When women speak, do doctors even listen?
This was the question I asked myself as I lay on the floor of a parking garage, unable to move —again. This was the third time in three months I found myself in such a situation.
The first time, I was at work when I experienced intense cramps that sent me crashing to the floor. Luckily, I worked in a medical center, so my colleague walked with me to urgent care. Once I got there I was told, “You’re just having a panic attack,” given some fluids and shown the door.
Then it happened again. This time it was at a large public market in New York City. Again, it started without warning. Someone called an ambulance, but before it arrived, an Uber did. For this I was grateful; I didn’t have the money to pay for an ambulance bill. My friend lugged me into the Uber and got us to an urgent care five blocks away.
Again I told the doctor what happened, and this time I told them I had been seeing blood in my stools. So they checked for hemorrhoids, found none, and with a shrug of their shoulders told me to see my primary care doctor the next time this happened.
That brings me back to the parking garage. This time no one was around to help me. I lay there, with my face covered in sweat and tears, angry and livid with frustration. What was the point of trying to get medical care again if no one was going to listen to me? If I worked in healthcare and had access to some of the best doctors in the world, and yet I still could not get the care I needed, what did other women do?
Finally, I forced myself to crawl back up, open my car door and call my husband to come get me. By the time he arrived, I had made a decision: It was time for better health and healthcare for every woman.
Learning how to advocate for yourself
At different stages in life, women face different health challenges and have distinct health needs. Yet it seems that we are rarely prepared for (or even informed about) the health journey ahead. For many of us, middle school health class was the first and last time we learned about our changing bodies; after that, we were expected to “just know” how to take care of ourselves.
That means it’s assumed we should know things like what our blood pressure should be (what is blood pressure even?!), how to eat right, common conditions we may experience, how to prevent certain conditions, how to find the right doctor and so on.
Another complicating factor for women is this: Many conditions — such as heart disease, arthritis, stroke, depression and many more — impact women differently from how they affect men.
It’s overwhelming when you don’t even know where to start — or, as in my case, you try to get help only to be shrugged off.
That’s why Dr. Mary I. O’Connor and I wrote “Taking Care of You: The Empowered Woman’s Guide to Better Health” to support women of all walks of life, ages, races and ethnicities in becoming better advocates for their own health.
If, like me, you’ve felt like your healthcare team wasn’t listening to you or you weren’t getting quality care, it may be time to find a new primary care team. Dr. Mara Gordon, and I wrote about this issue in “Taking Care of You” and have some advice.
Finding the right primary healthcare team
It’s important to understand some basics about healthcare in the United States and equip yourself with strategies to get the best out of the relationship with your primary care team.
- Visits are short and sweet. Short appointments are the unfortunate reality of modern medical care. Most primary care practices offer visits that are between 10 and 20 minutes long. (The exception to this is concierge medicine, sometimes known as direct primary care, where you pay a fee in addition to your insurance costs for greater access to your clinician.) Make sure you have realistic expectations for what you can accomplish during this period of time. You can always make a follow-up appointment.
- You and your clinician are on the same team. Sometimes, it can feel like your clinician doesn’t share your priorities. You want to talk about your back pain, for example, and your clinician wants to talk about your weight or your blood pressure. Remember that your clinician is trained to prioritize emergencies, so if the clinician is worried about something, it could be because it’s a health problem that needs to be addressed urgently. However, it should still feel like you’re on the same team. Your clinician should be asking both, “What is the matter?” and “What matters to you?”
By bringing up what is perhaps most important to you, both you and your clinician can have a focused agenda during the visit. For example, if your clinician tries to redirect the agenda for a visit, discuss it directly: “It seems like you want to talk about my weight, but today, I want to work on my back pain.” You may not be able to fix everything in one visit, but a good clinician makes room to address what matters to you. This is part of shared decision-making and it leads to better healthcare and experiences.
- Stick to one or two challenges. Since primary care appointments are so short, you’ll be better served if you thoroughly address one or two issues that matter to you in your time with your clinician rather than trying to tackle too many at once and failing.
- Write it down. Bringing a list of questions with you can help you stick to those one or two problems and make sure you get every last concern about those specific problems addressed. Keep track of your symptoms in a simple diary in your smartphone or take pictures of a rash, for example. This can help you make sure you’re giving your clinician an accurate portrait of your symptoms.
- A good plan can take time. Despite the impression you might get from watching a show like “Grey’s Anatomy,” sometimes the right diagnosis and the right care plan can take time. A good clinician never blows off your symptoms or makes you feel dismissed, but it can take multiple visits for even the best experts to arrive at a diagnosis. And when you get the right diagnosis, finding an effective treatment plan can take time and hard work. Sometimes the best treatment is no treatment at all or it involves a holistic approach like focusing on exercise, stress management and healthy eating. Don’t be too quick to jump ship for a clinician who offers a fast fix, since sometimes the most effective remedies require patience.
- You’re entitled to a second opinion. Clinicians expect that you’ll seek out second opinions, especially for serious conditions or before a procedure. You should feel empowered to hear from other clinicians regarding a diagnosis or a plan of action. Do be upfront when you’re seeking a second opinion — that will help both your original clinician and the new one, whom you’re seeing for that additional opinion, tailor the visits to your needs.
- Don’t settle. You’re investing in a long-term relationship, so connecting with the right person may take a while. That’s OK. Be honest with yourself and your clinician about what you need.
Women deserve good health and healthcare. I’ve joined with others on a journey to get better health and healthcare for every woman. We invite all women, from age 18 to over 100, to join us. You can share your health and healthcare challenges and goals with us at www.1millionmorewomen.org.
Together we can improve the lives of women, their families and our communities.
Part of this article is an edited excerpt from the book “Taking Care of You: The Empowered Woman’s Guide to Better Health.”
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