infertility

Should I fire my fertility center's marketing manager?

By Griffin Jones

Fertility doctors frequently ask me, “Is it better to have an in-house marketing person or contract an outside marketing firm?” You might expect me to favor the choice of hiring the firm. I don’t. The two are not mutually exclusive; each role is critically important to the other. In fact, across the board, your staff are paramount to your fertility practice's efforts to recruit new patients. There are assignments that your in-practice marketer should and should NOT be tasked with to maximize effectiveness and cost-efficiency. The same is true of your agency. Depending on the size of your practice, it may seem redundant to have both an internal marketing person and an agency on retainer. When used correctly, they will each pay for themselves and then some. 

marketing manager or clinic liaison?

If the practice has only one dedicated marketing person, his or her greatest productivity may very well come from the assignment of practice liaison. This is a function that is extremely difficult to outsource. As a marketer, my focus on digital media is owed only to its powerful results in attracting new patients. Digital’s proven ability to grow fertility practices doesn’t make physician referrals any less meaningful. Even in 2017, OB/GYN referrals still count for a tremendous share of new patients. Having someone who can regularly schedule physician-to-physician lunches, deliver semen analysis kits and information about infertility support, and educate OB/GYN staff in your area is tremendously valuable to the practice. Markets differ widely on the return on investment (ROI) of MD referrals, but in some cases, it may be a fertility center’s fastest path to growth.

physician referral case study

I asked an expert on the topic to share her experience on nurturing relationships with referring doctors. Shirley Sinclair is the practice manager of the Fertility Center of Chattanooga.

"For over 10 years, we’ve tried to find the magic source of how to bring in more patients and one of the top ways is still through referring physicians.  This process has taken us some time to fine-tune, but it has proven to be very successful.  We know our physicians are very busy, especially OB/GYN’s, so it is critical to remember that every minute of their day is valuable.  With that in mind, we developed a few different ways for doctors to easily consume our message.
•    Distribute referral packets in a beautiful folder filled with
o    information about our clinics
o     fact-sheets about infertility and testing
o    semen analysis kit.  
•    Provide a referral sheet for the referring physician, in which they can
o    add the patient name,
o    check off the type of appointment they are requesting (such as semen analysis, consult, etc.)
o     Fax back to our office

"We contact the patient to set up the appointment, thereby freeing up the referral’s time.  We take these packets to each office about every 6 weeks, along with some type of goodie for the staff.  This is not the time to ask to speak with anyone!  They will remember you more if you do not become a nuisance.  Also, do not leave too many packets; the idea is to show consistency and for you to become familiar with the staff.   

"Another great tip is to set up lunches with referring practices.  While this can be time consuming, this is a wonderful tool to use, especially when you have a new program or new protocol that you would like to share with the doctors.  Always take one of your physicians and, in addition, it is helpful to take someone from your staff that is familiar with the clinical side, as well as financial.  Physicians are always curious about what insurance will pay for as it is one of the first questions patients ask their doctor when they are encouraged to see a fertility specialist.  

"Use this time to assure the physicians that you would like to set up a partnership in providing the best care for their patient.  In other words, remind them that your goal is to help the patient become pregnant and send them right back!  Also, educate the physician that referring a patient sooner, rather than later, will save the patient precious time, money, and especially undue emotional stress.  Hanging on to a patient 6 months longer could be the deciding factor of what type of treatment the patient will end up having, therefore, adding additional hardship to the patient.  

"While these tips are vital, they are worthless unless you track them.  We use an EMR that is designed for fertility clinics, called eIVF, to track our referral sources.  Keep track of which physicians’ offices refer to you! In addition, make sure your physicians follow a protocol to send letters to the referring physician after the patient’s visit. Then send a follow up letter when you send the patient, hopefully pregnant, back to her OB/GYN.  Keeping your referring physician in the loop about their patients will solidify a long, successful relationship that will not only be beneficial to each of you, but, most importantly, to the patients for whom you both care!"

WAYS YOUR MARKETING MANAGER CAN HELP YOUR AGENCY

If you have more than one practice marketing person, or you live in a market where physician relations is not a full time job, your marketing manager is irreplaceable for a number of tasks that need to be accomplished within the practice. 

hiring a fertility marketing agency

Content sourcing. I don’t fly a member of my team to Honolulu every time we want to post a picture of the Fertility Institute of Hawaii’s staff to Instagram. Homemade and frequent content is vital to any practice’s content marketing strategy. In-practice marketers can serve as “brand journalists”, collecting the necessary images, stories, and videos to be sent to the agency for editing and distribution.

Operational changes.  You may find that your online reputation is not as great as it should be, simply because of one or two common patterns. Patients might love your staff, but report your response time to be abysmal. The practice manager super-serves the practice when he or she is able to implement systemic changes that are needed to improve the marketing imprint of the practice.

Tracking. Your marketing agency will be able to tell you how many people RSVPed to your practice’s IVF informational session. Your in-practice marketer will tell you how many actually showed up. If using a CRM or not, the in-practice marketer is critical in measuring and reporting the volume and sourcing of new patients.

WAYS YOUR AGENCY CAN SERVE YOUR MARKETING MANAGER

Not the first time I've included a Jerry Maguire meme on my blog 

Not the first time I've included a Jerry Maguire meme on my blog 

One stop shopping. Your practice manager has enough to do without searching for a website developer, a photographer, a graphic designer, a writer, or a cinematographer every time your practice needs something. Your agency can provide that to you under one roof. 

Social Media and Online Community Management. It’s not a good use of your practice manager’s time to respond to every comment on social media or online review sources, or to have to scour for content to post every day. Your agency can handle online interaction and take the lead from your practice manager when specific questions arise. 

Content Development. Your agency can turn the raw text, photo, and video your practice sends into polished infographics, edited e-books, and maximize their distribution on social media and the web. The creative content and design that your agency helps you create doesn’t have to stay on your online properties, either. Digital materials like infographics and guides make for valuable resources that turn your clinic liaison’s visits into less of a sales call, and into more of a service to the referring doctor. 

Advertising. It’s possible to waste a lot of money on bad advertising. Does your team know how to target same-sex couples, who married within the last year, who recently visited your website and live within 25 miles of your practice? Mine does.

Tracking. Your business manager doesn’t have to be an expert in Google Analytics or using a customer relationship management (CRM) software. Your agency can be in charge of mastering your conversion system. 

THERE IS NO "I" IN aggregate TEAM MARKETING EFFORTS

A clinic liaison or marketing manager can be very effective for your practice. So can a hired agency. When they work in tandem, they return their investment exponentially. Studies find that marketing leads convert seven times more frequently when employees are fully involved in the process.  Patients often mention their favorite staff when they leave positive reviews about their fertility center, and the compassion of team members can be invaluable in the fertility journey. Some personnel may want to be the star of a video, and others may prefer a “behind the scenes” role. From contributing to blog posts, to planning events like the baby reunion to promoting support networks, there are plenty of ways to engage staff in the practice’s marketing strategy.

