A few years ago, I dipped my toe into the pool of living with a chronic illness: out of the blue, constant, chronic migraines hit. Within weeks I was spending most of my days in bed. Luckily, I grew up surrounded by health care practitioners (HCP) – my dad is a doctor, and many of his friends and our family friends are health care practitioners as well. Health care practitioners include doctors, nurse practitioners, physician assistants, midwives, certified nurses, and anesthetists, and so on. This meant I had some idea of how to talk to doctors and present my case well. This was important because suddenly, so much of my time was spent at doctor’s offices.
But my skills weren’t developed enough: I had to learn how to advocate for myself in a way I never have before. And through discussions with other people dealing with migraines or chronic illnesses, I discovered how hard it can be to effectively talk to health care practitioners.
So many times we’ve left appointments feeling frustrated or with an overwhelming sense of, “Huh? What just happened there? Did they even listen to me?” If this sounds familiar or if you’re worried about expressing yourself correctly with health care practitioners, buckle in – we’ve got you covered. Dr. Kim Choma, Women’s Health Nurse Practitioner, is here to help.
Preparing for the Visit
Before even getting to the doctor’s office, it’s a good idea to prepare first. A good first step if it’s the first time visiting the practice is to fill out any paperwork before your first visit. You can ask for a copy of it via email when you set up the appointment. Dr. Choma mentioned that this “will take the pressure off of the patient to fill it out quickly … they often leave information off the form that is important to know. Don’t rush: fill it out ahead of time.” If it’s not your first appointment, think about how you are compared to the previous appointment. How have things changed or stayed the same?
If there’s enough time (e.g., a few days or weeks), try keeping a log of your symptoms and concerns: “timing, what makes the symptoms better or worse, and previously attempted treatment (such as medication or alternative medicine like acupuncture)” are useful factors to track, Dr. Choma notes. Who knows, maybe you’ll even find a pattern in your symptoms yourself – another tool for your doctor when they create your care plan!
Another recommendation from Dr. Choma is to do some initial research. Look into different resources to find “credible websites (such as the Center for Disease Control or National Institutes of Health, or society webpages) that can add more information to your pool of knowledge … once you read different websites and articles, you will be able to find the information you need!” Researching this information can help you ask your doctor intelligent questions or suggest changes to your treatment and care plan. Additionally, “using these types of sites can help you come up with questions, especially if something different is happening to you than what the source states.”
What do HCPs wish their patients knew? “I wish they knew more about their own medical history, family history, and surgical histories. Many patients don’t recall when they had a surgery or the name of it.” If you don’t have it off the top of your head, that’s okay! Try looking up your files or calling your previous doctor for more information.
While you’re at it, Dr. Choma recommends “exchanging medical information with your family so your history is complete!” This is important for doctors, she adds, “to determine what you may be at risk for.”
This isn’t only beneficial for health care practitioners: “knowing this information empowers a patient to have a professional relationship with the health care professional that is more meaningful.” So, start keeping track of your pap smears, colonoscopies, and general checkups! This is easier than ever since many practices have online portals people can sign up for to track and view their records and test results. Ask your practice if they have one – if not, they can give you a copy of your records at any time!
- Keep track of your symptoms, when they occur, and attempted treatment methods in a symptom diary.
- Research your concerns before the appointment to help you ask questions and discuss treatment plans.
- Talk to your family to get a complete medical history.
- Keep track of your appointments, tests and procedures, and their outcomes.
- Use your doctor’s patient portal.
At the appointment
So you prepared for the appointment, battled through traffic, arrived at the health care practitioner’s office on time, checked in, and then … you’re in the waiting room. After sitting there for what seems like an eternity, you finally get to see the doctor or HCP, but you feel like they’re rushed. How can you get through all of your concerns and questions?
Here’s where all of the preparation comes into play. Tell your HCP about your symptoms, research, and any updated history or information. Dr. Choma suggested using a polite, calm phrase such as this as an introduction: “I know you are very busy with your time, but I do need to address some things that consistently bother me because I am not getting relief. To save time, I wrote down some questions to ask you.”
If you’re still confused, that’s okay! Dr. Choma recommends calmly saying, “Last time we talked about …. Since then, I (have stayed the same or had other symptoms emerge). I don’t understand why this is happening to me. Can you please explain it to me again?”
