What’s Up, Doc?

The first time I ever saw my mom cry was when she came out of a doctor’s appointment one day when I was a child. She cried the entire drive home. I’m sure I was more than old enough that it should have occurred to me to give her a hug or ask if she was okay, but I was so stunned that I just sat there in silence the entire drive. (Sorry about that, mom). When we got home, I sobbed also because I had only ever seen my mom as a strong, confident woman who knows all the answers. It terrified me to see her cut down like that. 

She hadn’t been given news of a terminal illness. She wasn’t sick. Quite simply, the doctor had humiliated her. She had gone to him for help with a health issue, and he had made a cruel comment about her weight. She recounted that he had looked at her with disgust. 

Unfortunately, women receive sub-par health treatment all too commonly. Doctors are often condescending, or don’t take the time to do a thorough exam or really listen. 

In my 20s, I went to a doctor for advice on birth control. I shared that I was struggling with anxiety, asked if it could be due to the pill I was currently taking and requested some alternatives. The doctor handed me a list of birth control pills and asked if I’d like to try a different one. I remember thinking that it was just the stupidest conversation and feeling so disappointed that a professional I trusted had provided no insights or advice to help me with my health. I left feeling embarrassed and frustrated. 

During pregnancy, they make you fill out a mental health survey each visit. The questions ask if you are anxious, feel hopeless, have thought you would be better off dead, etc. Normally I answered no to all the questions, but I remember marking “sometimes” for a couple of the questions at one visit. They took my paper, but no one ever asked me about it. I have no idea if they read it. I wasn’t depressed or suicidal or anything, but I was dealing with some anxiety. It’s uncomfortable enough to admit it on the survey, and the complete lack of response definitely made me feel like no one really cared. It was like an awkward silence after you risk saying something vulnerable.

I’m not trying to bash doctors or play the victim here. My two children and I have worked with many amazing doctors. My daughter was born with a heart murmur. It was caught immediately at the hospital, her pediatrician monitored it in the first week and made a specialist referral, and we saw an incredible team of nurses and doctors at Seattle Children’s hospital. (She is completely fine, thank goodness). 

I think the issue is partially due to the setup of our healthcare system. Doctors contend with the pressures of insurance bureaucracy and mountains of paperwork; thus they are in a constant rush. I believe many doctors are great at what they do but lack interpersonal skills. So we are actually probably receiving much better care than what we perceive. 

After many instances of feeling frustrated, rushed, unheard and embarrassed after leaving the doctor, I’ve realized that I need to make a change in how I approach appointments. It might sound strange, but as patients we can do some simple legwork to prepare for a successful appointment. As a teacher, I equate it to making a lesson plan. Know what your goal is and plan how you’ll achieve it. 

#1. Set an objective. In teaching, we always start a lesson plan with the end in mind. What do I want my students to learn today? We should set an objective when going to the doctor. Are you dealing with a chronic health condition that you’ve already seen three other doctors about? Maybe your objective is to make sure they run different tests. If you aren’t clear about exactly what you need or want, you might find you leave the appointment without resolving the issue you went there for in the first place.

#2. Make a list of questions. Whenever I take my kids to the pediatrician, I always forget to ask at least one question. I have the questions in my head and assume I’ll remember them, but then I get side-tracked when my newborn starts screaming during her weight check or has a giant poop blowout. Write your questions down so you can address them all with the doctor. You can use an app or the notes feature on your phone if you don’t want to carry a notebook. If it’s an appointment for your kiddo, check with your spouse or partner before leaving the house and see if they have questions for the doctor as well. (My husband inevitably has some really obvious question that I already know the answer to, but he still wants the reassurance from the doc. So I ask.) 

#3. Stay focused and efficient. This goes along with setting an objective and bringing a list of questions. As mentioned, doctors are in a rush, so they may only give you 5-10 minutes. If you know exactly what you want to address, know the outcome you’re looking for and have your questions ready to go, a short visit may be plenty of time to cover everything. And, if you need more time, the doctor is likely to give you that time if you effectively articulate your needs and get right to the point. It’s easy to fall into the victim mentality of “the doc spent 2 minutes with me and didn’t listen to my concerns.” When maybe what really happened is my concerns were in my head, but I didn’t do a good job of expressing them out loud. I’m definitely guilty of this one. We can’t expect the doctor to guess or assume what we need. It could even be helpful to mentally rehearse what you want to say on the drive to the appointment. 

#4. Advocate for yourself. Sometimes you will encounter that sub-par doctor, or a doc with the interpersonal skills of a manatee. You might need to speak up. During my last pregnancy I got really sick with a stomach bacteria in Peru. Worried my baby could be at risk, I was biting at the bit to get home and get to my next checkup. The midwife asked a few of the standard questions, went to get my after-visit summary and handed it to me with one foot still out the door. The visit was over and we hadn’t addressed any of my concerns. I was feeling frozen but snapped out of it enough to say, “Wait, I have some questions.” I was mad and flustered that she hadn’t asked me more about my illness and seemed to be in such a hurry. But when I was direct and said I had questions, she came back into the room and answered them. Honestly, I left that appointment crying and feeling like she didn’t care, but in reality I did get my questions answered. 

#5. Shift your attitude. Many of us have had bad experiences that have tarnished our trust in doctors. But chances are, your doctor probably does know what he or she is doing. (Think of the years of schooling and training required for a medical license). And, even though it may not seem like it, more likely than not your doctor does care. I’m a teacher, and though we sometimes get a bad rap, 99% of the teachers I know truly care about helping kids. I’d like to believe the same is true about doctors. It’s a helping profession, and likely most choose to do it because they care about others. Keep this in mind and try not to judge your doc based on how friendly he or she is. Don’t expect a display of sympathy for your issue, necessarily. Remember, they see patients all day every day; it’s their job to help you feel better through a treatment plan, not with their verbal reactions. If you need sympathy or to chat about your issues, try to save that for a close friend. 

These tips for going to the doctor are really advice for myself. I’m 33 and it took me this long to realize that I can approach my doctor appointments in a more effective way. I hope these ideas help other women (and men too!). The steps above are simply a mental process to take yourself through and aren’t meant to be a time-consuming burden to add to your already overflowing plate. It would be ideal if medical programs focused more on teaching doctors to foster a relationship with the patient, and if doctors actually had the flexibility to dedicate more time to patients. But since that’s not the current reality, we can try to do our part to advocate for ourselves as patients.

Please leave me a comment and tell me about your strategies for ensuring a positive experience at the doctor’s office.