Dr. Kaser has wonderful bedside manner. He always made you feel welcome in his presence...The reason I have rated him neutrally is although he was very kind, so many mistakes were made to my care at RMA under Dr. Kaser's care... once we were in the throws of IVF, I felt completely bewildered by our experience - it was not at all how he had presented IVF to us...As soon as we hit rough waters, he completely abandoned us and left us completely lost as to what to do next...
Billing department [at RMA of Northern California] is a NIGHTMARE. I was billed for things that were not done and overcharged for certain procedures even though we had signed a contract for a bundled package...The price of these procedures is not given to you beforehand...Spruce is accessible by the entire clinical staff, not just the nurses and doctors...
How was your experience with Daniel Kaser at RMA of Northern California?
Dr. Kaser seemed so genuinely sweet when my husband and I met him over video visit for our initial consult. He was very caring and seemed so invested in us having the family that we wanted. After my initial ultrasound he was thrilled with my antral follicle count and thought we would be very successful with IVF. I definitely wish he spent more time telling us the truth about the potential steps in the IVF process (he oversimplified the process and never mentioned certain procedures like saline ultrasound, hysteroscopy, birth control, etc.) in our consult, as well as the potential outcomes after an embryo transfer in more realistic terms (he gave us a 70% success rate with our first embryo transfer which was not successful). I am a physician myself (not an Ob) so I expected him to be very thorough in his explanation of all the procedures. He was so generous with his time and sometimes didn't charge us for certain procedures, but once we were in the throws of IVF, I felt completely bewildered by our experience - it was not at all how he had presented IVF to us. During our first frozen embryo transfer, we did get a positive pregnancy test, but there was no yolk sac visible during the initial ultrasound. My HCG level had started really low, but it doubled quickly as expected. Instead of explaining why there was nothing on the initial scan, he ran out of the room looking panicked and said "you need blood work" over his shoulder before heading out the door. My husband and I totally freaked out and started sobbing when he left. We didn't sleep well until our follow up ultrasound 5 days later where thankfully we saw a yolk sac, but unfortunately this transfer ended in a blighted ovum (I had no idea what a blighted ovum was or that it was a potential outcome of a transfer). I had lots of issues with my insurance so I decided to do a D&C outside of RMA. My colleague also went to RMA where she was charged almost $5K for a D&C (she was not told this cost upfront) that was not covered with our insurance so I decided to get the procedure done in my hospital system. I had told Dr. Kaser that I needed a break because I was so devastated by this outcome. I did not feel properly prepared for the potential of a loss after a successful implantation. He never called me afterwards to check in on me after this devastating loss. I was so distressed that I might have put myself at risk for breast cancer (I have a strong family history of breast cancer and was rightly concerned about taking high potency hormone injections for IVF). When my husband called Dr. Kaser crying that I was inconsolable after the loss because of my fear of having increased my chances of breast cancer by doing IVF Dr. Kaser immediately became defensive and said "our drugs don't cause cancer!". I felt completely abandoned, invalidated and betrayed by Dr. Kaser. I could not see him as my provider afterwards even though we still had 3 remaining embryos at that time. I lost my respect for him and no longer felt safe in his care.
I think Dr. Kaser is a great doctor if everything goes smoothly in your case and there are no setbacks. As soon as we hit rough waters, he completely abandoned us and left us completely lost as to what to do next. I think he lacks maturity and will hopefully learn to be a more steadfast guide on this very scary, tumultuous and personal journey for couples.
What's one piece of advice would you give a prospective patient of Daniel Kaser at RMA of Northern California?
Make sure you ask detailed questions about the process. This process costs tens of thousands of dollars, has many risks, and is a LONG journey - you deserve his time. Do not feel rushed to make any decisions while you are in his presence (we did). Think things over and make sure you have all the information you need to make an informed decision. Hold Dr. Kaser accountable when mistakes are made.
During treatment, were you treated like a number or a human with Daniel Kaser at RMA of Northern California?
Dr. Kaser has wonderful bedside manner. He always made you feel welcome in his presence. He also shared his personal IVF journey to make us feel comfortable as IVF is very emotional and overwhelming. The reason I have rated him neutrally is although he was very kind, so many mistakes were made to my care at RMA under Dr. Kaser's care. My hysteroscopy was cancelled an hour and a half before it was scheduled even though I was NPO for 10 hours because the anesthesiologist needed a negative covid test. No one had told me to get a covid test so of course my case needed to be cancelled. Both my husband and I had taken time off work to get this procedure done and we were very upset that this happened when it easily could have been avoided if we were told to get covid tested beforehand. I also had to go back to the clinic 3 times on the same day to get supplies for our IVF injections because of communication error. Every time we messaged on the Spruce app, some random person would respond, not just Dr. Kaser. We also had to wait over a week to get our PGT-A testing results back. Dr. Kaser is usually so prompt in his messaging we were surprised that he took almost 2 weeks to get our results back. My husband even called the lab directly and they said they had already given the results to RMA. When my husband called the front desk about our test results, the secretary told him that they didn't know where our results were (my husband thought they had lost our precious embryos). The whole experience was very traumatizing and could have been smoother with more effective communication. I definitely felt like the clinic dropped the ball several times in our care.
Describe the protocols Daniel Kaser used in your cycles at RMA of Northern California and their degree of success.