MRS 2016 Meeting Recap: How To Use the Patient Experience as a Business Strategy

By Griffin Jones

You could put summer-time Chicago against just about any city in the world, so we're all glad that Dr. Angeline Beltsos, MD doesn't hold the Midwest Reproductive Symposium international (MRSi) in February. From June 15-18, without a cloud in the sky and an oceanic view of Lake Michigan, we met at MRSi 2016 at the historic Drake Hotel in Gold Coast. The event boasted a Business Minds Meeting, a Nurses' Practicum, and a Scientific Program. I went back to Chicago this year for my second MRSi because it's just the right size. It's a great place to connect with colleagues who share your practice role and also for physicians, nurses, and practice managers to share programming and meaningful conversation with one another. If you haven't been, add MRSi to the list for next year. You'll be able to talk to people and listen to topics that you won't always be able to get to at ASRM.

Panel discussion at MRSi Business Minds Meeting

Panel discussion at MRSi Business Minds Meeting

While I did attend some of Friday's Scientific Program, I'll use this post to run down Thursday's Business Minds Meeting for some of the things that you really need to know about utilizing different aspects of your clinic operations to grow your practice.

The ART of Incorporating the PATIENT EXPERIENCE as the Center of the Business Strategy

Janet Fraser, Board President of Fertility Matters and the COO of Atlantic Assisted Reproductive Therapies (AART), co-chaired the meeting with Derek Larkin, CEO of Boston IVF. 

“Improving our patients’ experience makes our patients happier and it’s better for our business”, Fraser mentioned of the day's theme. The thought was reinforced by all of the speakers; fine-tuning our operations so that our patients are more satisfied is measurably beneficial to the top line of the practice. Larkin emphasized the importance of continually adjusting to patient needs. "Patient expectations are continually evolving, and so must the experience that we provide to them. It's an unending process."

Incorporating Emotional Support to Decrease Patient Burden During Infertility Treatment

Dr. Alice Domar, PhD of the Domar Center for Mind/Body Health at Boston IVF talked about the importance of focusing not only on patient recruitment, but also on patient retention. “It’s human nature to pay attention to the patients in front of you, and not the ones who you don’t see (those who have dropped out of care). Studies have shown that people who were depressed were far more likely to drop out of their IVF cycle." Domar points to a 2004 Boston IVF study: Of 112 respondents, 40% displayed psychiatric disorders while going through infertility treatment. A separate 2011 study shows that care was significantly higher of a priority for patients, as opposed to physicians, for whom the greatest priority was success rates. "67% of people declined to fill out a survey on self-reporting depression because they didn’t want their physician to know how depressed they were," Domar adds. To date, four different studies show that infertility patients have the same levels of anxiety as cancer patients. 

Boston IVF tested retention techniques in a 2015 study that was published in Fertility and Sterility. Drop out rates reduced 67% in the intervention group."If you have effective communication with your patients, they perceive that you spent more time with them". Domar brings to attention the dollar amounts that practices spend on marketing to new patients, and how little is spent on retaining them by responding to trends in drop outs. 
 

Getting Staff Buy-In On The Importance of The Patient Experience

Hannah Johnson speaking on patient retention, courtesy of Vios Facebook page

Hannah Johnson speaking on patient retention, courtesy of Vios Facebook page

“Intrinsic motivation tends to be lost when we only focus on the extrinsic motivators, so we have to focus on activities where the reward is inherent in what we’re doing". Hannah Johnson, Director of Operations at Vios Global dives deep into how we motivate and empower our team members to take personal interest in each of their patient interactions. We need to allow our team to step back to appreciate the positive difference they make, including making sure they are aware when they are named in positive patient comments. We also need to empower them to correct errors. "It’s okay for your staff to make mistakes. Let’s talk about how we can make the patient feel really good about what happened.”

 

The Magic of Using the Patient Experience as a Focal Point of Your Employees' Day

“People don’t do what the mission of the organization states, they do what their managers pay attention to.” Lisa Duran is the CEO of Reconceived and has trained dozens of fertility centers in North America on how to build a patient-focused culture. Duran says that when many practices don't feel like they're fulfilling their mission statements, it's often because of a breakdown in the details of execution. We broke out into separate teams to identify challenges that different members of our team face in their day-to-day duties, and how we might be able to support them. Departments and staff need reinforcement and understanding from one another. “I want to know that my opinion matters,” Duran says of the most common desire that staff report before going into training.

In their own words

We had the privilege of hearing the first hand account of a couple who has gone through infertility treatment for many years. When asked what would have most benefited them to know when they first began their treatment, they each replied
"Don't be complacent if you're not getting the answers you need. Keep asking". 
"I wish that I wouldn't have waited so long. I wish I would have sought out treatment much earlier".
Hearing from patients in panel-form was a first for me at MRSi, and should be common practice at our conferences...imho.

Strategic Planning: Folding the Patient Experience into Your Business Plans

"Perception is reality. What patients feel is what they share." Rick Dietz, Chief Business Officer of Boston IVF, spoke in detail about the constant feedback loop of implementing and adjusting to patient input. Dietz says that practice strategy should be informed by a number of different metrics, and that self-reporting from patients is only one method at our disposal. "We can use patient surveys to give us clues and direction. But they don't tell the whole story."

Never Underestimate the Role of the Nurse in Patient Retention

"Nurses need proper training of how to talk with patients or you're going to get a lot more questions." Lori Whalen, RN, of HRC Fertility spoke about the importance of nurses as agents of patient retention. Whalen reminds us that nurses frequently have the most contact with patients and can be excellent sources of what patients want or what about our operations might be frustrating them. They can even find other solutions to patient problems, such as helping them find ways to save money. "Shared donors can cut costs in half for patients who wouldn't be able to afford it otherwise," Whalen says.

The Vital Role of Digital Media in Recruiting New Patients 

It was my first time speaking in the field and I was very pleased to have a great audience that asked meaningful questions. What can I say in this single post that isn't better summarized in greater detail throughout the blog? Suffice it to say that I reaffirmed what matters above all else in fertility marketing: the attention of people dealing with infertility. When we know what people with infertility are paying attention to, then we can measure how we will increase IVF cycles, increase patient-to-patient referrals, and improve our conversions of prospective patients to scheduled patients. You can view the first half of my talk here:

It takes a village

The strongest recurring theme of the Business Minds meeting was the critical involvement of everyone at the practice. I frequently see public feedback when patients are happy with their physicians, but not their staff, and vice-versa. Patients form their opinions about their experience based on every interaction they have with us; from the receptionist who greets them, to the medical team that cares for them, to exceptional customer service both online and offline. When we support all of the role players on our team, and learn about best practices from clinic groups across North America, we can dramatically improve both our delivery of care and patient satisfaction. Now that's an excellent foundation for growth. I recommend that at least once a year, you accompany a few of your team members to an inter-role meeting like MRSi to identify how you can improve your practice operations. You might be pleasantly surprised by what you learn from your own team, and what they learn from you.

See you next year at MRSi 2017!

