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.
Just...weary sigh to all of this. We haven't had the exact same problems but we've had the same emotionally bankrupt interactions. I'm so glad you advocated for yourself.
And thank you for the kind words! It took some restraint writing it...but I've discovered being a combative little justice scout 100% works against me. Unfortunately.
After years of frustration, I got a new doctor. She's young, empathetic, and wears a hijab. Everyone who works in the office is female, except one of the PAs. I got a prescription for my asthma controller through her that Walgreens and CVS both told me was unavailable.
Not just great advice for doctor appointments --- also a hot tip for dealing with any professional working in a predominantly male industry: don't walk in with a chip of combativeness on your shoulder. Even you're angry. Even when you're ill. And especially if you're female.
I do hate it. Hate, hate, hate it. But damn it, it IS super-duper helpful. No cap.
(Woot! Look at me, being all slangy and hip at 66!)
How do I say no to doctor & get a good (or at least an accepting) reaction?
I just say no. And then explain why, as specifically needed to address their reaction.
I've had 70 trips around the sun &;had weird health issues all my life so lots of experience. I don't know that I have any wisdom to share that can help any that hasn't already been shared but first, I learned the hard way, always doing what the doctor said. As a child. In elementrry achool. THAT didn't last long
Second, I started asking everyone I knew about their doctors & started only going to docs with positive reviews from real patients. Mostly worked. Not always. We all have different needs & personalities, some mesh, some don't.
Saying no was hard for me until I had a few "got so sick I almost went to the ER OR jumped off my roof OR felt like I needed an exorcism" experiences. This part kicked into hiooogh gear when I got COVID 5 years ago & got sicker, not better. Then I got real picky about A) the doctors I saw, aka doctors who respected my opinion, had a good rep with real people, not online ads & would accept my no, sometimes after an uncomfortable debate, but would still accept it & proved they truly care about what I'm going thru & how to heal it without killing me trying and B)
Changing the way I approached them (not talking game playing bullshit) & put myself in their shoes & when it made sense, softened my defenses & made decisions human-to-human as much as professional trained doctor-to-proficiently well knowledged about their health & illness patient.
Everything l've read in this has been a mind blowing salvation. Having seen double digit doctors in the past 5 years & STILL experiencing new weird physical issues, my blessing has been my PCP, who thank somebody i'd been seeing for a decade before covid hit & always has my back no matter what. I did find a few docs on my own to supplement & most have joined the Beth Team & been a help.
Too many doctors stirring the pot CAN be challenging &n when you're feeling like shit & not being heard, Itz challenging to even have the strength to utter no much less explain why.
I always prep by reminding myself that I am the customer shelling out $$ for a service & I am the one who will suffer (or enjoy let's hope) & li be with the consequences of decisions made.
And that NO is a complete sentence
That's the hardest one for me.
Thanx to all who shared so much, in comments & the topic itself.
Great tips, once again. The bottom line to all of this is that the doctor-patient relationship involves an inherent power differential, and finding ways to assert your power in the relationship without threatening theirs is the key. Sometimes, you get to know a doctor well enough to know their ego is not some delicate little flower, and you can speak more plainly and directly. I think those docs also respect you more when you do. But until you know, best to tread lightly and strategically.
Lastly, gently, there is again no $1k deposit required for an Ally savings account 🫣. I am living proof 🤑
Thank you for putting this so much better! It really does come down to the size and fragility of their ego. There ARE good doctors out there. We don't need so many tips for them.
Good grief...I changed it and then must have copied it from a less-recent post! Thank you Amy, your patience is legendary. I don't know how to emoji inline but the cry laugh applies here!
I have done that umpteen times with my own posts - absentmindedly copying and pasting from prior posts without rereading it at all. All that really matters is that your fresh content SLAYS 🔥.
(But I also don’t want people scared off of Ally by the minimum and have you miss out on your referral clams!).
Inline emojis = right click! (if you’re right-hand dominant). It should be the top item on drop down menu.
How do I have this post sent to me automatically every time I'm about to have a dr appt? Because I neeeeeeeed it.
Though I've finally had some breakthroughs of my own around this. The biggest one was finally getting it that I AM AN ADULT and this person is providing me a SERVICE and I have both agency and responsibility in this situation. Agency to make any fucking decision I want, and also responsibility to be an active participant in the appointment and the dynamic, state my needs and goals and desires, and treat both the doctor and myself with respect (I mean, I don't HAVE to do those things, but if I don't, and things don't go well, I don't exactly get to blame only them). Going in like a little girl trying to please a punishing dad is an understandable trauma response to decades of medical trauma (and patriarchy and misogyny), but it isn't serving anyone (least of all me). With this new approach, I not only managed to turn around how my appointments go, but managed to turn around how they go WITH THE SAME DOCTOR. One week he was a judgmental asshole. The next, he was my fun and helpful teammate. What changed? Hint: it wasn't him.
