How to speak up for yourself when your doctor isn’t listening | Expert Opinion
Here are some ways to advocate for yourself during a medical appointment.
It’s an all-too-common story: You have symptoms you’re worried about but your doctor says, “it’s nothing” or “it’s probably just anxiety.” So many people can share this kind of experience, and social media is full of their stories. The narrative typically includes a description of symptoms and how long it took to get a physician to take them seriously. Sometimes, the diagnosis is life-threatening; other times, it’s an easily remedied condition.
No matter what the outcome, however, these stories are variations on the same theme: patients feel like they aren’t being listened to and their concerns are dismissed too quickly.
On the physician side, there are many reasons this may happen. Too-short appointment times, overflowing email inboxes, and understaffed offices may contribute to creating overworked and distracted physicians. Sometimes unconscious bias plays a role; research has shown that a patient’s gender and ethnicity can influence how they are perceived and how seriously their concerns are taken.
And let’s not ignore the fact that some physicians truly are not listening, or at least aren’t great at it.
Regardless of where the problem originates, patients can be harmed by missed diagnoses, delays in care, and feeling so brushed aside, you may not want to go back.
Conversely, feeling like you’re not being heard can make you even more insistent about your need for help. This can create a Catch-22 situation: the harder you work to convey your concerns, the more likely you’ll appear anxious, angry, or aggressive, making it even more challenging to get the care you need.
So, what can you do to advocate for yourself in a way that helps your doctor hear what you’re saying?
Bring a list. Writing things down before a visit is very helpful for several reasons: You won’t forget to mention something important, the time you take to make the list may help clarify your thoughts, and you can prioritize what you want to talk about. While a single visit may not be enough time to address everything on your list, you’ll be prepared for the next. When you and your physician are on the same page (literally), it can help you both stay focused on the goals for your time together.
Assign a “support” person. A trusted family member or friend at your visit can be a calming presence. They can take notes so you can focus on talking (and listening). Having another set of ears can be helpful, as they may hear something you missed. They can also help clarify information by asking your physician questions you may not think of.
Get ahead of the anxiety discussion. Symptoms of anxiety can overlap with many other diagnoses but people with anxiety have other medical conditions, too. Doctors can sometimes get stuck in a rut in their thinking, cutting off fruitful conversation. Asking your physician to discuss possible diagnoses other than anxiety that explain your symptoms can help both of you get a clearer idea of how to proceed.
Create a timeline. If your doctor suggests a specific treatment, ask how long it takes to know if it’s working (or not). Same for a suggested evaluation: When should you anticipate results and what will you do with them? You and your physician should both be clear on the plan, including when you should return to the office for further discussion. Schedule your next visit before you leave, so you don’t face a delay waiting for the next available appointment.
Clear communication can be challenging but accurate treatment relies upon it. Leaving a visit feeling like you weren’t listened to is a painful experience that erodes the patient-physician relationship. It can lead to a ripple effect, where patients enter every healthcare encounter fearing the same experience, or, even avoid seeking care at all. Ultimately, physicians shoulder the responsibility to be excellent listeners and communicators, but you’ll never go wrong being prepared and proactive.
Amanda Finegold Swain is a family medicine physician in the University of Pennsylvania Health System.