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	<title>Comments on: Last night&#8217;s journal club</title>
	<atom:link href="http://fertilityfile.com/2009/02/11/last-nights-journal-club/feed/" rel="self" type="application/rss+xml" />
	<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/</link>
	<description>The inside view from a reproductive endocrinologist</description>
	<pubDate>Thu, 29 Jul 2010 18:38:39 +0000</pubDate>
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		<title>By: MLO</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3264</link>
		<dc:creator>MLO</dc:creator>
		<pubDate>Fri, 13 Feb 2009 20:20:52 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3264</guid>
		<description>One worrisome note that my husband brought up was that perhaps complaints were not taken seriously because the complainants (if there were complaints) were taking fertility drugs.

This is a very real, and disturbing possibility that brings into light the way women's medical issues are treated differently than men's medical issues.  

I hope that he is wrong and that it is just a case of no one thought to make complaints about his behavior.</description>
		<content:encoded><![CDATA[<p>One worrisome note that my husband brought up was that perhaps complaints were not taken seriously because the complainants (if there were complaints) were taking fertility drugs.</p>
<p>This is a very real, and disturbing possibility that brings into light the way women&#8217;s medical issues are treated differently than men&#8217;s medical issues.  </p>
<p>I hope that he is wrong and that it is just a case of no one thought to make complaints about his behavior.</p>
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		<title>By: IVF-MD</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3261</link>
		<dc:creator>IVF-MD</dc:creator>
		<pubDate>Fri, 13 Feb 2009 18:42:05 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3261</guid>
		<description>MLO, thanks for the comment. 

There are so many different unrelated aspects of this whole story including:
The issue of the government paying women for children they can't support on their own
The issue of one particular physician being allowed to run unchecked
The issue of the potential of IVF as a whole to result in high order multiples
The issue of a person using willful initiation of an adverse event to capitalize on the press's willingness to pay for a story
The issue of doctor's power to decide who should be allowed medical assistance to become a parent

It will be interesting to see if there have been OFFICIAL past complaints sent to the board on Dr. K and how they were handled.</description>
		<content:encoded><![CDATA[<p>MLO, thanks for the comment. </p>
<p>There are so many different unrelated aspects of this whole story including:<br />
The issue of the government paying women for children they can&#8217;t support on their own<br />
The issue of one particular physician being allowed to run unchecked<br />
The issue of the potential of IVF as a whole to result in high order multiples<br />
The issue of a person using willful initiation of an adverse event to capitalize on the press&#8217;s willingness to pay for a story<br />
The issue of doctor&#8217;s power to decide who should be allowed medical assistance to become a parent</p>
<p>It will be interesting to see if there have been OFFICIAL past complaints sent to the board on Dr. K and how they were handled.</p>
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		<title>By: MLO</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3260</link>
		<dc:creator>MLO</dc:creator>
		<pubDate>Fri, 13 Feb 2009 18:37:31 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3260</guid>
		<description>I agree that micromanaging medicine is a bad idea - on the level of embryo transfer.  I am reticent to not suggest that perhaps the California licensing board has been lax around this Kamrava character.  If what we are hearing is true, why has he been allowed to continue to practice?

His practices, if the allegations are true, are, well, shady.</description>
		<content:encoded><![CDATA[<p>I agree that micromanaging medicine is a bad idea - on the level of embryo transfer.  I am reticent to not suggest that perhaps the California licensing board has been lax around this Kamrava character.  If what we are hearing is true, why has he been allowed to continue to practice?</p>
<p>His practices, if the allegations are true, are, well, shady.</p>
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		<title>By: Robin</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3245</link>
		<dc:creator>Robin</dc:creator>
		<pubDate>Fri, 13 Feb 2009 01:58:55 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3245</guid>
		<description>Here's another one Dr. Lee, this woman in Georgia is speaking out.  She claims Dr. Kamrava was so careless he almost killed her.  She ended up in the hospital from ovarian hyper-stimulation, breahtless, in a life threatening situation, pregnant with triplets which she didn't find out til she went to the hospital!
http://www.11alive.com/news/local/story.aspx?storyid=126883&#38;catid=3