24 Things You Would Never Know About Infertility Until You #StartAsking

By Griffin Jones

Last night I had one of the coolest conversations that I've had in a little while. The best part, is, we recorded the whole thing. This week is National Infertility Awareness Week and I wanted to participate in the #startasking dialogue, not just with sound bytes or with a scripted narrative, but a candid, meaningful conversation between people who really want to see the infertility community receive the recognition they deserve. So I invited a few cool people to chat on Blab.

  • Chris and Candace Wohl, are a married couple who have been on their infertility journey for nine years. They have a daughter through surrogacy and they write the blog, Our Misconception
  • Angela Bergmann and her husband have unexplained infertility. Angie writes the blog, Rad Kitten, and she leads an infertility peer support group in Ohio.
  • Fran Meadows struggled with infertility for seven years. After she had her son she decided to break the silence about her experience and author the book, The Truth Behind the Secret "Infertility".

Watch our conversation about infertility and how much you can take control by promoting awareness.

Despite no shortage of technical difficulties, Mid-Atlantic thunderstorms, and Blab still being in beta (Watch this at 2:38 if you don't mind the f bomb), we farmed some really valuable ideas from our talk. Here's what you missed

On speaking out about infertility

"#startasking doesn't have to be about your personal infertility. We need people to start asking their employers, and doctors, and healthcare providers and anyone who will listen to give us access to the family building options that we just don't have access to right now". --Angie

"It's up to you to set the boundary of what you're willing to share and what you're not willing to share. Maybe you don't want to share anything at all and that's totally fine. You set those boundaries at the beginning".--Angie

" For the first two to three years of our journey we didn't tell anyone. We didn't have any support. We weren't seeking counseling." We didn't know about organizations like RESOLVE. I just felt alone."--Candace 

"Before we had our son, I felt like it was easier for my husband and I to deal with it as a couple than to open it up to the world to know every step we were going through."--Fran

"It is very common, that people keep silent [about infertility]. There are so many people that are afraid to open up and they relate to someone who felt their pain".--Fran

"Being able to talk to me, since I've always been open about infertility has helped people figure out that maybe they were being silent not necessarily because they wanted to, but because they didn't know how to broach the topic with their family members."--Angie

"We decided to take our struggle and make something positive out of it."--Candace 

"Even though we have our daughter, we still are infertile. Somehow getting all these voices together and talking about what we go through makes it that much easier" --Chris

"You can set boundaries with your family members: this is what I need from you, this is what I don't need from you."--Angie

"We realized that we needed to debunk the stigma. We need to help other couples who may be on the fence. We need to help couples who may not know there are options like counseling and organizations like RESOLVE that can help".--Candace

On the misunderstanding of infertility as a disease

"There's just a lot of misunderstanding as to what the options really are."--Chris

"I don't have to have had a child to have beaten infertility. I beat infertility every day because I own it. It's a disease. I could have five kids I'm still going to be infertile."--Angie

"The number one thing I get from people is 'well if you're having trouble having kids, that means you just get all kinds of sex, right?'. There's going to be a whole series of bedroom antics that have nothing to do with having fun".--Chris

"It's a disease. Would you be afraid to tell your family that you had diabetes?" --Angie

"Adoption solves the need for children. It doesn't solve infertility."--Angie

On being your own advocate

"Millennials are hungry for information. The key is to provide them with the right information. They need to look at SART data, at ASRM, at the CDC, and they need to look at RESOLVE. It's all about being your own advocate and taking this information to your RE".--Candace
,
"Being your own advocate gives you more confidence knowing what you're doing getting into whatever treatment you choose. The doctor is the doctor, but sometimes you have to question certain things to know that you are making the right decision."--Fran

"If REs have that bedside manor where they appreciate you asking questions it helps you move forward in the journey with trust". --Fran

On taking action to make a change

"We need to get more people to advocacy day. We're never going to make a change until they see 1,000 of us walking to our appointments. We need to get laws passed to get the national recognition we need".--Angie

"There's so many people who are angry and who want change. You can do it. You have a choice. You have the right as a U.S. citizen to make a change. Join us and change the world so that family building is no longer a financial barrier. So that people can get treatment for their disease. This isn't an elective. This is a disease. RESOLVE's Advocacy Day is May 11, and we're so close to 200 advocates".--Candace

"Millennials want to make a change. That's what they do. They get loud and they make change".-Angie

"Use your voice on the phone, with your e-mail, with your letters. Even if you can't make it [to advocacy day], you can still be really involved".--Fran

"[Advocacy Day]" is truly the most overwhelming and empowering day of your infertility journey to be able to take that moment of control".--Angie

"If you can't make it to DC, you can still support us. Take a look at resolve.org/advocacyday or follow us on social media and we'll lead you in the right direction".--Candace

 

12 Nuggets of Wisdom You Missed at the New England Fertility Society 2016 Annual Meeting

By Griffin Jones

It was a weekend of fools at the New England Fertility Society's (NEFS) 14th annual meeting, which took place on April Fools'weekend, April 1 and 2. The meeting was set amidst the gorgeous landscape of Vermont's Green Mountains in the resort town of Stowe. Yes, we had dessert catered by Ben and Jerry's Ice Cream. NEFS President, Jill Attaman, MD, thanked the roughly 170 people in attendance, and introduced the April Fool's theme, with practical jokes played throughout the weekend. Yes, there were woopie cushions. If you weren't fortunate enough to have joined us for this year's meeting, here is a brief synopsis of what you missed.

1). 2014 SART reports expected to be released this week. Brad Van Voorhis, MD, the President of the Society for Advanced Reproductive Technology (SART) discussed Big Data for Personalized Medicine and the role that SART has played over the last thirty years as the nation's first national patient health registry. Dr. Van Voorhis reports that just under 400 treatment centers report directly to SART, with only roughly 30% of that number reporting directly to the Center for Disease Control (CDC).

2). Selwyn Oskowitz has left the building. Well, sort of. Selwyn Oskowitz, MD, the founding president of NEFS (then the Boston Fertility Society), retired from his storied career at Boston IVF the day before the meeting began. His colleagues paid him an emotional homage, and he received a standing ovation from everyone in attendance. "Is this real?" Dr. Oskowitz joked, referencing the April Fool's theme. Dr. Oskowitz will be traveling to Rwanda intermittently over the next year to provide pro bono medical services to those with infertility.

Dr. Oskowitz's colleagues remember his career fondly

Dr. Oskowitz's colleagues remember his career fondly

3). 60% of human embryos result in pre-clinical losses. Steven Young, MD, PhD, of the University of North Carolina School of Medicine lectured on Endometrial Receptivity. Implantation abnormalities are common causes of infertility, pregnancy loss, and pregnancy complications. Dr. Young believes that the next major breakthrough for infertility therapy will come from optimizing successful embryo implantation, which may have important downstream advantages in reducing pregnancy complications.

4). Focus on fertility preservation. Clarisa Gracia, MD of Penn Fertility Care discussed Ovarian Tissue Cryopreservation. With respect to reproductive function, high-risk cancer survivors in their mid twenties have measures similar to naturally aging women in their early forties. She adds that maturing immature eggs from tissue in vitro eliminates the risk of transplanting cancer cells.

