jcash Posted January 5, 2017 Share Posted January 5, 2017 Hello! I just interviewed at a job that sounds intriguing but I'm unsure. Wondering if anyone has worked in this area? The practice started as an IVF clinic and some pt just had repeat miscarriages or did not conceive and once a genetic screening was run there were certain mutations that came up could be fixed with certain supplements to optimize conception and keeping the pregnancy to delivery. They now run them in a PCP like setting as well. It sounds really nice and interesting. But the down sides are it's kind of a niche practice, mostly cash pay pts, I might have to push supplements, far drive and so so salary. Pros are I think genetics are a direction medicine is heading in and seems interesting to learn more. Anyone have any experience doing a job like this? Thank you! Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Febrifuge Posted January 5, 2017 Share Posted January 5, 2017 Sounds sketchy. I would need to see a big pile of good evidence that these supplements can actually fix the problems - and also, evidence that the genetic testing really is uncovering problems that directly cause the poor outcomes. That's thing one. Thing two is the cash basis; that can be fine, but historically, if something isn't covered, the bias is that it's not necessary, or not validated and evidence-based. Just on the basis of professional ego, I'd be wary of being part of a practice that works the way low-T or dermabrasion clinics do. Right or wrong, that's my gut reaction. Thing three is that people struggling with IVF issues are vulnerable, and potentially desperate, open to badly-validated treatments. That doesn't mean that every nonstandard modality is a rip-off, but it certainly raises some flags. ExtraordInary claims require extraordinary evidence. So we're back around to the first point. I would go to an interview, and treat it as an informational meeting. A good clinic would appreciate seeing skepticism, compassion, and intellectual rigor from an applicant. A sketchy, scum-sucking, opportunistic outfit would see those qualities and run away fast. Link to comment Share on other sites More sharing options...
jcash Posted January 5, 2017 Author Share Posted January 5, 2017 Sounds sketchy. I would need to see a big pile of good evidence that these supplements can actually fix the problems - and also, evidence that the genetic testing really is uncovering problems that directly cause the poor outcomes. That's thing one. Thing two is the cash basis; that can be fine, but historically, if something isn't covered, the bias is that it's not necessary, or not validated and evidence-based. Just on the basis of professional ego, I'd be wary of being part of a practice that works the way low-T or dermabrasion clinics do. Right or wrong, that's my gut reaction. Thing three is that people struggling with IVF issues are vulnerable, and potentially desperate, open to badly-validated treatments. That doesn't mean that every nonstandard modality is a rip-off, but it certainly raises some flags. ExtraordInary claims require extraordinary evidence. So we're back around to the first point. I would go to an interview, and treat it as an informational meeting. A good clinic would appreciate seeing skepticism, compassion, and intellectual rigor from an applicant. A sketchy, scum-sucking, opportunistic outfit would see those qualities and run away fast. Thank you for you input! I thought all those thoughts too. I asked to shadow the other PA for a day. They said no since it was proprietary information. Which was irritating. My gut is saying this is a cool practice that I wouldn't mind knowing my genetics BUT do I want to sell that everyday. I'm not sure. But I feel like if I'm this skeptical already it may not be a good fit...... Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
camoman1234 Posted January 5, 2017 Share Posted January 5, 2017 Thank you for you input! I thought all those thoughts too. I asked to shadow the other PA for a day. They said no since it was proprietary information. Which was irritating. My gut is saying this is a cool practice that I wouldn't mind knowing my genetics BUT do I want to sell that everyday. I'm not sure. But I feel like if I'm this skeptical already it may not be a good fit...... Sent from my iPhone using Tapatalk Why couldn't you shadow if you signed a non-disclosure agreement. Same type of agreement if one is getting finical statements/balance statements, etc if one is thinking about buying out a practice. I would not be against digging deeper into this possible opportunity. You never know unless you dig for it. Link to comment Share on other sites More sharing options...
cbrsmurf Posted January 5, 2017 Share Posted January 5, 2017 Situation is weird, but, just because it's not covered by insurance doesn't mean it's not evidence-based. Most IVF procedures are not covered by insurance, even if there is a clear medical reason for infertility. There certainly are genetic conditions that can cause infertility. I don't know what exactly they are screening for with genetic testing, but most genetic causes of infertility as pretty serious as far as I know and 'supplements' are not going to fix that. This isn't really my specialty and I don't know enough about the literature or research in this area as I would like to, but whenever I hear 'supplements' being pushed, it immediately triggers skepticism and most of the time ends up being snake-oil. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted January 6, 2017 Share Posted January 6, 2017 As a former fertility patient who had a full karyotype done looking for these issues -- supplements ain't gonna do anything. Translocation of foci, deletion and mutations don't just adapt and not to something like boswelia or some funky plant. If a genetic problem is located - options include sex selection to avoid X linked or Y linked issues, use of donor sperm or eggs or adoption or the crap shoot of 25, 50% chance of the mutation knowing that the presence could lead to miscarriage, deformity, disabilty or lifelong problems or shortened lifespan. I haven't seen any new pt therapies for gene splicing. Things like IVIg, heparin and immunosuppression can improve autoimmune rejection of pregnancy - been there. All with risks, costs and emotional tolls. Any clinic that promises results for cash using proprietary info is likely full of poo and about as useful as standing on your head after sex to conceive. I would say loudly -- BEWARE. Playing with folks' emotions for cash is a slippery slope towards ethical decline.... Just my 2 cents and prior experience Link to comment Share on other sites More sharing options...
jcash Posted January 6, 2017 Author Share Posted January 6, 2017 Thank you everyone! I decided to decline the job. I think it has potential and the idea is good but more research needs to be done. I appreciate all the input! Once again this forum has really helped me! Now onto another job search Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
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