How to Empower Patient Voices in Health Care
In the wake of #metoo campaign and the louder voices in human equality, I believe it's crucial to discuss a health care issue frequently overlooked: the disempowered patient. It can be really difficult to bring up concerns, especially relating to sexual, pelvic, or women’s health. Sometimes pursuing a conversation is challenging because it feels awkward or embarrassing. Sometimes the conversation comes to a jolting stop because the patient may feel shut down by a provider’s response.
It’s easy for your voice to get lost in a sea of medical terminology
How to empower patients to advocate for their needs when not feeling heard
I sat down with some friends and family members to hear their experiences with not feeling heard when asking about legitimate medical concerns or mishandled during medical appointments or procedures.
Some Anecdotes:
A 19-year-old female patient who had been recently prescribed birth control shared with her provider that something did not feel right during sex, that she felt more dry and uncomfortable. The response from a provider shouldn’t be, “Well maybe you’re not having sex with the right person.”
This person changed her birth control and has not experienced these symptoms since.
A 32- year-old woman, 1 year postpartum, with a history of cancer complained to multiple providers a number of symptoms including hair loss and fatigue (which is not abnormal during postpartum) that has not subsided was told, “this is motherhood.”
This person was recently diagnosed with thyroid conditions.
A 50- year-old woman complained to her doctor that sex is painful. She was told to have a glass of wine to relax.
This person eventually sought out pelvic floor therapy, and no longer has these concerns
A 30-year-old woman 6 weeks postpartum asks her OBGYN about returning to sex after an episiotomy during childbirth. Her doctor tells her she’s “fine” and to “have her put it in.”
She tells this to her pelvic floor therapist who teaches her how to do self perineal massage and tips on safely returning to sex with her partner
After initiating dialogue with women about their experiences, I reflected on a time I went to an urgent care clinic and requested an STI exam to a medical professional after a sexual encounter with a new partner. The medical provider reported his findings and ended it with “looks like he was a good guy after all” before sending me on my way. I remember walking out of the office completely mortified for asking to be tested in the first place. I did not share whether it was consensual sex or whether there was sexual violence. In retrospect, he was slut shaming me for being sex-positive and proactive in my sexual health. As I write this I wonder what I would say if I ever felt deeply uncomfortable in a medical appointment again.
It takes courage to share intimate and vulnerable concerns with a medical provider. With our current healthcare system, we don’t necessarily have a lot of time with our doctors for developing rapport so it can feel uncomfortable sharing with someone who is essentially a stranger. I’m not saying we should rebuke the system or disregard the advice of medical professionals. I’m saying that medical professionals are human beings. They face pressures, time restraints, and balance a million things at once, including their own health issues and home lives. It doesn’t give anyone permission to be an asshole, but it should give us, the patients, the ability to level the power dynamic of the doctor-patient relationship. To express that you’ve been noticing patterns in your symptoms or how it has impacted your daily life emphasizes its importance and provides more information. Initiating an open dialogue empowers patients to discuss concerns and allows a medical professional to further understand your experience.
Below I’ve included some scripts of how to advocate for your needs when you feel you’re not being heard in an appointment:
”Are there any other possibilities of why these symptoms are occuring”
”I’ve been keeping track of symptom X and there seems to be a trend with….”
(If you’re one to consult Dr. Google or WebMD) “I’ve done some research on my symptom[s], I’m curious what makes you rule out [insert diagnosis, procedure, screening, etc]?
”I’m deeply concerned about X. It has impacted [ways it impacts your life with detail on activities, work, school]”
If a doctor is unwilling to engage in a discussion regarding your concerns, then switching providers or seeking a second opinion may be a viable option.
For anyone who has ever been in a situation similar to me, where you’ve felt uncomfortable in an appointment, it can be difficult to have perspective in the moment. Truthfully, at the time I would have never felt comfortable articulating my negative visceral reaction directly to this person. Maybe someone else would! Depending on the situation, respectfully sharing that a statement made you feel uncomfortable or felt that a statement was not perceived in a professional manner may be the best way to advocate for yourself. You could also request that another person be in the room for the remainder of the session or choose to end the session entirely. This is a grey space and there are so many different scenarios with different advice for each. The biggest takeaway is to ensure your safety and comfort with a medical provider, and to make sure you are seen and heard.
In my specific situation, I consider these suggestions the personal advice I would give to my younger self:
”Do you have a feedback survey I could fill out before I leave?”
”Do you have an office manager I could speak to or get in contact with?”
This is an article of reflection and stories. From someone who works in the health care field, I am sensitive to the patient/client experience and have taken an interest, especially in women’s health. Have you ever been shut down after bringing up a medical concern or felt mishandled in an appointment? What are your experiences? If you were able to utilize your voice to advocate your needs, how did you navigate this? Feel free to comment or send a private email to dana@functionalwellness.space