Verified
This patient has provided documentation of treatment at this clinic.
2020, Unknown Success
6
3
Dr Dobson is a very capable fertility physician. At our first appointment, he went into great detail about the factors affecting fertility and conception, hormonal changes during each cycle, potential timing problems, possible points of intervention etc. He also explained age-related factors, chromosomal abnormalities and probabilities...I found myself having to make rushed choices, while filling out forms with the NP / patient coordinator. Likely due to time constraints, the doctor would often only review charts during the appointments, and have to be reminded about findings, NP's suggestions etc. The plan of treatment for the next cycle, was also communicated on-the-fly, and it seemed without much analysis of prior data
PAMF-REI (like other PAMF specialties), is a practice designed for high patient-throughput. This invariably results in treatments feeling impersonal. Doctors rotate, case specifics have to be recalled, treatment coordination is left to non-medical staff...The visit with the NP was long and detailed. She reviewed all hormone tests, looked for the trends in fertility, and changes in cycle...Diagnostics (SHG ~ $1204 , some ultrasounds $322) were covered by my insurance. Fertility treatments were not (IUI without medication ~$1384).
How was your experience with Anthony Dobson at Palo Alto Medical Foundation?
Dr Dobson is a very capable fertility physician. At our first appointment, he went into great detail about the factors affecting fertility and conception, hormonal changes during each cycle, potential timing problems, possible points of intervention etc. He also explained age-related factors, chromosomal abnormalities and probabilities. This was very informative, and helpful in understanding why conception at advanced maternal age gets harder.
He also asked relevant questions about our overall health, as it pertained to ability to conceive, and reviewed some issues from a previous pregnancy.
With this backdrop, we expected to have specific troubleshooting, cycle monitoring and diagnoses, of whether there were the aforementioned issues. However, aside from an SHG - there wasn't much effort spent, on trying to determine the rootcause of our failure to conceive (presumed to be chromosomal abnormalities due to advanced maternal age).
Overall, the approach was to follow established protocol of (possibly several) cycles of treatment, with hormone supplementation / injection as part of protocol (regardless of need), and without necessarily customizing it to each couple's circumstances. While this might actually be the most efficient path to achieve pregnancy, it wasn't necessarily what we were looking for. Too often, it seemed to us that the treatment was shooting in the dark.
Dr Dobson was willing to work with our reservations about extensive interventions, refusal to consider IVF and PGT-A. He was understanding and respectful, and suggested instead to proceed with IUI cycles.
As the cycles proceeded, it would have been better to have a consultation where the plan of treatment was clearly discussed, chances of success for various alternatives explained, and a recommendation made. I found myself having to make rushed choices, while filling out forms with the NP / patient coordinator.
Likely due to time constraints, the doctor would often only review charts during the appointments, and have to be reminded about findings, NP's suggestions etc. The plan of treatment for the next cycle, was also communicated on-the-fly, and it seemed without much analysis of prior data. This is likely an artifact of the oversubscribed PAMF-REI practice.
Other than that, Dr Dobson had good bedside manner, compassion and a great sense of humour, which was a relief during otherwise awkward procedures.
What's one piece of advice would you give a prospective patient of Anthony Dobson at Palo Alto Medical Foundation?
If you want to get more information - ask questions.
The doctor is knowledgeable, but doesn't necessarily explain the tradeoffs, and calculations behind making informed choices. (Again, not every couple may want to know those details, but we did). When we did, we got detailed, accurate and honest answers.
During treatment, were you treated like a number or a human with Anthony Dobson at Palo Alto Medical Foundation?
We actually went into this, with an intention to make data-driven decisions. So we sought information about age-related fertility statistics, success rates of procedures etc., and these were provided (both by the Dr & the genetic counselor), in detail - which we appreciated.
The PAMF-REI practice is set up in a way, that there isn't continuity of care between multiple doctors, who rotate at different PAMF clinic locations. Overall, the number of patients each doctor sees is likely so high, that the doctor may not remember the specifics of each case, until they look at the patient charts. That made the treatment feel somewhat impersonal.
Communication between nurse practitioners, doctors and coordinators could also be better. It seems that treatment plans, prescriptions and issues/concerns, were not reviewed/understood by the entire team.
Describe the protocols Anthony Dobson used in your cycles at Palo Alto Medical Foundation and their degree of success.
IUI with Clomid, progesterone supplementation.
Describe your experience with your nurse at Palo Alto Medical Foundation. (Assigned nurse: Terri Stewart)
The visit with the NP was long and detailed.
She reviewed all hormone tests, looked for the trends in fertility, and changes in cycle.
Her suggestion of possible luteal phase insufficiency was plausible. However, wasn't communicated to the Dr.
The care coordinator, wasn't aware of medication protocol (e.g. Ovidrel injection was not needed in IUI cycles without Clomid).
Describe your experience with Palo Alto Medical Foundation.
PAMF-REI (like other PAMF specialties), is a practice designed for high patient-throughput. This invariably results in treatments feeling impersonal.
Doctors rotate, case specifics have to be recalled, treatment coordination is left to non-medical staff. (I overheard so many phone conversations while waiting in the lobby, where the appointment staff was having to explain the treatment steps to patients, so they could schedule dates!)
Specifically for the EPA clinic, the doctor isn't available all 5 days. If you want to see the same doctor, you will have to trek to another faraway location (Fremont, San Jose). If your cycle days are on a weekend, ditto for treatment at the SJ clinic. Logistically, that is a nightmare.
My OB-GYN is also in the PAMF system - that helped to get the data from previous tests, and case specifics about some other relevant medical issues were reviewed easily.
Describe the costs associated with your care under Anthony Dobson at Palo Alto Medical Foundation.
Diagnostics (SHG ~ $1204 , some ultrasounds $322) were covered by my insurance. Fertility treatments were not (IUI without medication ~$1384).
What specific things went wrong at Palo Alto Medical Foundation?
- Failed to call in prescriptions to pharmacy
- Failed to inform you of changes in protocol
Describe the specific things that went wrong at Palo Alto Medical Foundation.
Minor things:
* NP didn't put in an order for antibiotic before SHG (the doctor promptly put it in).
* IUI with/without Clomid - protocol change meant certain medications were not needed. Prescription was put in anyway.