Thanks as always for sharing your hard won wisdom. You are so very smart at this.
I have recently found three things really helpful in working with my newest doctor:
1. Learning how to perfectly pronounce my prescriptions. Hy-dro-klor-i-qwain. Loo-flid-a-myd.
2. Having very specific and measured descriptions of how I am doing on a treatment, good or bad.
3. Having a specific idea or a couple of ideas on where to go next.
For instance, "The damnitol worked well on the recurring throat lesion issue! My throat is completely clear and has been for about a week. Unfortunately, it had me running to the bathroom about once an hour with extremely urgent trots, even at night. I killed an entire 6 pack of TP in three days. I'm wondering if there is a similar drug in that same category that we could try, or if it would make sense to add in a drug to manage that specific side effect. But I'm worried about side effect soup, since anti-diarrheal sometimes cause me to have vertigo."
But I've absolutely had doctors where this wouldn't work nearly as well as it does right now. I've had a Nurse Practitioner where I could walk in and say "Doc (former military medic, so this is the appropriate appellation!), I'm not doing right. I feel like I got hit by a truck. Hook me up with something good and ship me to a gastro, thanks bye." Super casual. Not my usual. But it worked. I think that what this has taught me is that you have to find the approach that works with your specific doctor. Maybe give it three visits before you throw in the towel, if you see promise in the practitioner.
But also, you have to find a doctor where your approach to medicine works well too! If you are "med me up, let's fail fast" type you don't want to be seeing the lady that is in love with supplements and very conservative approaches. And vice versa.
Stay tuned for next week, where we shall unpack your third point!
I feel like pronouncing meds perfectly works great with great doctors. It tends to backfire on the ego-y ones. They consider you know "just enough to be dangerous." Better to refer to it as damnitol (love that)!
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.
Yes! I've started so many appointments with local doctors with, "we don't have to solve this today! I'm just here for this weird flesh wound..."
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.
Just...weary sigh to all of this. We haven't had the exact same problems but we've had the same emotionally bankrupt interactions. I'm so glad you advocated for yourself.
And thank you for the kind words! It took some restraint writing it...but I've discovered being a combative little justice scout 100% works against me. Unfortunately.
After years of frustration, I got a new doctor. She's young, empathetic, and wears a hijab. Everyone who works in the office is female, except one of the PAs. I got a prescription for my asthma controller through her that Walgreens and CVS both told me was unavailable.
I'm holding out a lot of hope for the young ones. It makes it so much easier to have a good doctor.
Not just great advice for doctor appointments --- also a hot tip for dealing with any professional working in a predominantly male industry: don't walk in with a chip of combativeness on your shoulder. Even you're angry. Even when you're ill. And especially if you're female.
I do hate it. Hate, hate, hate it. But damn it, it IS super-duper helpful. No cap.
(Woot! Look at me, being all slangy and hip at 66!)
No cap!
How do I say no to doctor & get a good (or at least an accepting) reaction?
I just say no. And then explain why, as specifically needed to address their reaction.
I've had 70 trips around the sun &;had weird health issues all my life so lots of experience. I don't know that I have any wisdom to share that can help any that hasn't already been shared but first, I learned the hard way, always doing what the doctor said. As a child. In elementrry achool. THAT didn't last long
Second, I started asking everyone I knew about their doctors & started only going to docs with positive reviews from real patients. Mostly worked. Not always. We all have different needs & personalities, some mesh, some don't.
Saying no was hard for me until I had a few "got so sick I almost went to the ER OR jumped off my roof OR felt like I needed an exorcism" experiences. This part kicked into hiooogh gear when I got COVID 5 years ago & got sicker, not better. Then I got real picky about A) the doctors I saw, aka doctors who respected my opinion, had a good rep with real people, not online ads & would accept my no, sometimes after an uncomfortable debate, but would still accept it & proved they truly care about what I'm going thru & how to heal it without killing me trying and B)
Changing the way I approached them (not talking game playing bullshit) & put myself in their shoes & when it made sense, softened my defenses & made decisions human-to-human as much as professional trained doctor-to-proficiently well knowledged about their health & illness patient.
Everything l've read in this has been a mind blowing salvation. Having seen double digit doctors in the past 5 years & STILL experiencing new weird physical issues, my blessing has been my PCP, who thank somebody i'd been seeing for a decade before covid hit & always has my back no matter what. I did find a few docs on my own to supplement & most have joined the Beth Team & been a help.
