Mohamed Taranissi: 'I am not your standard person. I do things my way'
The Monday Interview: The world's most controversial IVF doctor tells Jeremy Laurance how he has seen off his many enemies
Monday 06 December 2010
He is the bad boy of the fertility world. He has been the subject of a criminal investigation, a police raid, a disciplinary hearing, and a savaging by the BBC Panorama programme. He has clashed repeatedly with the fertility regulator, the Human Fertilisation and Embryology Authority (HFEA), and is loathed by his professional colleagues. Lord Winston once said he "makes you weep for the medical profession".
Yet Mohamed Taranissi is still Britain's most successful in-vitro fertilisation (IVF) specialist as well as being one of the richest. His clinic, the Assisted Reproduction and Gynaecology Centre, has topped the league tables every year since it opened in 1995. The latest results, published by the HFEA in August, showed his pregnancy rate for women under 35 was 64.3 per cent, twice the national average and a third higher than his nearest rival. For older women over 40, the clinic also tops the league with a pregnancy rate of 41 per cent, again a third better than its nearest competitor. Doctors don't come closer to God than this.
Taranissi is the archetypal maverick, defying the rules, taking on the medical establishment and determined to prove he is the best. Remarkably, he has won all his battles, including libel actions against the HFEA and Panorama (which cost the BBC well over £1m). The warrant for the police raid on his premises obtained by the HFEA was quashed by the court, and nine cases referred to the police for criminal investigation were thrown out. The disciplinary hearing before the General Medical Council involving two patients who complained they were mistreated was abandoned for lack of evidence.
Now the HFEA itself is to be axed under the "quango cull" announced by Andrew Lansley, the Health Secretary, with its regulatory function absorbed into the Care Quality Commission. An internal inquiry into its mishandling of his case has been postponed nine times and its report is now due to be presented to the authority in January. Taranissi's victory seems complete.
But while he may lay claim to the title of Britain's greatest IVF specialist, professional rivals still doubt his figures. Quite simply, they seem too good to be true. How does he do it?
The first thing that strikes the visitor to his clinic in Wimpole Street, next to Harley Street in London's West End, is its modesty. It may be one of medicine's poshest addresses, but there is nothing posh about the interior. Taranissi's consulting room on the first floor looks distinctly tired. Files are piled in boxes on the floor, thank-you cards from grateful patients fill the fireplace, ageing photos – some of his own children, some of patients' – are propped against the walls, which are in need of a lick of paint. The doctor himself, in blue operating theatre "scrubs", is seated behind a desk piled with papers. He peers at an elderly desktop computer from which he prints out on an ancient fax machine.
This is the haunt of a man whose fortune was once estimated at £38m. One thing is immediately clear – he is not interested in spending it. Born into a wealthy Egyptian family he says he has "always been in a fortunate situation". He does not own a car and has not had a holiday or travelled abroad since a weekend business trip to Chicago in 2002. The money is important to him not for what it can buy but as a measure of his success.
"I am not into materialistic things. About four years ago my bank manager came to see me. All the revenues we were generating from the clinic were sitting in a current account [earning no interest]. He kept asking me why – he thought I must have a plan. I had never thought about it."
His unworldliness is evident in other ways. He does not mix with colleagues or attend conferences and, as a Muslim, does not drink. He has five children aged 27 to nine but confesses to not having known the name of the school in Knightsbridge where the youngest went. His son, aged 12, is a singer – but Taranissi has never heard him. He lives with his wife and family in a large flat round the corner from the clinic but works seven days a week, only in the last four months taking a few hours off on a Saturday to visit his sick father. He does not know how many staff he employs – "about 50" – or how many patients he treats in a year. He concentrates on what he does best: work.
"There hasn't been a single day when I have not been here. I wouldn't say it is ideal – it is just the way it is and everybody accepts it. I try to stay focused on my work and keep doing what I do because I know that one day it will end and I like to make myself useful while I am capable. I may be hard on people but they know I am hard on myself."
It is 7pm, the end of another long day, and the staff have left. But Taranissi seems eager to talk. In the course of our 90-minute conversation he is open, cheerful, self-deprecating, familiar with every charge against him and comfortable answering each one.
