Don't go to the doctor without this trick (Tip #2)
You're gonna hate this one AND it's super duper helpful.
Remember every medical appointment you’ve ever had? I know, I’ve tried to black them out, too.
My guess is if you’re in Mystery Disease Land (aka, ME/CFS, Long Covid, anything other than male pattern baldness and erectile dysfunction), then the bulk of those appointments bombed.
But I’ll check my biases.
Hopefully this doesn’t make me look like a goober later.
Anyway, if you’ve been having focused, empathetic, needle-moving appointments, please skip STRAIGHT to the comments to fill us in on how. (No cap, we need to know! Also, did I just try to say “no cap” as a forty-something? Heh.)
For the rest of us huddled masses…let’s get on with the tips. (Last week’s is here, and she’s a banger.)
Sneak preview of now: appointments don’t cure me, but they also don’t send me reeling toward ativan and/or rage crimes.
Last week, I had a doctor visit where I was listened to, things were explained to me clearly, she got the tests and procedures ordered I needed, and it was all over telehealth…in 15 minutes.
This is what I want for you (if you don’t have it already), because it’s what I wanted for past me.
We’re on tip 2 of 3—one more coming next week!
2. Master the aggravating (but necessary) art of saying no... without saying no.
Do I want this to be our reality—that we can’t just say a DIRECT no to all doctors? Hard no. But it is. So let me give it to you straight: some doctors can get their MeUndies in a bunch if you’re “non-compliant,” and that shit goes on your chart. Forever. Which means you run the very real risk of getting judged by future doctors who haven’t even met you yet…for something you didn’t do wrong.
But patients *need* to be able to safely decline procedures, tests, and medications. I’m thinking specifically of the gyno who told me I “just” had to get pregnant to clear up that endometriosis (despite my then-lack of partner and/or any desire or means to have kids). Or the GI who wanted to “just” yeet my gallbladder (and now that’s been proven to not be the bestest idea for IBS.) Or…we digress.
So first of all? Know that you CAN say no. Too many patients suffer through following doctor’s orders that don’t work for them at all because they don’t know—you don’t have to.
In fact, good doctors encourage your input. Great ones trust your instincts (and gently challenge them). These are the ones we want to support and stay in business. With them, it’s easy: just say no. And done. This post isn’t for working with docs who get it.
This post is for when you have to find a way to say no to not-so-great doctors (rife in small towns and underserved markets) without damaging consequences. This requires subtlety, diplomacy, and truth-slanting, none of which come remotely naturally to me.
You neither?
Yeah, this sucks. And while I’m usually all for challenging the status quo, you probably need tests, meds, and procedures more than a medical revolt right now. When you’re better, you can write that doctor the scathing review you’re surely plotting. I’ll help.
In the meantime, let’s teach you how to be an ever-so-slightly manipulative minx.
Step 1: Before we begin: put yourself in your doctor’s shoes.
Damn! You look hot in a lab coat.
Okay, so: Doctor You threw yourself into debt to go to medical school. Which took over 10 years of higher ed. You memorized piles of Latin names for every body part, worked ridiculous shifts to learn to do medicine in your sleep, and jumped through a million hoops in the medical system to treat patients. At one point, you just wanted to help people. And usually, you can.
And then these intangible diseases came along. They look an awful lot like anxiety. These sickies seem suspiciously smart, functional, and charming. There’s nothing wrong with them that you can see on routine labs…yet they seem obsessed with their health and genuinely distressed.
You feel a little puzzled, but you pull from over a decade of medical school to offer a suggestion, a thought, or a diagnosis.
Step 2: Okay, now we’re back in your shoes again—and you hate your doctor’s idea. The first thing out of your mouth? “Yes.” (Trust me.)
To begin, always positively acknowledge the offering. Scripts to use:
“Yes, that’s a good thought.”
“Yes, that’s an interesting angle.”
“Yes, I’ve heard that recommendation before.”
“Yes, I can see why you’d suggest that.”
“Yes, I’ve tried that before.”
“Yes, I’ve been thinking about that too.”
“Yes, that’s a new one.”
We’re starting with yes…even though we’re going to say no. Why? Because this means your doctor feels heard and respected for the professional input they worked so hard to be able to give. This makes sure they aren’t hearing your no from a place of defensiveness and frustration—and they know you aren’t giving it from one, either.
Step 3: Onto the no’s! Without any actual “no.” How? Make it a question.
Now that you’ve yesed, pick the one that fits:
Ask for more information. You can use this as a gentle way to bring up a major concern that your doctor may have missed. (Or just stall.) “So how does that work considering my gastroparesis?” “Is there any risk, given my MCAS?” “I’m curious why you think that’s the best treatment since I’ve had anaphylaxis following sulfa drugs before?” “What’s the efficacy rate on that one in patients like me?” “What kind of results are you seeing from that in your other Ehlers Danlos patients?” Making it a question allows your doctor to still be the expert.
Ask about alternatives. “Yes, great idea, and I’m curious what some of the other options might be?” “Yes, I’ve seen commercials for that, and I wondered what else might work similarly?” “Yes, I’ve heard of that, but I wonder if there are any conservative approaches we could try first?” (Doctors LOVE conservative approaches.) This shows you’re solution-minded, even if their first suggestion isn’t the right one. It also gives you options you might want to say yes to.