5). Cryopreservation now routinely applied to oocytes and embryos. Terry Schlenker, of the Colorado Center for Reproductive Medicine presented on the Vitrification of Oocytes and Biopsied Embryos. Ice formation is avoided by loading the cells with high concentrations of solutes to convert the water into a  non-crystalline solid. Vitrification is now considered indispensable to ART.

6). May the force be with you. Judith Daar, JD, of the Whittier Law School reports that in February 2016, U.S. Secretary of Defense, Ashton Carter, announced a $150 million pilot program to fund egg and sperm freezing for all active duty military. Due to Congress's current ban on IVF, however, the frozen eggs might never be accessed once the soldier is discharged from service.

7). Stress on the rise. 44% of Americans report that their stress levels have increased over the last five years, according to a 2012 American Psychological Association study cited by Courtney Lynch, PhD, MHP, of The Ohio State University Wexner Medical Center. Though not yet conclusive, evidence is suggestive of an association between infertility and stress. 

8). You're not crazy. Rachel K. Ashby, MD, of Brigham and Women's Hospital talked about the importance of validation of feelings with respect to Patient Centered Care in an Infertility Practice. "Patients are worried, 'I'm crazy, I'm not handling this well, everyone else's relationship is stronger than mine'". Dr. Ashby emphasizes the importance of validating these patient experiences as common and that distress is an appropriate reaction. 

9). Triplets don't come cheap. Barbara Luke, ScD, of Michigan State University cited a 2013 American Journal of OBGYN study in her lecture on Designing Research to Assess Health Outcomes After Assisted Reproduction. The per infant cost of triplets counts at $135,733, compared with $8,327 for singletons. Media outlets often sensationalize high profile cases of multiple births but omit information regarding the highly common medical risks.

10). Politics is messy business. 132 Congressmen and Congresswomen have co-sponsored the leading federal embryo-personhood bill. Lee Rubin Collins, JD, spoke on behalf of RESOLVE on Infertility, Ideology, Patients and Politics. RESOLVE has fought legislation threatening IVF in 24 states and counting. 

11). We're not the only ones. "Why would they invite a Canadian to come speak on law regarding funding for reproductive health in New England?" joked Neal Mahutte, MD, of Montreal Fertility Centre. Dr. Mahutte shared the legislative challenges to ART in Canada and in Quebec. Like the United States and virtually every nation in the world, it is very difficult for lawmakers to write consistent laws pertaining to ART. In Canada for example, clinics can import sperm from paid donors in other countries, but donor compensation within Canada is prohibited.

12). People aren't having enough sex. That was the conclusion of pretty much everyone I spoke with. Well...you heard it here first.

All In This Together: 4 Ways Practices and Patients Are Uniting Around Infertility Awareness Week

By Griffin Jones

If I asked you to name what comes between September and November, you might answer Breast Cancer Awareness Month (BCAM) before you say October. Is there any oncology center in America that doesn't participate in breast cancer awareness month? Is there anyone who doesn't recognize those pink ribbons? Over 1.5 million people participate in the Susan G. Komen races alone. With major partners like the NFL and Proctor and Gamble, the month is almost too popular; to the point where criticism is made that brands exploit the cause for their own profitability. Meanwhile, all the infertility community wants is recognition of their disease and the resources to treat it.  Yet of course BCAM is so much more widely known than National Infertility Awareness Week (NIAW). After all, statistics show that 12% of all U.S. women will develop breast cancer in their lifetime. That's dramatically higher than the 11.9% of women who receive infertility services within their lifetime. 

Oh.

Infertility lacks a giant brand champion, like the National Football League

Infertility lacks a giant brand champion, like the National Football League

Breast cancer is a serious disease that causes horrible hardship on millions of families. It deserves every bit of attention that it receives. I hope 2016 is the year when the infertility community acts in solidarity for the same.

NIAW 2016 is quickly approaching, April 24-30 (May 12-20 in Canada), and clinics and patients have a vested interest in spreading awareness about infertility. The lack of infertility awareness is one big problem that compounds many others. Practices have time and priority constraints that sometimes keep them from being fully active in their promotion of the cause. Those struggling with infertility have priorities of their own, and for some, infertility may be too personal of an issue to discuss with others. I understand; no one can tell you that you should talk about infertility in an open setting. It's a personal decision and one only you can make. It's worth examining, however, how obscuring infertility from the public eye compounds the other issues that come with it.

1). Social PRESSURE

"When are you going to have a baby?"
"Don't you want kids?"
"You can have my kids."
"You can always adopt."
"Just relax and it will happen."

People ask these questions because they know very little about the infertility journey. Comments like these are what spurred Tyra Banks and Chrissy Teigen to inspire the #stopasking hashtag in the fall of 2015. I know how much this bothers you because I see the companionship that forms around the #ttc (trying to conceive) community every time this pain point comes up. Some of the most popular themes that I post to social media are the articles that talk about what not to say to someone with infertility.

One of the most popular infertility e-cards on Pinterest

One of the most popular infertility e-cards on Pinterest

Discussing your plans for children makes for easy conversation...for someone else. Most of your friends and acquaintances have no idea how common infertility is or how painful such otherwise ordinary questions can be. I would have had no idea if I didn't work in the infertility space. I'm sure I would have made many of the same stupid comments, all with the best of intentions. If these conversations bring you great pain, it may be less painful to participate in the conversations that help educate people.

Social pressure may also be projected onto fertility clinics and their staff. When someone spends thousands of dollars on IVF, they are essentially paying you to solve their problem of infertility...problem...singular. Of course infertility actually becomes an amalgam of many problems. Because you are the one being paid to "solve the problem", by default, you can be assigned responsibility for all of them. By participating in the greater cause to address the social pressure that your patients face, you may be able to allay some of the pressure that you feel as well.

2). Financial BURDEN

At issue: far too many people think of infertility treatment as elective. Only 15 states mandate that insurances cover any kind of infertility treatment and of those, RESOLVE grades only five with an A.  Legislators and employers don't feel hurried to extend coverage because they don't perceive it as a great enough priority to their constituents or employees. If infertility was more widely talked about, and greater societal emphasis was given to its treatment, less cost would fall on you as a patient. It's a big deal when an insurance company tries to avoid paying for treatment of other diseases. If everyone you knew understood the severity of infertility, far more companies and states would mandate coverage for IVF and other services. Having to pay for IVF out of pocket is owed in no small part to a lack of knowledge about the disease.

States ranked by RESOLVE

States ranked by RESOLVE

Clinics, too, face financial limits when public understanding of infertility is poor. There are three reasons.

  1. Your "word-of-mouth" referral network is dramatically smaller than its full potential if your patients don't feel comfortable speaking about infertility. A patient cannot recommend you to someone who would really benefit from hearing about her experience if the conversation isn't welcome to take place. 
  2. People are sometimes terrified to see an infertility specialist, because they have insufficient information and a lack of assurance from confidants. Fear reduces the total number of people who should be coming to your office.
  3. Cost is the single greatest factor that prevents patients from proceeding with treatment for infertility. Dr. Tarun Jain of Chicago IVF finds that "in states where IVF coverage is mandated, about thee times as many people use IVF than in non-mandated states. It's about the same multiple seen in European countries which cover IVF." If infertility was enough of a public concern, your center could be doing three times the number of cycles that you  do now, and many of your patients wouldn't be overwhelmed with the stress of the cost.

