HealthCARE vs. Health Business: True Fertility Medicine ‘Helpers’ Don’t Hide Statistics and Agendas

health bioethics

It’s rare that male readers weigh in on the topic of fertility health and society’s response to the marketing of ‘fertility’ treatments. Such an occurrence introduced an added jolt to my morning coffee. More refreshing still were the “ah-has” that accompanied the insight-laden comment (a blog post unto itself really). Let’s annotate his comment further.

Brian begins:

Your blog reminds me of the importance of not letting hope replace reality.

Immediately the famous quote from Charles Revson, founder of Revlon, popped to mind: “In the factory, we make cosmetics, in the store, we sell hope.” Revson also said, “We don’t sell lipsticks. We sell dreams.”

Consider that when you walk into a mall or any retail establishment, you know you’re entering a spin zone of sorts. You anticipate slick marketing and seductive packaging. In turn, you activate your ‘buyer beware’ radar and off you go.

Contrast that with how you feel and behave when you approach a doctor’s office or hospital. I don’t know about you but when I visit well, let’s say an urgent care medical facility I don’t bring the same skepticism I do when approaching the counter of a department store selling wrinkle creams or beauty products. Both might be staffed with personnel wearing white coats but that’s where the similarities usually end.

In the case of a doctor’s office we’ve been socialized to expect the people in white coats to base their recommendations on solid science. They’re schooled after all in how to to dispense honest (hopefully compassionate) health expertise. Whereas an establishment that offers beauty products? There I expect some photo-shopped images of youthful skin and claims about how XX product will enrich my life.  Those smiling individuals in white coats are peddlers looking to enrich their bottom lines.

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Doctors, though, are supposed to be there to help us understand and make sense of health, biology and science.

HealthCARE vs. Health Business

Discerning fertility medicine claims is especially hard because as Brian goes on to make clear:

The truth is that we, on the receiving end of reproductive technology, are way ahead of the indifferent purveyors of pain masquerading as helpers. True 'fertility medicine helpers' don’t hide statistics and agendas. Click To Tweet

Indifferent purveyers of pain masquerading as helpers. That’s some bold language.

As I first mentioned in an op-ed and blog post two years ago — and often since — objective, independent advice from health professionals in the reproductive endocrinology field focused on the person’s well-being instead of the profit is, sadly, hard to find. On the healthcare continuum the fertility field has, with each passing year in the nearly 40 years since IVF was made commercially available, slid further from medically-indicated, evidence-based science to one of lifestyle marketing.

Unfortunately, today, when engaging with the fertility industry it’s not quite clear 1) who you can trust to tell you the truth and 2) when to, in so many words, stop buying the lipstick.

Complicating matters further most people don’t realize how much, yes, random luck, is involved in succeeding with any pregnancy and delivery. There is the illusion of control when we walk into a fertility clinic. Click To Tweet

But, as Brian notes:

Becoming pregnant is not always a matter of willpower. Sure, we can do all the “right” things to facilitate it happening but we don’t get to control the outcome.  Science can transfer an embryo to the womb but it can’t implant it.  Ultimately, nature calls the shots. This is a hard truth to accept.

Facing this hard truth that pregnancy may never succeed is made more difficult, still, when outside forces encourage more, More, MORE treatment. With an apt comparison to the lottery, Brian adds:

ART is, to a large extent, a lottery. There are a few lucky lottery winners out there. Basing an entire industry on a murky statistical probability is unethical and unprofessional. It exacts a cruel high human cost from the majority non-lottery winners to support the possibility of a magical, mysterious, miraculous (and let’s be serious, inexplicable) outcome.

The next spin of the wheel, the next Powerball lottery might pay off. How, then, do you walk away? I wish I had a good answer. As Sarah noted, “The space of ‘highly unlikely but not impossible’ that infertility and subsequent treatments catapults so many of us into is, unfortunately, highly romanticized.

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Separating Romance from Reality

I don’t see the fertility business and its acolytes moving away from romanticizing any time soon. It’s just too lucrative.  Instead we’ll have to hope that, like this blog readership, we see more open acknowledgement of this statement:

Each journey of fertility that didn’t work out is painful, lonely and very real and deserves to… Click To Tweet

Thank you, Brian, for your wise counsel and fertility medicine cautions. Makes me wish I could travel back in time to share your observations with the me first embarking on this experience. Instead, I’m content to explore further the ideas you raised as it may help the next 20 or 30-something just embarking on their fertility journey.

I’ll close today with the quote Brian shared from The Road Less Traveled:

“Truth or reality is avoided when it is painful.  We can revise our maps only when we have the discipline to overcome that pain.  To have such discipline, we must be totally dedicated to truth.  Mental health is an ongoing process of dedication to reality at all costs.”-    M. Scott Peck p. 50 The Road Less Traveled.

Now, dear readers, the floor is yours…

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3 thoughts on “HealthCARE vs. Health Business: True Fertility Medicine ‘Helpers’ Don’t Hide Statistics and Agendas

  1. On Friday, there was a piece in the Harvard Gazette taking about a recent study where it was found that most physicians undergo far less invasive procedures regarding end-of-life care. (http://hms.harvard.edu/news/how-doctors-die?utm_source=SilverpopMailing&utm_medium=email&utm_campaign=01.22.2016%20(1)). The idea is they are focusing on not only quality of end of life but a reality that undergoing treatment after treatment isn’t going to change the outcome they are facing.

    I’m reminded of this with the discussion here.

    The truth is, most of medicine IS driven by money, with patient care coming in second. It’s the reason why some specialties require their physicians to care extra insurance as they expect lawsuits. Given this and knowing that continual rounds of IVF will make the clinic far more money that having a RE who sits down and truly counsels the patient towards other paths of resolution, it’s not surprising we’re in this situation.

    Which means it’s time to start preaching the truth broadly, even if it upsets people. We need to have the focus be on addressing the causes of infertility and not achieving pregnancy. 9 rounds of IVF isn’t something to celebrate. It’s an indication that the doctor is failing their patient.

  2. I love the distinction between healthcare and health business, and the ethics of that. When you think of it, there are a lot of people who present themselves as healthcare professionals who aren’t, and are just in the health business, peddling hopes and dreams, often on no scientific basis. The reproductive health field is I guess in between the complete charlatans, and the doctors who treat us when we are in urgent need of healthcare. That infertility is seen mainly in terms of a health business in many parts of the world , rather than as healthcare for the sufferers, is sad, and ethically very disturbing.

    It was timely too that I read Brian’s words about ART as a lottery, just a few minutes after I had been reviewing something I have written about the gamble of fertility treatments. I particularly loved this comment. “Basing an entire industry on a murky statistical probability is unethical and unprofessional.” I had never quite thought about it like that, but I wholeheartedly agree.

    I am very proud to be part of a community that is speaking out about this, and that does, in fact, recognise that “each journey of fertility that didn’t work out is painful, lonely and very real and deserves to be acknowledged with kindness and respect.”

  3. It’s no secret that I said “screw the lipstick, I’m buying ice cream instead,” but the truth is that I might not have went the ice cream route had I not stumbled across your blog a couple of years ago while doing research about IVF. Essentially the doctor said x, and we believed him, but your writing made me look into it in more depth, and that research made us realize how low our chances of pregnancy really were. We were on the fence about IVF from the beginning, but once we saw how unlikely it was to work, that made our decision easy.

    I really, really hope this message goes mainstream. It’s so important for people to see through all of the marketing, skewed statistics, and highly romanticized nature of fertility treatment, and truly, critically examine unbiased facts before proceeding with a treatment plan.

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