I said to a patient in my office just yesterday, “If we put stress, time, and money aside, the best chance for you to get pregnant would be IVF with ICSI.” And then we talked through the stress, time, and money that actually ARE involved. She made the decision to proceed with a different treatment that was less intense – and less expensive, even though it would give her a lower chance of getting pregnant. (For those who don’t recognize the lingo, IVF with ICSI is a very high-tech option for conceiving in many cases of infertility.)

When can you ever put stress, time, and money aside? Medical care does not exist in a vacuum. There are times when a serious illness demands something be done right now – sometimes something intense and expensive. But there are many more situations where there are choices involved. And I believe those choices are available much more often than most people realize.

People get caught up in the problem, and you can understand why. Infertility hurts the soul of a couple like little else does. Few things are more terrifying to some than cancer, or the fear of cancer. Back pain completely takes over your life. And who wouldn’t want to do everything possible to help a sick child?

But just because a surgery is possible, a medication is available, or a treatment can be done doesn’t mean it SHOULD be done. Every choice has consequences, including those beyond the physical health of the “patient” involved. A risky chemotherapy may extend someone’s life a couple months – at the cost of miserable side effects. Expensive infertility treatment may result in a pregnancy – at the cost of the couple’s relationship.

Another patient told me this week, “I came to understand that if I wanted to stay married I needed to stop fertility treatment.” She still hopes for a baby, but the stress had become so great it was destroying her marriage. She made a choice to focus on the most important things in her life, including her relationship with her husband. And perhaps God will still bless her with a baby one day.

I respect patients who place such treatments in their proper perspective. And I respect other medical professionals who do the same. Those who haven’t – who have pushed or advocated for certain medical treatments even partially on the basis of money – have given the many conscientious and caring professionals a bad name.

Some say that if medical care were “free” to those needing it these discussions would not be necessary. I strongly disagree! Cost involves much more than money. Time and stress – physical and emotional – need to be thoughtfully managed just as money does. And that is never truer than in our high-tech world of medicine today.

Your turn: Have you faced medical decisions where the cost – financial or personal – was an important factor? How did you work that through? I’d love to hear from you.

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