There are lots of factors that impact a person's ability to go to the doctor, from affordability to lack of transportation. But Tina Gupta, MD, co-founder of The Lifestyle Cure—a blog dedicated to expanding health beyond the doctor's office—says that many people avoid the doctor out of fear of how they'll be treated. "I think a lot of patients hesitate to advocate for themselves for fear that the doctor will get angry or get mad," says Dr. Gupta. "A lot of times, patients are scared entering a doctor's office already, so asking questions which might 'upset' the doctor may discourage them from questioning them further—and I don’t blame the patient for this. We as doctors should make the patient feel comfortable enough to ask questions. To me this tells us that we are doing something wrong to instill a kind of fear in our patients that they don’t feel right in asking about their own health."
"A good doctor will not only recognize that but applaud you for taking control of your health." —Tina Gupta, MD
For Black Indigenous people of color (BIPOCs), the doctor-patient relationship can feel even more strained, and—at its worst—toxic. Research has well-documented proof that Black people and minority groups in the U.S. experience more illness, worse health outcomes, and premature death. Systemic racism in the medical profession coupled with past unethical experiments on people of color—from forced sterilizations to the infamous Tuskegee experiment—has also created deep distrust of doctors in many BIPOC communities. Many BIPOCs also report feeling unsupported and even unbelieved by their white doctors.
Advocating for yourself in health settings is a common piece of advice people dish out, especially when combatting health disparities. Dr. Gupta says it's crucial to know what questions to ask so that you champion your own health next time you find yourself sitting in a plastic chair, reading a decade-old copy of Us Weekly, and waiting for your name to be called.
"As a patient, you can challenge your doctor on their thinking in a way that gets your point across but is not confrontational. Your doctor wants the best for you but if you feel in your gut something is not right, don’t hesitate, speak up," says Dr. Gupta. "A good doctor will not only recognize that but applaud you for taking control of your health."
But speaking up to someone with multiple degrees, particularly when you're swathed in a paper gown in a freezing-cold exam room, is easier said than done. Below, you'll learn exactly how to do just that in concrete steps to take before, during, and after your visit.
How to advocate for yourself at the doctor—step by step
Before your appointment:
1. Research and choose the best doc for you
Just like you wouldn't go on a date with just anyone, you should avoid picking a random doctor on ZocDoc and going into the appointment blind. Instead, comb their Yelp reviews with a fine-toothed comb, ask a friend who they go to, and if they'd recommend them, and don't be afraid to call practices and ask questions if you need to. If you're BIPOC and/or a member of the LGBTQ+ community, this research is doubly important. If you're Black, this is a good website to search for your physician.
2. Call your doctor's office and express your expectations for the visit
So you've made your appointment. Usually, after that, everything goes into autopilot: You show up, fill out forms, step onto the scale, find out if you've grown taller since your last visit, and so on. Dr. Gupta says you should break this cycle before your appointment by giving your doctor's office a ring.
"When making the appointment for your annual physical, ask the receptionist that she pass along certain information to your doctor," advises Dr. Gupta. "For example, if you have an eating disorder and prefer not to be weighed or want to be weighed with your back turned to the scale, this can be expressed before entering the doctor’s office." Similarly, many people experience what Dr. Gupta calls "white coat hypertension," or increased blood pressure readings at your doc's office due to nervousness and anxiety. If that's the case for you, call beforehand to tell your physician's office so they can know what to expect.
3. Prepare yourself with research, questions, and concerns
"Come up with a list of questions you know you have on your mind that you need to be answered or addressed in any visit," says Suzie Welsh, RN, founder of Binto, an on-demand personalized health-care service. "For instance, if you're dealing with any symptoms please write it down! Once we get into the room, we can forget everything we wanted to review."
Dr. Gupta agrees, adding that you can bring up your own research and that it might even be helpful to write down your symptoms so that you don't have trouble recalling them when speaking with your medical professional. "Most appointments only allow about two complaints and are limited in time, which is why it’s crucial you get the most out of them," she says. "Include a list of medications that you take or anything the doctor asked in your previous appointment—blood pressure readings, blood glucose readings, etcetera."
During your appointment:
4. Don't be afraid to take notes or record while you're there
Sometimes, the information you receive at the doctor's office can fly at you quickly before you have time to think, process your questions, and ask them. That's why Dr. Gupta recommends recording your session by taking notes or recording on your phone (just give your doc a heads-up on the latter) so that you can reference the convo later and think about any follow-up quandaries you might need to be addressed.
5. Make sure your doctor asks about all aspects of your health
A bad doctor's appointment can leave me with the distinct feeling that I'm not really a person—just a collection of physical matter that either weighs the correct number or doesn't, has high cholesterol or is in the normal range, and has reflexes that don't raise concern. Welsh points out that your discussion with your doctor should be about so much more than that.
"Always make sure your doctor talks about mental health [and] reviews your body from head to toe," says Welsh. If there is something bothering you, or something key that you think your doctor overlooked, say something in the moment. Which brings us to our next point.
6. Speak up, speak up, speak up
Listen up, fam—this is the most important takeaway of all. "After explaining your symptoms, your doctor might do a physical examination, order some tests, or prescribe a treatment. Don’t hesitate to ask why these are being done," says Dr. Gupta. "As scary as it might be to ask questions, it’s your health and your doctor is there to help you feel better. Providing you with knowledge about your health can help you both achieve this feat."
There really are no "dumb" questions, particularly when it pertains to your health. "When it comes to an examination, asking questions about the examination can also help you feel at ease as to why it’s being done in the first place," adds Dr. Gupta. This can help take some of the stress and surprise out of some of the more intimate physical exams, like breast checks and pap smears. "If you still feel uncomfortable with a physical exam in that moment, simply state so. The doctor will most likely understand."
Conversely, you can also speak up if you feel that you would like a certain test to be done. "In many cases, we are supposed to order tests for screening based on age and family history, so patients should definitely speak up when it comes to these," says Dr. Gupta. In both cases, ask questions like:
- Why are these tests being done?
- Are there any risks or side effects of taking the tests?
- What do I have to do to prepare for them?
- How do I schedule them?
- What will the tests reveal?
- When will I get back the results?
- What about ____ test? Should I get that one?
If you do wind up getting something prescribed while you're visiting your physician, ask:
- Why is this being recommended for me?
- How effective is this treatment?
- Are there any side effects?
- Are there any interactions with my other medications or supplements?
- Are there any alternatives?
- How do I take this medication?
- How long do I take it for?
- How much does it cost? Is it covered by my insurance?
- Do the generic brands work just as well as the name brand?
- Are there any lifestyle modifications I can do that can help as well?
- What should I expect after treatment? Is there any recovery time?
Once you've asked these FAQs and heard your answers, consider repeating them back to your doctor in your own words so they can confirm that you're understanding correctly. Do your best not to leave with any lingering questions. You can even ask for a copy of your health records so you can reference them later or get a second opinion.
After your appointment:
7. Follow up and review
After your appointment, call the office with any remaining questions and ask if there are any follow-up appointments you need to make. If you had a good experience, consider reviewing your doctor online so that someone who now finds themselves in your shoes knows who to book with. A huge part of advocating for yourself is, of course, helping others do the same.
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