The People Patients Remember: The Role of Individual Care in Fertility Treatment

Ask a patient what made their fertility treatment bearable, and the answer is very often a person rather than a process. It might be a nurse who took the time to call after a difficult appointment, a receptionist who remembered them when they came back to clinic, or an embryologist or technician who recognised that a particular conversation needed more time and care than usual. These individual interactions can have a lasting impact on how someone remembers their treatment, sometimes long after the treatment itself has ended.

I have now carried out three separate studies within my fertility support communities, asking patients to reflect honestly on their experiences of fertility treatment. I wanted to understand what had made their experience more difficult, what had helped them through it, and where they felt clinics could make a difference to the emotional experience of treatment.

Across all three studies, two themes have consistently stood out. When patients described aspects of their experience negatively, one of the most common feelings was that they had been treated as though they were simply another number within the system. Patients talked about feeling processed, rushed or as though the focus was on the next stage of treatment rather than on them as an individual.

When patients talked positively about their experience, however, their feedback was very often centred around a particular member of staff who had gone above and beyond. What is striking is how specific these memories can be. Patients can remember a person's name, something they said, the way they handled a difficult conversation or the fact that they took a few extra minutes to sit with them. In some cases, these are memories that remain with patients years after their treatment has finished.

This contrast has stayed with me because it raises an important question about where patient experience is actually created. It is easy to think about patient experience in terms of policies, systems and pathways, and these things are undoubtedly important. Clinics need good processes, clear communication, appropriate support and well-designed patient journeys. However, the experience of those processes is ultimately lived through interactions with people, and some of the most important moments can happen in very small and seemingly ordinary exchanges.

A nurse who notices that a patient is unusually quiet and takes a moment to ask how they are really doing can change the experience of that appointment. A member of the team who remembers something that a patient mentioned at their previous visit can make them feel seen rather than processed. Someone who has to deliver difficult news can choose to slow down, move somewhere private and allow the patient time to absorb what they have heard rather than immediately moving on to the next clinical question.

One patient's reflection from my research captures this particularly well:

“I felt this was down to individuals I had made a connection with rather than clinic policy. I had 2 nurses, S & T, who were lovely and called to check how we were doing. S always tried to get me on her lists when she sees me in clinic. I had the same lovely technician, T, who had to tell us on 2 occasions that we had no heart beat and as heart breaking as it was for us, I could see how emotional he felt sharing this with us too. He took us to a private room to talk and gave us all the time we needed. When I’ve seen him since he had always been great too. In terms of consultants, whilst I feel she is extremely knowledgeable etc I haven’t had the emotional support.”

There is a lot to consider in this feedback. The patient remembers the nurses who called to check how they were doing and the nurse who tried to make sure they saw her when they returned to clinic. They remember the technician who had to tell them, on two occasions, that there was no heartbeat. They remember that he appeared affected by having to share that news with them, that he took them somewhere private and, importantly, that he gave them the time they needed.

None of these things are particularly complicated. They are not examples of an entirely different model of fertility care. They are examples of people responding thoughtfully to another person at a very difficult point in their treatment.

The comment about the consultant is also interesting. The patient makes it clear that they recognised the consultant as extremely knowledgeable, but knowledge and emotional support are not necessarily the same thing. This isn't about suggesting that every member of a clinical team should communicate in exactly the same way, or that every patient needs the same level of emotional interaction. It is about recognising that technical expertise and emotional experience are both important parts of fertility care, and that patients can notice the difference.

I know from the conversations I have with fertility teams that this is not usually because staff do not care. In fact, the opposite is often true. Staff are working in an environment where they are supporting people through highly emotional circumstances while also managing busy clinics, competing demands, staffing pressures and the need to deliver safe and effective clinical care. They may have several difficult conversations in a single day and very little opportunity to stop and reflect on how each one has affected them or the patient.

That is why I don't believe improving patient experience is simply about asking staff to do more. Fertility teams already have enough demands placed upon them. The more useful question is how we can help them make the interactions they are already having more supportive and consistent.

Sometimes it isn't about adding ten minutes to an appointment. It may be about what happens during the minutes that are already available. Do we pause before moving on to the next question? Do we notice the patient's reaction to what we have just said? Do we give them an opportunity to ask what they need to ask? Do we recognise when someone needs a little more time? Do we explain what happens next so that they don't leave feeling uncertain about where they go from here?

These are relatively small changes, but they can have a significant effect on how a patient experiences their treatment.

There is also an important organisational point here. A clinic shouldn't have to rely on patients being fortunate enough to encounter the particular nurse, technician or receptionist who naturally provides this kind of care. Individual staff members will always bring their own personalities and strengths to their work, but compassionate communication and emotional support should not be left entirely to individual instinct.

The aim should be to create a culture where everyone understands their role in the patient experience and has the confidence and practical skills to handle those moments well. That doesn't mean every interaction needs to be scripted, nor does it mean removing the individuality that makes a good clinician or member of staff so valuable. It means creating a shared understanding of what good emotional care looks like and giving teams practical tools that they can adapt to the individual patient in front of them.

This is particularly important when things don't go to plan. A failed cycle, an unexpected result, a cancelled treatment or a negative pregnancy test can be moments that patients remember for a very long time. The clinical information is important, but so is the way in which that information is delivered and what happens immediately afterwards. Staff cannot change the result, but they can influence whether a patient feels hurried through it or supported while they process it.

For me, that is at the heart of good patient experience in fertility care. It is not about creating a perfect experience, because fertility treatment is inherently uncertain and there will inevitably be difficult and disappointing moments. It is about making sure that patients feel that there are people within the clinic who see them as an individual and understand that, for them, this is much more than another appointment, another result or another stage in a treatment pathway.

Patients may not remember every detail of their treatment, but they often remember the people who made a difficult experience feel a little more bearable. They remember the person who sat with them, the person who called, the person who noticed, and the person who gave them time.

That is why patient experience needs to be something we build into the culture of a clinic rather than something we hope individual members of staff will naturally provide.

My training and workshops for fertility clinics focus on helping teams develop that shared approach, with practical tools and conversations around patient experience, emotional support and the more difficult moments in fertility care. The intention isn't to add another layer of work to already busy teams, but to help staff feel more confident about the interactions they are already having and to create greater consistency in the experience patients receive, whoever they happen to see.

Because ultimately, the question I keep coming back to is a very simple one: when a patient looks back on their treatment, what will they remember about the people who cared for them?

If you'd like to know more, email me at [email protected]