Since You Asked: I often find myself being talked down to by my health care providers. How can I be more assertive when interacting with my providers?

At the NWHN, one of our primary goals is to ensure all women are able to receive the health care that is best for them. We believe that women are the experts of their own bodies. However, it is easy to feel intimidated at the doctor’s office, especially when jargon you don’t understand is being used, when things feel like they are moving too fast, or you don’t feel respected by your provider. Through decades of experience working on patient advocacy, we have gained insight as to how to be your own best advocate in health care facilities. 

It is useful to keep an up-to-date list of your diagnoses, medications, and providers. Have this information easily on hand to give your new provider. We also recommend that you research the health-focused community assets in your area. Where are the nearest hospitals and health centers in your area? What do they specialize in? How are their health outcomes? Having this information on hand before an emergency occurs can help you make better decisions if you find yourself needing to make decisions quickly.

Generate a list of questions that you would like to ask your health care provider before you arrive at your appointment, and be sure to write them down. You can refer to this list during the appointment in order to make sure nothing slips through the cracks, and you make the most of the time with your provider. It can be easy to forget questions that you meant to ask, especially if an appointment is stressful or non-routine. We also recommend learning what avenues your provider makes available for providing feedback. Some providers have text services, an app, or a survey where you can express yourself. If how to provide feedback is not clear, ask what avenues there are. Feedback is vital and helps providers continue to do what is working and stop doing what’s not when it comes to patient interaction.

During your appointment, be sure to take notes, have a friend take notes, or ask if you can record the conversation on your smartphone. If the provider is new, ask if they’ve had a chance to read up on your history. If they haven’t, request a few minutes of the appointment be dedicated to this or to asking you questions about it. It is extremely important that your provider has a sound understanding of your medical history, and you can hold them accountable to ensure this is a reality. 

You can also ask a trusted friend or family member to come with you to take notes. This is especially important if you suspect you’re going to get some bad news. Studies have shown time and time again that when health care providers use powerful “trigger words” such as cancer, patients have trouble retaining anything after that.

If your appointment is non-routine, your health care provider may propose treatments. If possible, get these treatments in writing. Ask your provider which studies are informing their decisions to recommend a certain treatment, and if these studies involved people of your demographics (sex, gender, race, ethnicity, age group, etc). You should also ask what side effects (if any) have been associated with the proposed treatments, and where you can learn more about such treatments. It is absolutely okay to be apprehensive when it comes to your health. If you are not ready to make a decision regarding a certain course of treatment, you can firmly tell your provider, “I am not ready to make a decision at this time,” and/or “I will follow up with you when I have had more time to process our conversations,”.

If at all feasible, plan on seeking a second opinion from another provider following your initial appointment. This is something every patient should do for a non-routine diagnosis or proposed treatment as a matter of course. It is also important to seek this opinion from someone that is part of a different practice than the provider who gave the original opinion. It is likely that the incentives and approaches within medical groups are similar.

You deserve to have each piece of your identity affirmed by your health care provider, and you deserve a provider that listens to you attentively and is not dismissive of your concerns. If your health care provider made you feel uncomfortable in any way, it is always acceptable (indeed, it is  encouraged) to change your provider. Once a patient-provider relationship becomes adversarial, most of the time it’s better for a patient to move on, move out, and find someone better attuned to their needs. This can be tough, if your insurer or clinic places limits on patient choice of provider, but it’s worth fighting for. It can also be useful to ask your trusted friends and family members for provider recommendations. This can be especially important if you are seeking a provider that is explicitly LGBTQ+ affirming, or one that has experience working with people of your demographic. 

*These tips were developed through interviews with Charlea Massion, M.D., and Dr. Ngina Ruth Lythcott, who are experienced health care professionals.

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