3). Emotional STRESS

Many people going through infertility say they feel much better when they are able talk to others who can validate their feelings and experiences. "I am so happy to have found all of you" is a very common sentiment among the #ttccommunity on Instagram. Many more would love to connect with people who share their experience: they just don't know they exist. Not all support groups are equal and some types of support may be better fit for you than others. You may feel more comfortable face to face, or you might like an online setting with anonymity. Some may prefer not to connect with anyone at all, and that's perfectly fine, but everyone should be informed of their options. Most people struggling with infertility say that they found their support resources on their own. Neither peer support nor mental health professionals (MHP) can eliminate the burden of stress that accompanies infertility, but a lack of general attention to infertility lays an unnecessary barrier to emotional relief.

Photo from Good Housekeeping

Photo from Good Housekeeping

Emotional stress has even broader implications for practitioners than only their patients' mental health . According to a study by Courtney Lynch, PhD, MHP, of The Ohio State University School of Medicine, women with high stress levels had decreased odds of pregnancy of 29% compared to women with low levels. While there's no data to prove that greater emotional support will increase the likelihood of pregnancy, research from the University of Michigan Health System concludes that peer support helps reduce stress, isolation, and depression.

Equally, my research shows that only 2% of negative fertility center reviews mention a successful pregnancy or the birth of a baby. The contrapositive is true for positive fertility center reviews. What's interesting is that several dozen fertility doctors in the United States and Canada have very few negative reviews. We know that their success rates are not above 80%. For reasons not yet defined, patients feel they have other venues for venting their stress. Neither the clinic, nor the doctor, nor the nursing staff should be the focus of an individual's emotional stress, so it is in the practice's interest to empower patients to access other avenues of support if they so choose.

4). Medical Impact

A very common concern shared by reproductive endocrinology and infertility (REI) specialists is when a woman waits too long to be seen by a fertility doctor. Time can be a crucial factor in the process of fertility treatment and if a woman is reluctant to schedule an initial consultation, she may be equipped with less options later on. Melissa Campbell of the infertility awareness blog, Triumphs and Trials, shares that women dealing with infertility are often hesitant to see an REI because they are nervous that the doctor will pressure them into IVF.

"To me, it felt like a death wish," Campbell says. "I'm going to go [to a fertility clinic] and they're going to push me into IVF. I feel like I have to do everything possible before I even go see an RE"  

"We need to remove the perception that REI equals IVF," says Dr. Matt Retzloff of Fertility Center of San Antonio. "One of the trade-offs is, the longer we wait, the less tools we have in the tool chest to help out. We want to see you sooner. It gives us more options."

Is it a reach to say that clinics' success rates would improve if couples and individuals coping with infertility scheduled their first appointments earlier in life? Very generally, patients would have increased probabilities of having a baby if they were able to take advantage of more options and benefit from earlier detection. As a society, we can both receive and deliver better medical services if the public is more alert to the challenges of infertility.

Take action: #Startasking

It's time to team up. Practices, advocates, couples and individuals dealing with infertility, and their collective communities can act together to turn the tide to bolster understanding of infertility. This year, RESOLVE has laid the groundwork for a very powerful social media campaign. Instead of a theme that demands that people stop asking, the #startasking initiative addresses social stigma head-on, by encouraging people to learn more about infertility, its implications, and options for treatment. Working together, and taking advantage of the tremendous power of digital media, here are four ways to make National Infertility Awareness Week 2016 the most successful yet.

1). Snap those selfies
 People love to see their fertility doctors and nurses through social media. People love seeing IVF babies. People still struggling with infertility love to see their supporters from the #ttccommunity. Download the official NIAW selfie sign which includes a #startasking bubble to write in your #startasking topic. Here's the easiest way to approach the topics you'll pick for your #startasking questions. 

  • For clinics: What are the five most common misconceptions that your new patients have about infertility and treatment? These usually tie into patients' greatest fears. For example, if you find that your patients are reluctant to schedule an initial consultation because they are afraid that they will be pressured into using IVF, your post might be, "#startasking us about options other than IVF".
  • For people with infertility: This is your chance. You get to control the conversation for once. Instead of holding back tears because someone else took your conversation in the direction of when you will have kids, this is your opportunity to decide what you want people to know about your journey. 

2). Ask with video
Instagram video allows for fifteen seconds and there's no such limit on Facebook. For no cost, use your smartphone to record your video questions and post them on your own channels and those of others. Practices can both pose and answer general questions to and from their communities. People dealing with infertility can record their questions and answers and share them with both the #infertilitycommunity and their clinics.

3). Share each other's content
I normally don't recommend that clinics spend too much time on Twitter, but if you have a Twitter account, this is the time when it makes sense to post and share other groups' content using the #startasking and #niaw hasthtags. Share RESOLVE's posts on Facebook and Twitter. The #ttccommunity is very good at sharing content, even on Instagram where there is no native reposting function. Sharing one another's posts about #NIAW is a tremendous way to increase the visibility of the community.

4). Tag each other
I know I needn't say more, #ttccommunity. You are the best at tagging one another and bringing each other into the conversation. I hope that #startasking and #niaw make for a very meaningful dialogue for all of you. While fertility centers can't tag patients without the proper authorization, we can tag @resolveorg and other support resources, and even tag other clinics. Yes, competing fertility centers can collaborate on content distribution. Competitors joining forces for a specific cause is often very well-received, like when the three major news networks came together for the fight against cancer.  Patients find it reassuring and media outlets pay greater attention.

Push for The Turning Point

Nearly every problem we face in the infertility space is compounded when awareness about infertility is low. You face unfair social pressure and financial stress because not enough people are conscious about the devastation caused by infertility. Medical treatment is denied to hundreds of thousands of people every year. Other medical conditions have found tremendous recognition through their awareness efforts and the infertility world has an opportunity to unite in a way that benefits everyone and gains the acknowledgment it deserves. RESOLVE President and CEO, Barbara Collura, encourages "the entire infertility community to call attention to this disease. By asking the tough questions about infertility, we not only have an opportunity to raise awareness about this disease, but also to motivate all who are touched by infertility to commit to the cause.”

At the very least, National Infertility Awareness Week 2016 is an opportunity to gain more exposure for your practice and more understanding for your fight as a patient. As a specific time-frame with a specific goal, it is easy for the media and public to understand and support. More ambitiously, it could be a turning point in this long, exhausting struggle of an issue that people know so little about, or worse, doubt its seriousness. You don't have to hope that a major network reporter will pick up your press release and decide to cover infertility awareness week. We have the power to call attention to the cause with the content that we create. Our own social media efforts give us the distribution to reach beyond our immediate communities. Our creativity will determine how far it will go. Patients, practices, and advocates are coming together to benefit the entire field. 