Kellie Toothman will file a complaint with the Medical Board of California against Dr. Michael Kamrava -- and wants to tell as many people as she can.</description>
		<content:encoded><![CDATA[<p>Here&#8217;s another one Dr. Lee, this woman in Georgia is speaking out.  She claims Dr. Kamrava was so careless he almost killed her.  She ended up in the hospital from ovarian hyper-stimulation, breahtless, in a life threatening situation, pregnant with triplets which she didn&#8217;t find out til she went to the hospital!<br />
<a href="http://www.11alive.com/news/local/story.aspx?storyid=126883&amp;catid=3" rel="nofollow">http://www.11alive.com/news/local/story.aspx?storyid=126883&amp;catid=3</a></p>
<p>Kellie Toothman will file a complaint with the Medical Board of California against Dr. Michael Kamrava &#8212; and wants to tell as many people as she can.</p>
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		<title>By: IVF-MD</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3243</link>
		<dc:creator>IVF-MD</dc:creator>
		<pubDate>Thu, 12 Feb 2009 23:37:09 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3243</guid>
		<description>Sarah, you are absolutely right. There is a difference between policing and denigrating. I may have blurred the two in my comment because years ago, a friend tried to refer someone to me, but that person said that Dr. K's marketing materials and claims were more impressive and went to see him instead. I guess I could have offered an opinion specifically regarding seeing HIM in particular, regardless of whether she ultimately came to me or not.

Every field has it's good and bad. There are bad teachers, bad lawyers, bad politicians, even bad priests and bad nuns. It's sad. Alas, the American people are no better protected against them than they are against bad RE's.

I agree with you that deceptive practices and advertising by RE's can "prey on vulnerable patients", but there is some hope on the horizon in that the spread of information via the internet can help improve transparency everywhere, including in this field.

I totally disagree with you on the part about lawyers successfully policing themselves to prevent there from being unscrupulous lawyers in this country. In fact, I am of the opinion that there are far far more unscrupulous lawyers than unscrupulous RE's, even percentage-wise. (Actually, I don't think you said that. Sorry) :) You merely stated that lawyers have established rules by which they must abide. We do too. One of the hospitals where I have privileges is among the strictest in overseeing physicians.

One of the reasons I started this blog was to help empower patients with more information. I get feedback from patients from far away who say that the information here helped them make better decisions. For now, I'll keep trying to do my part. I encourage patients to do theirs as well.</description>
		<content:encoded><![CDATA[<p>Sarah, you are absolutely right. There is a difference between policing and denigrating. I may have blurred the two in my comment because years ago, a friend tried to refer someone to me, but that person said that Dr. K&#8217;s marketing materials and claims were more impressive and went to see him instead. I guess I could have offered an opinion specifically regarding seeing HIM in particular, regardless of whether she ultimately came to me or not.</p>
<p>Every field has it&#8217;s good and bad. There are bad teachers, bad lawyers, bad politicians, even bad priests and bad nuns. It&#8217;s sad. Alas, the American people are no better protected against them than they are against bad RE&#8217;s.</p>
<p>I agree with you that deceptive practices and advertising by RE&#8217;s can &#8220;prey on vulnerable patients&#8221;, but there is some hope on the horizon in that the spread of information via the internet can help improve transparency everywhere, including in this field.</p>
<p>I totally disagree with you on the part about lawyers successfully policing themselves to prevent there from being unscrupulous lawyers in this country. In fact, I am of the opinion that there are far far more unscrupulous lawyers than unscrupulous RE&#8217;s, even percentage-wise. (Actually, I don&#8217;t think you said that. Sorry) <img src='http://fertilityfile.com/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> You merely stated that lawyers have established rules by which they must abide. We do too. One of the hospitals where I have privileges is among the strictest in overseeing physicians.</p>
<p>One of the reasons I started this blog was to help empower patients with more information. I get feedback from patients from far away who say that the information here helped them make better decisions. For now, I&#8217;ll keep trying to do my part. I encourage patients to do theirs as well.</p>
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		<title>By: SarahW</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3241</link>
		<dc:creator>SarahW</dc:creator>
		<pubDate>Thu, 12 Feb 2009 22:35:03 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3241</guid>
		<description>Cautiously temper your remarks about colleagues - but of course.   Denigrating competitors is not the same, however, as policing one's own profession,  and holding other members of the profession accountable for clear breeches of standards of ethical or safe practices.   

Lawyers, oddly enough,  have very strict standards of conduct, and reporting requirements for breeches of professional canons by other members of the profession.
Overseeing bodies investigate and discipline members,  in fairly transparent proceedings.