I overreacted to the medications so I underwent less medications than I was supposed to do. I believe I did 3 days of gonal F and menopur, then they added Ganirelix until I was ready to do the trigger shot (0.25 of 10,000 units HCG). I was told I was ready for retrieval on my first ultrasound which made me so overwhelmed because I was expecting to do the medications for 2 weeks.
Describe your experience with your nurse at RMA of Northern California. (Assigned nurse: Kristen)
Kristen is a really sweet, but she was so disorganized and became very defensive if a mistake was made because she failed to communicate something important to me. The day before my retrieval she called me panicked because I did not have an HIV test results (and something else sorry I forgot). We had gone over the lab results with our doctor before the retrieval and he said everything was in order. Instead of admitting that a mistake was made she said "Dr Kaser told you to get this done". He did not. We were given a list of lab tests to be done. I showed them the tests that I had done. They said they had reviewed them but clearly they did not. I had to wake up 2 hours early to go to the lab to get these last minute tests done before working as a physician myself in order to get the results to them prior to the retrieval. The retrieval was SO stressful and having this last minute test done added unnecessary stress. I also had so many nurses interact with me who often didn't know my protocol (or anything about me). When Kristen did call with HCG results she was always professional and sweet, but it was not consistently her who was calling me.
Describe your experience with RMA of Northern California.
- RMA can get you in super quickly and they will churn and burn you.
- They are open 7 days a week so a modified natural cycle is a possibility at this site.
- They use an app called Spruce to communicate with you. You can expect a response from someone on the team within 2 hours (sometimes as quick as 5 minutes!).
- The staff are very welcoming and kind.
- Billing department is a NIGHTMARE. I was billed for things that were not done and overcharged for certain procedures even though we had signed a contract for a bundled package. We needed to get the central billing department involved and we still do not have our issues resolved. The billing is not transparent and the person who we are interacting with is not consistent in emailing you back and gives you contradictory information. SO FRUSTRATING.
- You feel very pressured to keep doing procedures. The price of these procedures is not given to you beforehand.
- The IVF process was oversimplified and the expected outcomes over promised. For something as intimate as having a family, I would expect these doctors to deliver more realistic odds of success and to have more compassion when things go wrong. Most other clinics have a follow up check in 6 weeks after a loss so you don't feel lost and abandoned by your clinic. My friends who have gone elsewhere thought the fact that our doctor never reached out to us was inhumane and just mean.
- You are definitely treated like a lab rat as a woman at RMA - poked and prodded SO many times with no impact on your outcome. Your protocol is not tailored to you at all. It is there way or the highway.
- I also think they promote procedures to get more money without always adding to your clinical outcome. I think it is wrong that they added certain blood tests without my permission (of course not covered by my insurance) just for monetary gain.
- Spruce is accessible by the entire clinical staff, not just the nurses and doctors. I remember receiving a message from one of the billing staff about my vaginal bleeding and I was horrified. I asked that my account remain private to just MD/RNs but that is not possible through the Spruce app. I felt like this was an invasion of my privacy and I wish someone had told me this before I started using it.
Describe your experience with your monitoring appointments at RMA of Northern California.
Monitoring appointments were so overwhelming. We would get an appointment slot but the doctor would be doing an egg retrieval or something else in an entirely different area so you were often asked if you wouldn't mind seeing the NP instead. I am not sure why they offered appointments when the doctor was not available. I found this very frustrating.
Describe the costs associated with your care under Daniel Kaser at RMA of Northern California.
IUI was around $650; egg retrieval cost around $14K, drugs for IVF cost around $4.5K; transfer was supposed to cost $4200, but ended up being $4500-7000+ for each transfer not including medications.
Describe Daniel Kaser's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at RMA of Northern California.
I agree with only transferring one embryo at a time. It did not seem like RMA promoted multiple embryo transfers.
What specific things went wrong at RMA of Northern California?
- Lost appointments
- Failed to call with results
- Lost results
- Provided conflicting information
- Failed to convey critical information
Describe the specific things that went wrong at RMA of Northern California.
We were not given our PGT-A test results during the time frame promised (7 days). When we called the lab who did our testing on a Wednesday, they said they had already sent it to RMA on the previous Monday. When my husband called RMA about this, the front desk staff said they didn't know where our test results were. My husband thought she meant they lost our embryos and we were both so upset. Thankfully Dr. Kaser called us the following evening to go over the results, but this was so upsetting and completely avoidable.
I was told I needed an emergent hysteroscopy after Dr. Kaser saw something on my saline ultrasound on a Friday. We were told to do the procedure on Tuesday when we both had work. We cancelled our work schedules, I was NPO since the night before and then 1.5 hours prior to my procedure, Dr. Kaser called to ask me if by chance I had a covid test done. I was not advised to do a covid test and didn't need one for my egg retrieval a couple weeks prior so I was surprised that he didn't tell me about this requirement. The anesthesiologist refused to see me and my scope was cancelled. My husband is a lawyer and had to cancel he had with a team in Japan and I am a physician so I had to cancel my clinic. I was so upset about this cancellation and had to wait until the following Wednesday to get the scope done.
I had specifically asked how painful the hysteroscopy was but Dr. Kaser said I shouldn't have any issues since I had no pain after the egg retrieval. I woke up with 8/10 pain while still foggy from the anesthesia and needed two boluses of fentanyl to stop sobbing from the pain. When I informed him that I experienced a lot more pain than I had expected he dismissed me and said "cervices are irritable". I was LLIVID with this response. We are taught in medical school to show compassion and to say you are sorry if things do not go well. He has never said he was sorry for causing me so much pain.