 

10 Infertility Support Ideas from a Conversation That Never Would Have Happened 10 Years Ago

By Griffin Jones

"We're all working together. That's the secret." --Sam Walton

On one hand, I absolutely hate millennial business buzzwords, and on the other, I deliberately use them often. I choose to say "silo busting" because of how important it is for different "departments" to be familiar with each other's goals and challenges. "Silos" aren't just separate departments within companies, they can be any sub-category of any group.  According to social scientist, Tom Wolff, PhD, of the University of Kansas, all community stakeholders have to be engaged in order to solve common problems facing the community. In the infertility community, our many roles account for many different stakeholders.  We have embryologists (scientists), reproductive endocrinologists (doctors), nurses, business managers, patients, support groups, mental health professionals, and advocates (among others). 

Bringing ideas together

Bringing ideas together

Physicians need to focus on the clinical treatment of hundreds of patients. Embryologists have to worry about the conditions of the lab and of the gametes. Patients are managing their personal aspirations, medical concerns, relationships, and financial status at once.  Business managers have goals for new patient consults and IVF cycles. With such demanding tasks, it's easy for all members of the team to lose sight of the complete patient experience, and it's easy for patients not to understand why. 

According to the Harvard Business Review, "customer-centric companies live by a set of values that put the customer front and center, and they reinforce those values through cultural elements, power structures, metrics, and incentives that reward customer-focused, solutions-oriented behavior".  In other words, we need feedback from every stakeholder in the community to collectively agree upon mutual goals. How the heck do we that? We can start by talking to one another...at the same time.

New technology=new opportunities

Just two decades ago, we  had very few opportunities to bring together people from different ends of the fertility space for public conversation. Today, new media allows us to bring together experts and advocates from nearly every part of the world.  Blab is a relatively new social media platform that is still in Beta (product and market testing). Who knows if it will skyrocket in growth like Snapchat or fizzle away like Foursquare, but the forum gives us something we are all hungry for: the ability to openly meet around a topic with public dialogue. Think Twitter meets Google Hangouts. Blab is a way, for up to four people with webcams, to have a conversation that is open to the public to comment on and ask questions in real time. Last year, when I first learned about Blab, I immediately thought about its potential benefit the infertility space. We don't have too many opportunities to bring together doctors, patients, and support advocates in a public setting. I wanted to do exactly that.

WHERE DO WE START?

We know from psychological research that infertility causes as much stress and anxiety as a cancer diagnosis. Yet we frequently hear from patients that they found out above their infertility support group on their own.  We  also observe from fertility clinic reviews, that patients are three times more likely to leave a negative review if their fertility treatment did not result in a pregnancy. So if the practice is only concerned with the clinical outcome of treatment, the public reputation of the clinic will suffer accordingly. Informing patients of support resources has an emotional benefit to the patient, a professional benefit to the physician, and a business benefit to the practice. According to a 2013 survey by Dimensional Research, 90% of customers report that their buying decisions are influenced by online reviews. If we want patients to be as satisfied with their experience as possible, we need to know what support resources exist, and how to direct the patient to them, if they so choose. In order to do that, we need representation from everyone involved.

Who's responsible for what?

In January 2016, I hosted a Blab with

  • Dr. Matt Retzloff, Reproductive Endocrinology and Infertility (REI) physician at Fertility Center of San Antonio
  • Rebecca Flick, Vice President, Communications, at RESOLVE, the National Infertility Association
  • Melissa Campbell, Infertility blogger and support advocate from the website, Triumphs and Trials

From four different perspectives and one half-hour conversation, we were able to extract at least ten different observations that are important for practices, patients, and support groups to know:

  1. People are often reluctant to see an REI because they are afraid that IVF will be pushed on them. REI practices may want to inform local OBGYN offices of infertility support groups in their area, because some patients seek peer opinion before they seek professional opinion. Equipping OBGYN practices with support contact deepens the relationship with the referring office and provides another step in which patients may become comfortable to seeing an REI. 
  2. "Writing a prescription for RESOLVE" is one way for patients to leave their first consult with information on support. It also ensures that talking about support resources becomes part of the standard of care.
  3. RESOLVE flyers on local support group information belong in folders that go home with all new patients. When a new support group forms in your area, RESOLVE will e-mail you a flyer with the group meeting details and contact information. This info may also be found through RESOLVE's zip code search
  4. Go through RESOLVE training: For areas where support groups don't exist, interested patients can go through RESOLVE training online.
  5. Instagram is home to one of the most vibrant online infertility support communities. People dealing with infertility sometimes send each other care packages and cards to the communities they form online. This free resource, for you to give to patients about infertility blogs and podcasts, came largely from suggestions on Instagram. 
  6. Social media can be great for peer support, but professional input is limited because of HIPAA regulations. For medical advice, patients should always contact a physician.
  7. Staff may need training on responding to and distributing information on requests for support. Unfortunately this is not the first time I've heard of someone wanting to leave support information with their doctor's office and not receive a response.
  8. Remove the perception that REI=IVF. All options are only available when the patient comes to see the REI. More content on when IVF may not be necessary, could help patients make their decision to schedule an initial consultation sooner than later.
  9. Patients should do additional research on support resources: The practice can give the patient an excellent start on infertility support information, and they will be able to find out what is best for their individual needs with some investigation.
  10. Training/education on support may be beneficial for REI fellows. At issue, too many people are not receiving emotional and social support for their infertility despite receiving clinical treatment for their condition. By setting a training standard for REI fellows, we could incorporate support into the standard of care. 

we're just getting started

One conversation won't cover all of the issues we have in the infertility space. Still, twenty years ago, we didn't have the opportunity to bring people together to consider various perspectives on a common issue. With emerging digital media, we have the opportunity to remove barriers that don't need to exist anymore. We have a chance to learn from each other so that we can all benefit from the improved patient-practice relationship. Using new media like Blab can be the first step in building more and stronger relationships across different disciplines within the field of infertility.

 

The Truth Is Undefeated: A hard look at "questionable techniques" and the current state of fertility marketing

By Griffin Jones

You can tell I'm still relatively new to the fertility space. I don't appear in the top ten Google search results for "fertility marketing". I'm working on that, that's what brought me to check. I was both encouraged and discouraged by something else that did come up, however.

On the first page of Google search results for the term, "fertility marketing".

On the first page of Google search results for the term, "fertility marketing".

It's unfortunate for the field of reproductive medicine when our top search results for marketing include, "Many Fertility Clinics Use Questionable Marketing Techniques Online", a Jezebel reiteration of a Huffington Post article from three years ago. I would normally argue that we should avoid questionable marketing techniques by using only real patient testimonials and images. But authentic content does not fully address the issue of transparency in fertility marketing . The fundamental problem is that fertility clinics serve two different populations who sometimes overlap and who are sometimes at odds. Until we equally recognize both groups and the value of their experiences, I'm afraid we'll continue to have more problems. 