Too many doctors stirring the pot CAN be challenging &n when you're feeling like shit & not being heard, Itz challenging to even have the strength to utter no much less explain why.
I always prep by reminding myself that I am the customer shelling out $$ for a service & I am the one who will suffer (or enjoy let's hope) & li be with the consequences of decisions made.
And that NO is a complete sentence
That's the hardest one for me.
Thanx to all who shared so much, in comments & the topic itself.
Thank you Kira!! This is so helpful!!!
I’ve been following this doctor and seriously wondering if I can drive 3 hours each way to be her patient.
https://substack.com/@zedzha?r=2vmna0&utm_medium=ios&utm_source=profile
@ZedZha ...I wonder if you do telehealth? (I also wonder if Substack tags like other apps...about to find out!)
I don't think so but maybe this will work! https://drzedzha.substack.com/
Great tips, once again. The bottom line to all of this is that the doctor-patient relationship involves an inherent power differential, and finding ways to assert your power in the relationship without threatening theirs is the key. Sometimes, you get to know a doctor well enough to know their ego is not some delicate little flower, and you can speak more plainly and directly. I think those docs also respect you more when you do. But until you know, best to tread lightly and strategically.
Lastly, gently, there is again no $1k deposit required for an Ally savings account 🫣. I am living proof 🤑
Thank you for putting this so much better! It really does come down to the size and fragility of their ego. There ARE good doctors out there. We don't need so many tips for them.
Good grief...I changed it and then must have copied it from a less-recent post! Thank you Amy, your patience is legendary. I don't know how to emoji inline but the cry laugh applies here!
I have done that umpteen times with my own posts - absentmindedly copying and pasting from prior posts without rereading it at all. All that really matters is that your fresh content SLAYS 🔥.
(But I also don’t want people scared off of Ally by the minimum and have you miss out on your referral clams!).
Inline emojis = right click! (if you’re right-hand dominant). It should be the top item on drop down menu.
How do I have this post sent to me automatically every time I'm about to have a dr appt? Because I neeeeeeeed it.
Though I've finally had some breakthroughs of my own around this. The biggest one was finally getting it that I AM AN ADULT and this person is providing me a SERVICE and I have both agency and responsibility in this situation. Agency to make any fucking decision I want, and also responsibility to be an active participant in the appointment and the dynamic, state my needs and goals and desires, and treat both the doctor and myself with respect (I mean, I don't HAVE to do those things, but if I don't, and things don't go well, I don't exactly get to blame only them). Going in like a little girl trying to please a punishing dad is an understandable trauma response to decades of medical trauma (and patriarchy and misogyny), but it isn't serving anyone (least of all me). With this new approach, I not only managed to turn around how my appointments go, but managed to turn around how they go WITH THE SAME DOCTOR. One week he was a judgmental asshole. The next, he was my fun and helpful teammate. What changed? Hint: it wasn't him.
Thanks as always for sharing your hard won wisdom. You are so very smart at this.
I have recently found three things really helpful in working with my newest doctor:
1. Learning how to perfectly pronounce my prescriptions. Hy-dro-klor-i-qwain. Loo-flid-a-myd.
2. Having very specific and measured descriptions of how I am doing on a treatment, good or bad.
3. Having a specific idea or a couple of ideas on where to go next.
For instance, "The damnitol worked well on the recurring throat lesion issue! My throat is completely clear and has been for about a week. Unfortunately, it had me running to the bathroom about once an hour with extremely urgent trots, even at night. I killed an entire 6 pack of TP in three days. I'm wondering if there is a similar drug in that same category that we could try, or if it would make sense to add in a drug to manage that specific side effect. But I'm worried about side effect soup, since anti-diarrheal sometimes cause me to have vertigo."
But I've absolutely had doctors where this wouldn't work nearly as well as it does right now. I've had a Nurse Practitioner where I could walk in and say "Doc (former military medic, so this is the appropriate appellation!), I'm not doing right. I feel like I got hit by a truck. Hook me up with something good and ship me to a gastro, thanks bye." Super casual. Not my usual. But it worked. I think that what this has taught me is that you have to find the approach that works with your specific doctor. Maybe give it three visits before you throw in the towel, if you see promise in the practitioner.
But also, you have to find a doctor where your approach to medicine works well too! If you are "med me up, let's fail fast" type you don't want to be seeing the lady that is in love with supplements and very conservative approaches. And vice versa.
Stay tuned for next week, where we shall unpack your third point!
I feel like pronouncing meds perfectly works great with great doctors. It tends to backfire on the ego-y ones. They consider you know "just enough to be dangerous." Better to refer to it as damnitol (love that)!
Def a lot of reading the room, as you say here!