Infertility providers' and patients' views and experiences concerning doctor shopping in the USA.

Many questions arise concerning how infertility patients decide whether, how much and why or why not to consult more than one doctor and change physicians. To explore this issue, a total of 37 US in vitro fertilization (IVF) providers and patients were interviewed in-depth. Many infertility patients feel disappointed with infertility providers, especially after treatment failure, and then struggle to evaluate and weigh relative 'bedside manner' against technical skills, finances and hope, facing dilemmas of which doctor to choose, whether and how much, to 'shop around', how to do so, and whether and how much to give doctors 'second chances'. Complex, dynamic processes can ensue: shopping for initial or subsequent physicians and consulting and/or changing doctors multiple times, based on differing treatment approaches. Patients may alter perceptions of physicians over time. Providers are often busy and have difficulty addressing patients' emotional stresses; and may provide providing 'false hope', and/or criticize colleagues' approaches. These data, the first to explore how infertility patients decide whether, how and why to consult with more than one infertility doctor, suggest that patients may 'doctor shop,', engaging in dynamic processes, wrestling to weigh communication vs. other skills. These data have important implications for future practice, research, guidelines and education.