Flowers over figures

Both articles are sensational summaries of a report called Selling Art: An Empirical Assessment of Advertising on Fertility Clinics' Websites by Jim Hawkins, of the University of Houston Law Center. The report suggests that the content on fertility centers' websites may be misleading--using pictures of smiling babies and the words, "miracle" and "dream". The report offers criticism that these images and words may influence a prospective patient's decision instead of focusing on the Society for Advanced Reproductive Technology's (SART) published data on success rates. Such advertising may suggest that a pregnancy after IVF treatment is a certainty, when we know that in some cases, it's not even likely. 

It does seem that people sometimes feel misled. In a small survey I finished in April of 2015, patients told me that confusion about success rates was one of their greatest pain-points in selecting their fertility clinic. We also read in negative fertility doctor reviews that people sometimes feel rushed into IVF treatment. I recently spoke to a couple at Resolve's Night of Hope who felt the same way. It is certainly the case that some people feel that IVF is being sold to them. 

So why do I also find it encouraging that highly authoritative links to this report ranked so highly in the search results for "fertility marketing"? For the same reason I am building a company that will also rank among those results. I believe in a marketing strategy built on support and transparency. The report suggests that fertility clinic marketing should be more thoroughly regulated because of these questionable marketing tactics. My largest problem with that notion is that it shares a faulty belief with the lousy marketers that implement those tactics: obscurity works. Indeed, not being fully transparent may work in the short term. Some people clearly feel that they were persuaded with unrealistic expectations to pay for expensive IVF cycles. This strategy may have been tenable twenty years ago. Today's data, however, proves that people increasingly make decisions based on what they read in online reviews from their peers

You can run but you can't hide 

Fertility centers need to properly manage new patient expectations or their online ratings will suffer. Social proof in the form of online reviews should be the cornerstone of every good fertility clinic's marketing efforts. If any prospective patients or patient advocates read this post, I implore you to check the reviews of a provider before you decide on them. Investigate both the fertility practice and the reproductive endocrinologist (RE) on Yelp, Health Grades, Vitals, ZocDoc, RateMDs, Google reviews, or whichever of those are the most used in your area. Don't look at the star rating alone, but pay attention to the comments. If there are enough reviews, you will be able to get an idea of the culture of the practice or physician you are considering.

I don't know if fertility practices should be required to post their success rates, but I certainly think that they should post them. Patients are looking for that information and if they don't find it from you, it will be from a site like fertilitysuccessrates.com or from one of your competitors. Clinics should be transparent with success rate info and create content explaining the complex data to patients. 

Patients will find your success rates from one website or another. Fertilitysuccessrates.com

Patients will find your success rates from one website or another. Fertilitysuccessrates.com

Miracles happen and dreams are real 

I disagree that it would be appropriate to remove baby pictures and words like "dream" and "miracle" from your site.Those words belong to the patients themselves. If you look at the Facebook pages of nearly any fertility clinic in America, there is almost certainly a photo post from a happy patient that includes the word, "miracle". That child truly is a miracle for the parents that ventured that hard, lonely journey for so long. Their fertility specialist and their practice helped bring that miracle into existence. And for those couples and individuals that are struggling with infertility, it is their dream to have a baby of their own, a dream stronger than any other. We should speak to people in the language that they use, especially when it's based on results you've achieved. Your practice exists because people vividly dream of a miracle. Ideally, we should use baby pictures from actual patients. I think it's time to get the HIPAA release forms ready. The authentic account of someone who has actually realized their dream  is critical motivation for people under enormous emotional stress who are making a complicated medical decision. Sadly, however, we know that dream will not come true, in that form, for many people. So we must recognize the value of two communities rooted in the journey of infertility.

The word miracle belongs to the infertility community.

The word miracle belongs to the infertility community.

Serving two communities at the same time

I will oversimplify the infertility community for the sake of fundamentally understanding our responsibilities to them. As I see it, the infertility community is one population of people that becomes two. There are those who have ended their journey by achieving their dream of a biological child. In parallel, there are those who are still very much on their journey who may never realize that version of their dream. I hope this is the beginning of a much longer dialogue, because not recognizing the significance of both groups' feelings leads to many problems. We often hear complaints from patients without children when little ones are in the waiting room. Yet, we hear grievances from patients with children when they are asked not to have their child in the sitting area. For one group, Facebook and Instagram are places to celebrate their triumph over the darkest period of their lives. For the other group, they are in the midst of darkness and every pregnancy announcement on Facebook and every baby photo on Instagram is excruciatingly painful . Both communities have an inalienable right to the way they feel. These two communities overlap and we serve both of them. Because we're serving two communities, we have to be able to offer them a variety of benefits or some will never get value from their experience with us. I think fertility centers need to consider themselves agents of help beyond clinical treatment. Both groups need access to support; a peer support group member should never have to find out about her support group on her own. To better serve both populations, we need to

  • Send patients home with information on support groups in their area. RESOLVE facilitates infertility patient support groups in most mid-size to large U.S. metro areas and Fertility Matters is their peer in Canada. These are only two examples of support networks. There are patient advocacy groups and countless independent support groups throughout North America. I believe it's our responsibility to promote support groups when they ask for our help in distributing their information.
  • Empower people on social media. Whether it's on your fertility practice's Facebook page, or in a private forum, people coping with infertility use social media to connect with people who know their struggle. Promote RESOLVE Fertility Matters, and other groups online and share their groups if they ask you to. We don't not need to participate in these support forums (it may be better if we don't), but simply connect the people who are interested in them.
  • Give patients a list of popular infertility blogs and infertility podcasts so that they can interact with people who share their experience. 

Can you grow your practice by reconciling your results as a "miracle worker" with empirical expectation setting? I am building a business with my vote of confidence that it's the best way to do so.

Setting up for success

There are real life examples of the virtuous cycle I propose--attract new patients with the experience of delighted former patients, offer support and other resources, temper with very realistic expectations, and repeat. Dr. Ilan Tur-Kaspa is one of the highest rated REs in the Chicagoland area. I spoke with him about his approach. Dr. Tur-Kaspa says that the number of new patients that tell him they chose him because of his online ratings has increased. He credits a strong emphasis on properly managing expectations with the patient before treatment. "We talk a lot about the difference between disappointment and surprise," Tur-Kaspa says. "Whatever the probability of success is, it is important to communicate that in the terms of the probability of failure. i.e. if there is a 30% chance of success, we should communicate that there is a 70% chance that it won't work. The patient should preferably  acknowledge the odds of failure. Wait until they say 'I understand'".

When a patient looks at your online reviews on a site like ratemds (pictured), they are one click away from every other RE in your city. We want your reviews to be the best they can be.

When a patient looks at your online reviews on a site like ratemds (pictured), they are one click away from every other RE in your city. We want your reviews to be the best they can be.

I'm not a physician, so I certainly can't advise physicians on how to speak to their patients. Nor do I want to offer an incomplete solution, because I see that positivity is hugely important.  I'm simply a marketer who sees the impact that clear expectations have on the public image of the practice. Some marketers may ignore expectation setting for the sake of scheduling more IVF cycles in the short term. A good marketer will use the patient delight that comes from proper education as the pillar of their marketing strategy. For highly rated REs and fertility clinics, those reviews belong front and center on your website. A window to Yelp and Facebook  provide a balance to the testimonials that you've selected . It's okay for patients to see the occasional one-star review. Not every one will be satisfied 100% of the time. I believe that when we publicly acknowledge that, we begin to ensure that people are satisfied as much as possible.