Ask about waiting. Unless it’s an emergency, you don’t have to decide anything today. Most doctors are a fan of “wait and see,” so you’re speaking their language here. “Yes, I hear a lot of patients really benefit from that. I wonder if we might hold off on adding anything until after we know I’m tolerating this new diet change a little better?” “Yes, thank you for offering to do that today, but I’d better check my calendar and book when I’m less rushed.” It doesn’t discount the doctor’s idea—it just defers it. Which can be really handy if you ever DO want to come back to it, after all.
Ask what advice they would give if you were their own spouse/kid. Sometimes it feels like doctors are so busy, they miss the real human in front of them. I’ve found this question usually brings them to a softer, more thoughtful place. It helps if you share an emotional reason you’re balking. “Yes, that seems wise. It really scares me to consider biologics though. I wonder about conservative approaches or even just waiting. If I were your daughter, what would you say?”
Ask about other health problems. When the other tactics aren’t enough or aren’t worth the discussion, pull focus to another symptom cluster. “Yes, I’m thinking about that, and I’m so distracted by this other symptom, I wonder if we might talk about that?” “Yes, I’ll consider that. I’m more worried about migraines right now, could we discuss those?”
Last resort: Agree to everything, do nothing, and bail.
If the appointment truly tanks, and you just need to get something out of it—a disability letter, a prescription or referral written, a procedure booked—agree to everything and “reconsider” later.
You don’t have to fill a prescription just because they’ve already called the pharmacy. You can cancel the procedure they booked for you. No one will make you follow up with the 2-star neurologist. Get what you need today and find a new doctor later.
Look. I KNOW. The inanity chaps my rump too.
I’m very sad I’ve had to use my energy on being anything other than the straight-shooting Nelly Bly wannabe whistleblower I fancy myself to be.
But I’m also very glad I’ve gotten to a place where even basic doctors will fill pain-in-the-ass requests without blinking because I’ve bankrolled goodwill and respect.
So while all this sucks, the good news is, it can raise your standard of care…which might raise your standard of living. And that matters way more than one slightly nefarious appointment. You can do a mitzvah later to make up for it if you feel so inclined.
(Hilarious sidenote: my boyfriend edited this and reminded me that you can “be a mensch” or “do a mitzvah” but “do a mensch” was probably not what I intended. Thanks, brain fog!)
Tip #3 incoming next week! STAY TUNED.
A little footnote
These tips should make appointments better. But ya know…there’s a lot involved.
So if you do everything “right” and your appointment is still a straight Texas goat rodeo, blame literally everything else. The next one will be a gooder!
Dish in the comments please: Ever said no in an appointment (with or without saying no)? How did it go?
No? Dare you to try it—use the scripts!
In the meantime: Wish you had? What happened when you didn’t?
Or…what other hack changed your appointment game for the better?
No one’s bought a Meatscon in a minute so one last shill before I quit shilling!
This is my favorite review yet! Thank you so much, Lailah.
Already bought one? Please review it! A lot of people haven’t downloaded digital products and I want them to see it’s a good move.
Already reviewed it? Good grief, I adore all five of you.
Bless Substack for being so aggressively kind.
The other week, I left my coffee fund off. A reader IMMEDIATELY asked me to put it back. Aw. In the spirit of letting good things happen, I welcome decaf Americanos at Venmo kira-stoops, any payment you like on the Meatscon, and useful gifts are here.
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Some things that have helped me: I go in with a realistic goal for the appointment and share that in the first moments of the appointment with the doctor. Either something that can be accomplished in the 10 to 15 minutes or something that can be addressed gradually over a number of appointments. Often, doctors I see are overwhelmed by my chart and history and express this overwhelm, saying things like 'I don't know what I can do for' or 'You have a lot going on' - to which a refocus them and that I don't expect them to deal with everything that day, that I just need help with this one specific thing for this visit. That usually settles them and leads to a productive appointment. I'm also really upfront now about the fact that I likely won't be trying any new medications anytime soon, so I won't be taking anything they are prescribing. But I emphasize to them that for me, investigating what the diagnosis is and understanding why I have symptoms is more important to me right now.
This was a wonderful piece with so many solid, helpful phrases and approaches. It takes massive restraint for me not to lay into rude, ego driven doctors with such limited knowledge and ideas, and yet you are right about getting in their shoes and recognizing the system they are functioning in.
I’ve definitely had more disappointing doctor visits than good ones including a visit in the same doctor’s office where a year+ prior I learned of a miscarriage and when I got emotional the nurse told me she was going to leave some brochures about perimenopause behind when she ended the appointment. God forbid I was just sad and triggered being in that room!!! And regardless, what a cold reaction to someone’s emotions. Never went back.
On another occasion I was told I had fibroids on my uterus and I would need a D&C to remove them ( I was told they can be a precursor to cancer so I really should get them out now). I used the “thank you for telling me, let’s wait and give it a little time” ( in particular shouldn’t we wait till another time in my cycle to see if anything shifts?!!). I focused on natural remedies came back 1.5 year later and was told they are gone and the doctor had NEVER seen that before and has no idea or explanation for it. 🤯 I wanted to respond with “ of course you’ve never seen this happen because 99% of your patients probably go forward with the D&C because they are terrified!!” Instead I said “ oh gosh, wonderful news. I’m so glad we waited on the D & C, aren’t you?” Aaaaaand crickets.