Would that this medical specialty would work to act responsibly in the creation of new life, and to avoid preying on the vulnerable patients seeking reproductive technologies.</description>
		<content:encoded><![CDATA[<p>Cautiously temper your remarks about colleagues - but of course.   Denigrating competitors is not the same, however, as policing one&#8217;s own profession,  and holding other members of the profession accountable for clear breeches of standards of ethical or safe practices.   </p>
<p>Lawyers, oddly enough,  have very strict standards of conduct, and reporting requirements for breeches of professional canons by other members of the profession.<br />
Overseeing bodies investigate and discipline members,  in fairly transparent proceedings.</p>
<p>Would that this medical specialty would work to act responsibly in the creation of new life, and to avoid preying on the vulnerable patients seeking reproductive technologies.</p>
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		<title>By: Robin</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3239</link>
		<dc:creator>Robin</dc:creator>
		<pubDate>Thu, 12 Feb 2009 22:24:41 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3239</guid>
		<description>Dr. Lee,
I'm afraid Dr. Kamrava is at it again.  
Octuplets fertility doctor at center of another multi-pregnancy
1:22 PM, February 12, 2009

Kamrava_2  The Beverly Hills doctor who helped Nadya Suleman conceive octuplets also provided fertility treatment to a 49-year-old woman who is pregnant with quadruplets and is hospitalized at County-USC Medical Center.

Further down:
“I do think it is concerning, and dangerous, especially to the mother," said one doctor with knowledge of the case. "She is close to 50. When women get to be that age, our fear is the cardiovascular complications, such as stroke or heart attack. That’s how serious this is.”

The woman in the latest case arrived recently at Good Samaritan Hospital for treatment but was transferred last week to County-USC because she lacks insurance, the sources said. Doctors placed her on bed rest until the birth of the babies, which, they added, could be two or three months from now. 

So there is ANOTHER case this doctor has provided the tax payers with.

Here's the REAL kicker:
Kamrava could not be reached for comment and has declined previous interview requests. A woman who answered the phone at his West Coast IVF Clinic said, “If [a] mother wants to bring four kids, so what?”

Honestly Dr. Lee, this man is a criminal.  He MAY not have broken the law (although he certainly has breached standards of care) but his man is a MORAL criminal who is bad bad bad for your profession and is bad bad bad for all of us who have to foot the bill! And his "treatments" end up in DANGEROUS pregnancies both for the mother and the children.

I am MORTIFIED.
http://latimesblogs.latimes.com/lanow/2009/02/the-beverly-hil.html</description>
		<content:encoded><![CDATA[<p>Dr. Lee,<br />
I&#8217;m afraid Dr. Kamrava is at it again.<br />
Octuplets fertility doctor at center of another multi-pregnancy<br />
1:22 PM, February 12, 2009</p>
<p>Kamrava_2  The Beverly Hills doctor who helped Nadya Suleman conceive octuplets also provided fertility treatment to a 49-year-old woman who is pregnant with quadruplets and is hospitalized at County-USC Medical Center.</p>
<p>Further down:<br />
“I do think it is concerning, and dangerous, especially to the mother,&#8221; said one doctor with knowledge of the case. &#8220;She is close to 50. When women get to be that age, our fear is the cardiovascular complications, such as stroke or heart attack. That’s how serious this is.”</p>
<p>The woman in the latest case arrived recently at Good Samaritan Hospital for treatment but was transferred last week to County-USC because she lacks insurance, the sources said. Doctors placed her on bed rest until the birth of the babies, which, they added, could be two or three months from now. </p>
<p>So there is ANOTHER case this doctor has provided the tax payers with.</p>
<p>Here&#8217;s the REAL kicker:<br />
Kamrava could not be reached for comment and has declined previous interview requests. A woman who answered the phone at his West Coast IVF Clinic said, “If [a] mother wants to bring four kids, so what?”</p>
<p>Honestly Dr. Lee, this man is a criminal.  He MAY not have broken the law (although he certainly has breached standards of care) but his man is a MORAL criminal who is bad bad bad for your profession and is bad bad bad for all of us who have to foot the bill! And his &#8220;treatments&#8221; end up in DANGEROUS pregnancies both for the mother and the children.</p>
<p>I am MORTIFIED.<br />
<a href="http://latimesblogs.latimes.com/lanow/2009/02/the-beverly-hil.html" rel="nofollow">http://latimesblogs.latimes.com/lanow/2009/02/the-beverly-hil.html</a></p>
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		<title>By: IVF-MD</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3236</link>
		<dc:creator>IVF-MD</dc:creator>
		<pubDate>Thu, 12 Feb 2009 20:44:06 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3236</guid>
		<description>Liz, I'm on your side with dismay at our hard earned salaries going to pay for the support of these octuplets. I wonder if Americans are then wildly supportive of welfare $$ for girls who just get pregnant on their own and have kids that they can't care for. Apparently so, from the way this country votes. :)</description>
		<content:encoded><![CDATA[<p>Liz, I&#8217;m on your side with dismay at our hard earned salaries going to pay for the support of these octuplets. I wonder if Americans are then wildly supportive of welfare $$ for girls who just get pregnant on their own and have kids that they can&#8217;t care for. Apparently so, from the way this country votes. <img src='http://fertilityfile.com/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /></p>
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		<title>By: IVF-MD</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3235</link>
		<dc:creator>IVF-MD</dc:creator>
		<pubDate>Thu, 12 Feb 2009 20:27:26 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3235</guid>
		<description>Sarah, I love your idea of letting the consequences dictate the punishment rather than have inflexible rules. That way, in 10 years of practice, let's say I might encounter twenty cases in which I judge putting in six embryos to be the best thing to do. Let's say that in those twenty cases, we get 5 singleton pregnancies, 1 twin pregnancy and 10 negative cycles with zero quads or zero triplets even, then my judicious choice of strategy in those 20 cases would turn out to be right.