The truth is undefeated (eventually)

We don't have to use "questionable marketing tactics" because they won't grow our practices over the long term. For those that embrace transparency and connection to support, market share will grow and marketing will be more effective and less expensive. We have to provide the best possible patient experience in order to build public social proof. That social proof, tempered with clear expectations and information, is the best way to attract new patients. In order to preserve this virtuous cycle, delighted patients bringing in more patients, we have to recognize the dynamics of both populations in the infertility community, and the equal worth of their experiences. 

"Democracy Is Not a Spectator Sport": The Top 5 Things I Learned at ASRM's 2015 Advocacy Academy

By Griffin Jones

“This ban on IVF coverage for our nation’s vets is antiquated and unconscionable, it is past time for it to be lifted.'--Owen Davis MD, President of the American Society for Reproductive Medicine (ASRM).

Most of the attendees of ASRM's first ever Advocacy Academy. Photo taken by Suzan Henderson, @suzanhenderson. 

Most of the attendees of ASRM's first ever Advocacy Academy. Photo taken by Suzan Henderson, @suzanhenderson. 

ASRM held its first ever Advocacy Academy in Washington, D.C. on December 9th and 10th, 2015. About 30 ASRM members met to learn more about advocacy at the state and federal levels, for better legislation on reproductive care. Special focus was paid to Congress's current ban on IVF for veterans, and the pending pieces of legislation that would provide that care to our vets. On Capitol Hill, we met with the offices of our individual members. Being new to advocacy in this way, these are the five most valuable things I learned from ASRM's advocacy workshop.

  1. The ban on IVF for veterans is just bad legislation. Currently, through the Department of Defense (DOD), some IVF coverage is available for active service members who were injured or wounded in the line of duty. When those same service members are medically discharged from the military, they are not afforded the same coverage as veterans through the Department of Veterans Affairs (VA). Can we really expect service members to be thinking about their fertility at their time of discharge? Will we not give them any time to build a family? As it was explained in the workshop, only twenty service members have been able to take advantage of IVF under the existing DOD coverage.
  2. Congressional staffers will meet with you. I found this to be very surprising and encouraging. ASRM had scheduled meetings for us with the offices of our Representatives and Senators. Each office has a staffer that's responsible for veterans affairs issues and healthcare issues. Often, it is the same person. These staffers advise the legislator on bills that have been brought to their attention. They are tasked with investigating the background, status, and content of the bill. Part of their investigation involves gauging feedback from constituents. We met with our congressional offices as constituents voicing our stance on the IVF for veterans issue, politely asking for the favor of the legislator's co-sponsorship of the bill(s). What surprised me further, were the impromptu meetings that I was granted. I stepped into seven additional congressional offices, and staffers from four different New York Representatives took a few minutes to meet with me. 
  3. Allies are necessary. No matter the issue, it is important to find common interests who benefit from your desired goal. Lorri Unumb is the vice president of state government affairs at Autism Speaks, the national advocacy organization for autism. Lorri spoke to our group about how to impact changes in legislation at the state level. Lorri talked about the importance of local constituents asking their legislator for the favor of co-sponsoring the piece of legislation that they want to advance. It's important to pay attention to other patient advocacy groups and medical societies to learn how we can improve access to reproductive health.
  4. Educate the press. Reporters, journalists, and bloggers often cover multiple subject areas. Healthcare may not be their area of expertise. Reproductive health is almost certainly not their area of expertise. Your interviewer's familiarity with reproductive health may only extend to high profile cases such as California's "Octomom," and celebrity legal disputes like the one involving Modern Family's Sofia Vegara. In fact, from the experience of many of the panelists at the workshop, it's often after headlines like these that the media are most interested in talking to reproductive endocrinologists (RE). Carol Blymire of Blymire Communications advised being friendly and helpful to journalists. Connect them with other sources of information, educate them on the field, and thank them for their interest. Dr. Richard Paulson, president-elect of ASRM, advises setting a time-limit, twenty minutes, for the interview.
  5. Repetition is key. It is important to be repetitive. Repeating your message has importance. This is true for both the media and for lawmakers. As U.S. Department of Labor Secretary, Thomas Perez, stated in his keynote address on the first day of the academy, "Democracy is not a spectator sport. It requires continuous participation." Two of the legislative staffers that I met with told me that they had seen one of the IVF for veterans bills before. They had simply forgotten about it. It sounded like their legislators had never seen it. Senators and Representatives see more bills and proposals for legislation than they can possibly keep track of. It is helpful to be reminded of what is important to the constituents, and on what they should spend their consideration. The staff members thanked me for bringing the bill back to their attention.

ASRM has announced that they will hold another Advocacy Academy in late 2016 or early 2017. I encourage physicians and practice managers to attend, because laws regarding public health will be passed with or without your input. It is important for legislators to consider the expertise of health professionals in the field. I hope that by the next workshop, veterans of the United States Armed Forces will have the access to reproductive technology that they've earned. 

10 Highlights From What You Missed at RESOLVE's 2015 Night of Hope

By Griffin Jones

November 17, 2015 marked RESOLVE's 18th annual, Night of Hope, in Manhattan. As the cardinal event of the national infertility association, the gala promotes RESOLVE's mission to support men and women experiencing infertility.

Happy I got a photo opp with the Resolve dream team.

Happy I got a photo opp with the Resolve dream team.

It was a fun and thoughtful affair, with about 375 people from all over the country in attendance. Here are some of the highlights:

  1. Dr. Jason Griffith of Houston Fertility Institute won the Hope Award for Advocacy for his work to raise public awareness on infertility. 
  2. Julie Berman won the Hope Award for Service for her work to advance the mission of RESOLVE.
  3. Bobbie Thomas, style editor of NBC's The Today Show, hosted the evening. Thomas mentioned that she began her advocacy on social media and received support from hundreds of thousands of women, prompting her to take on a greater role in promoting awareness of infertility as a medical condition.
  4. The party favor for the evening was a magic eight-ball, with only a positive outlook for the future.
  5. Karen Grote won the Hope Award for best blog. Grote said in her acceptance speech that she originally wanted to keep her identity as an infertility blogger anonymous but that her role in the community quickly changed that.
  6. BASF Corporation now offers IVF coverage to their employees as an employment benefit because of a letter from one of their teammembers who needed treatment.
  7. Alisyn Camerota, who won the Hope Award for achievement, was unable to be in attendance because her duties as a  CNN anchor brought her to Paris to cover the events there.
  8. Dr. G. David Adamson of Palo Alto Medical Foundation (PAMF) won the Barbara Eck Founder's Award for his leadership in the field of infertility. 
  9. The evening pledge goal of $50,000 was met with an influx of supportive text messages displayed on the big screen.
  10. Not a single soul wanted to see Dr. Alan DeCherney have ice water poured over his head--the false prize for the pledge being met. We were all relieived to watch Bobbie Thomas sprinkle him with confetti instead.