy, IPs only seem to have a vague idea. I posted recently an article that stated the overall cost of surrogacy could reach over 100k and one response from an RE was that he was only familiar with what his clinic charged and not the overall costs…not realizing that a surrogacy agency and the woman herself could push that bill to at least another $30-$40 Thousand.
Money is a necessary evil and talking about it is all part of the planing, budgeting, and borrowing. Sadly, the cost is sometimes too high for Intended Parents to even consider a Third Party Intervention however, if along with talking about cost there could be a conversation about financial help such as loans, grants, fundraising, discounts and payment plans maybe that would make the conversation not so uncomfortable and give the patient hope.