I am willing to police my OWN actions and be held accountable if I show any pattern of poor judgment and I'm all for punishing those who deserve punishment.

It is a little trickier for me to monitor my competitors because that would be like a girl telling a guy that she likes, "Hey don't date THAT OTHER GIRL, because she is evil and dishonest and high-maintenance. You should go out with me instead." There would be potential conflict-of-interest clouding the opinion. If I were to quit working and my sister wanted to do IVF in Southern California, I would very strongly warn her about certain RE's who are unethical, marketing-savvy scam artists. However, if the general public were to ask me, I would have to cautiously temper my comments. Does that make sense?</description>
		<content:encoded><![CDATA[<p>Sarah, I love your idea of letting the consequences dictate the punishment rather than have inflexible rules. That way, in 10 years of practice, let&#8217;s say I might encounter twenty cases in which I judge putting in six embryos to be the best thing to do. Let&#8217;s say that in those twenty cases, we get 5 singleton pregnancies, 1 twin pregnancy and 10 negative cycles with zero quads or zero triplets even, then my judicious choice of strategy in those 20 cases would turn out to be right.</p>
<p>I am willing to police my OWN actions and be held accountable if I show any pattern of poor judgment and I&#8217;m all for punishing those who deserve punishment.</p>
<p>It is a little trickier for me to monitor my competitors because that would be like a girl telling a guy that she likes, &#8220;Hey don&#8217;t date THAT OTHER GIRL, because she is evil and dishonest and high-maintenance. You should go out with me instead.&#8221; There would be potential conflict-of-interest clouding the opinion. If I were to quit working and my sister wanted to do IVF in Southern California, I would very strongly warn her about certain RE&#8217;s who are unethical, marketing-savvy scam artists. However, if the general public were to ask me, I would have to cautiously temper my comments. Does that make sense?</p>
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		<title>By: Liz</title>
		<link>http://fertilityfile.com/2009/02/11/last-nights-journal-club/#comment-3234</link>
		<dc:creator>Liz</dc:creator>
		<pubDate>Thu, 12 Feb 2009 19:40:55 +0000</pubDate>
		<guid isPermaLink="false">http://fertilityfile.com/?p=435#comment-3234</guid>
		<description>I can't even type about the octuplet plus mom...it makes my blood boil.

I am however intrigued on PGD.  My husband and I tried IVF with PGD 4 times to overcome my husband's balanced translocation.  One chemical pregnancy resulted.  We tried one more time and skipped the PGD even though we were counseled on the low chance. (there were quite a few other variables as well on this attempt, for the 4 other I was travel from CA to MD to cycle) My daughters 1st birthday is in 11 days.  My pregnancy started off as twins (we transferred 3 embryos) and by 10 weeks one had stopped developing  (her brother is celebrating his 1st birthday today, surprise chance to adopt 11 days before I delivered) 

Now I have to go turn off the news before I hear how much of my tax dollars will be paying for someone else's family.</description>
		<content:encoded><![CDATA[<p>I can&#8217;t even type about the octuplet plus mom&#8230;it makes my blood boil.</p>
<p>I am however intrigued on PGD.  My husband and I tried IVF with PGD 4 times to overcome my husband&#8217;s balanced translocation.  One chemical pregnancy resulted.  We tried one more time and skipped the PGD even though we were counseled on the low chance. (there were quite a few other variables as well on this attempt, for the 4 other I was travel from CA to MD to cycle) My daughters 1st birthday is in 11 days.  My pregnancy started off as twins (we transferred 3 embryos) and by 10 weeks one had stopped developing  (her brother is celebrating his 1st birthday today, surprise chance to adopt 11 days before I delivered) </p>
<p>Now I have to go turn off the news before I hear how much of my tax dollars will be paying for someone else&#8217;s family.</p>
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