Describing Treatments and Symptoms
Dr. Choma recommends using a pain scale from 1-10 as a baseline when describing pain severity. But if the HCP just isn’t getting it, put them in your shoes by describing what the pain feels like. Dr. Choma sees both the patient and the practitioner’s side: “I’ve been known to say to HCPs that my migraines are so bad that I wish I could take a hammer to the left side of my head. That has gotten their attention before.”
If you’re analyzing or comparing treatment methods or medications, a 1-10 scale works again: tell your doctor in numbers “how medical treatments or alternative treatments rate for you.”
If you would like to modify an existing treatment plan, tell your doctor why. Is the current plan too difficult to stick to? Do the side effects of the medication outweigh the benefits of it?
Proposing your researching
Perhaps while reading different websites, you found some treatment methods that you would like to discuss. Dr. Choma suggests bringing it up in the appointment. “Many HCPs are open to hearing other treatment ideas. Some may be aware of the ideas already but feel they are not effective and don’t mention them to the patient. It can’t hurt to ask!” This has an additional benefit: proposing or using a treatment or care plan that you helped devise can be very empowering!
- Don’t be afraid to list your questions or ask for clarification.
- Describe symptom severity using adjectives or a 1-10 pain scale.
- It never hurts to ask – always bring up alternate treatment ideas!
How can we ensure that health care practitioners treat us in a way that’s respectful of our minority status, such as people of color or people in the LGBTQIA+ community?
Dr. Choma recommends looking for practices that use inclusive language. “When you call to make an initial visit, ask if the practice does this. I once had a patient who was assigned female at birth, but is transgender and uses ‘he’ pronouns. Michael needed to come to me for routine gynecological care. He was afraid to explain himself at first, so his mother called the office first and asked to speak to me. This was a good idea because I was able to prepare the staff for the patient. I explained to the staff what was going on so they would not make him feel uncomfortable. People are not used to seeing a male patient in the waiting room of a gynecologist. But a little information for the staff went a long way towards making him feel comfortable!”
That being said, be prepared for hiccups along the way. I am married to a woman, and my wife wanted to make an initial appointment for herself with my gynecologist. She started the email with, “my wife is a patient of yours; I’d also like to become a patient and make an initial appointment.” When the receptionist heard the word “wife,” they assumed that my wife was actually my husband, and were very confused! When in similar situations, speak as clearly as you can but expect bumps along the way: miscommunication happens.
Talking to friends to find recommendations about who they go to for health care can go a long way towards finding HCPs you’re comfortable with.
- Talk to the doctor or office staff about different pronouns or concerns you have ahead of the appointment.
- Utilize your network and see which doctors your friends recommend – and which to stay away from!
Knowing when it’s time to move on
Sometimes, even after a long professional relationship with a doctor, you aren’t progressing anymore. “There are times when an HCP doesn’t have all the answers … ask them if they feel stagnated by your case or if they have known of a friend or family member that has the same condition,” Dr. Choma advises. “How does it make them feel?”
If you weren’t given an official diagnosis, or there are problems with a doctor, “a second or third opinion” may be advisable, according to Dr. Choma. Alternatively, you can ask your current doctor “if they think another opinion will help. If time continues and nothing changes, it may be time to find another doctor.”
Then, sometimes, there are the worst-case scenarios: you’ve done your research, you come prepared to the appointment, and the doctor is just dismissive. Sometimes, a stubborn health care practitioner might refuse to run a test or explore a possible cause of an illness or set of symptoms. In this case, try bringing a second person with you to the appointment to act as a buffer and to help you ask questions or provide support. If a doctor refuses to run a test, have them note in your file that they won’t run the test and the reason. Then get a copy of your file and bring it with you to the next doctor.
Above all, do what makes you comfortable! If the doctor doesn’t work for you, even if they’re highly rated, that’s okay! Find one that works for you.
- Try getting a second opinion.
- Be comfortable with the fact that not every doctor works for every person. Try and see what works for you!
Managing your health, finding the right doctor, and preparing for appointments can be draining. It’s important to try to care for your emotional health during this time. “I strongly believe in acupuncture and meditation,” Dr. Choma encourages, “Meditation does not cost you anything – you can find videos on the web to guide you! Even if you feel yourself floating away, give it a chance. It gets easier over time.”
These are just some of the many tips out there for talking to health care practitioners that you can use as a springboard to become empowered in handling your health and care! Experiment a bit: see what works for you and create your own personal brand of self-advocacy.