His rivals claim his results are achieved by cherry-picking the healthiest patients. He says, on the contrary, that many of his patients are refugees from other clinics who have failed treatment elsewhere. The HFEA refused to publish his success rates at one stage, but later backed down. Tensions came to a head when it joined forces with the BBC, launching a police raid on his premises in full view of the cameras, on the night that the Panorama programme was broadcast in 2007. Ultimately, Taranissi won his disputes with the regulator, but only after years of costly legal action.
Now he keeps a close eye on what they do – checking their website regularly. He even corrected a figure they had given me for their annual budget. "I know it looks personal. I think it has been personal. It is sad. I know I have not been easy to deal with but I have always wanted to do the best for my patients. They have tried their hardst to undermine me – we have been audited trillions of times. What am I supposed to do? Do they want me to underperform to please people? It is really shocking."
A more substantive criticism of his methods is that he transfers multiple embryos to increase the chances of a successful pregnancy. But a twin or triplet birth increases risks for mother and babies as well as imposing a burden on the parents and the NHS, and the HFEA has set targets to reduce them. Taranissi's multiple birth rate is one of the highest but he remains unrepentant. "You need to put yourself in the patient's shoes. They may have been trying for a baby for years, spent God knows how much money and you tell them you can only put a single embryo back. How will they feel about that? There needs to be a dialogue between the clinician and the patient and they need to come to a sensible decision."
He is also charged with offering an unproven treatment called reproductive immunology for women who have suffered repeated miscarriages. This was one of the allegations levelled by the Panorama programme at the instigation of the HFEA but later withdrawn by the authority.
"For a woman to have a baby she needs good embryos, the right protocol and her body prepared in the best way. Many people in the IVF world don't believe there is a problem of implantation. We believe there is. It is very clear to me that [for women who had failed] the problem was never to do with their embryos, it was to do with what we put them into [the womb]. So we give them drugs, depending on what the problem might be. We don't know all the answers. We know some of them. There is a continuous effort to find out what helps."
His treatments are reputed to be the most expensive, but he denies this too. The clinic prices are published on the ARGC website – a single cycle costs a basic £2,500, the lowest in London bar one (the Homerton IVF clinic charges £2,450). The basic price does not include the cost of drugs or blood tests which can double it in any clinic. The difference at ARGC is that patients are monitored and tested daily – and each test adds to the cost.
But this, Taranissi says, is the secret of his success. "The way we work here is individualised to each patient. We don't have a one size fits all approach. If you are dealing with people who have failed you have to be more vigilant. It is not an easy way to do things. I still see the files of every patient every day, seven days a week. I still make all the decisions about what happens in a cycle. It means reviewing results, communicating with the patients, so each stage of the process can be carried out at the right time. It is a huge stress on the system."
What sets Taranissi apart from his rivals is his obsessive attention to detail. How long can he keep it up? Now 56, he has maintained his punishing workrate for 15 years, achieved extraordinary success and amassed more money than he knows what to do with. He insists his work is his passion and he can't slow down - "I only know one way of doing things". But he accepts that one day "this body" will not be up to it. It is a day he seems reluctant to contemplate - so he keeps working.
He is intensely competitive – determined to be at the top and to stay there. The recognition he lacks from his colleagues he gets from his patients. You can't argue with a woman taking a longed-for baby home – or with an IVF specialist clutching an armful of thankyou letters.
The case against him is that people can be harmed, desparate patients are especially vulnerable and it is incumbent on doctors in the rapidly advancing field of fertility treatment to play by the rules. Yet there is little evidence of harm. Over four million babies have been born by IVF globally and there is no queue of patients wishing to complain about the treatment they have received at ARGC. "I am not your standard person. I like to do things my own way," he says.
That may infuriate the HFEA but Taranissi's supporters seem unperturbed – so long as he continues to deliver the babies they seek.
Life in brief
* 1954: Born Cairo, Egypt
* Educated: Egypt and France
* 1976: Qualified in medicine, Cairo University
* 1983: Moved to the UK. Worked in hospitals in Cardiff, Sheffield, London
* 1996: Fellow of the Royal College of Obstetrics and Gynaecology
* 1995-present: head of private fertility clinic, Assisted Reproduction and Gynaecology Centre
* Married with five children
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