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There is increasing concern being raised in the media and professional bodies around unproven treatments in reproductive medicine. Whilst a measured response is necessary in order to ensure that clinical freedom and patient autonomy are maintained and that genuine innovation is not quashed at source, professionals working in this field have a duty of care to provide the best treatment possible for their patients safely and effectively.
That duty of care is implicit in the GMC Guidance for Doctors and should be expected of the whole multidisciplinary team. This point is especially important in a specialty where key leaders and managers in an organisation are often not GMC registered medics.
Reproductive medicine has suffered greatly over many years of low prioritisation by commissioners and a highly competitive private sector has developed particularly for tertiary services such as IVF. Privately or self-funded patients may be treated in NHS based centres, purely private stand-alone units or, increasingly, in a centre comprising part of a fully commercialised group.
In some regions, perhaps as a result of greater numbers of patients with personal affluence or a broader more cosmopolitan clientele, including international patients attracted to excellent UK health care, the competition between such centres/conglomerates is high.
Alongside this there is much about reproductive medicine – specifically implantation, early embryology and early pregnancy and their complex interrelationships, which are extremely difficult to research and until there is a really good basic understanding of a particular area it is impossible to make truly rational treatment decisions.
Coupled with a highly motivated, well-informed patient group suffering the injustice of being denied NHS-funded treatment, there is a toxic mix of the pressure to “try” something (possibly something different from the clinic down the road), the desire to “do” something –…