Five Ways to Nail Your Next Doctor's Visit
There is a shared experience among Black women of being ignored or, even worse, silenced when discussing our health issues with medical professionals. As someone with a chronic illness, I am no stranger to this treatment.
During a recent interaction with the healthcare system, the neurologist who was treating my multiple sclerosis went on medical leave and decided not to return to the medical group at all. The hand-off to a new neurologist was handled completely by this medical group and there were several missteps that resulted in me missing an entire month of medication. My body reacted almost immediately with an uptick in MS symptoms of numbness and tingling in my arms and legs on a daily basis.
My experience is one of many that dates back to the foundation of Western medicine. Much of the Western medical field was built on the backs of Black women, without our consent, and somehow it still fails to meet our most minor needs. The American healthcare system is long overdue for a complete restructuring that centers patients' care and voices, with a particular focus on the most vulnerable populations. While there are several amazing people working on innovations focusing on just that, the new products and processes being developed will have a slow roll out, with providers and insurers likely being the first recipients of the positive outcomes and patients merely existing as secondary benefactors. This trickle down effect of innovation can take years, if not decades, but our lives are now. Black women are dying now.
When I finally got reassigned to a neurologist, I decided to take a proactive approach for my first appointment. Perhaps, like me, you are knowledgeable about the healthcare system but rarely advocate for yourself. Or maybe even unlike me you do advocate for yourself but seem to get no where in your conversations. Regardless of which group you fall under, many of us do not have the privilege of time and resources to wait for innovators and investors in Silicon Valley to decide America's new health care system, nor can we wait on the medical education system to become more equitable in allowing access for more Black doctors (though I look forward to seeing many of my friends get their white coats in May 2019 and beyond!) We need to act now in the ways we can. I urge you to incorporate these five actions in your next medical appointment:
(1) Start with your intention
Clearly define how you want to feel after the appointment (or in general) and work backwards from there. For me, I wanted to return to my base level of minimal to no MS symptoms. I was desperate to stop the daily numbness and tingling in my limbs, which were likely indications of the progression of the disease.
Intention: Return to my baseline and leave the appointment with a game plan to avoid missing treatments in the future.
Write down or visualize your intention before your visit to make it clear to yourself what you want to accomplish in the 20-25 minutes you have with your doctor.
THM: Write a vision. Make it plain.
(2) Stay ready so you don't have to get ready
Come to the visit over-prepared. If you are among the lucky bunch who have amazing care teams with great information transfer processes, you can probably skip this one. The vast majority of Americans have to take on the role of CEO of their own health. A typical patient has to set and adjust their schedules around their physician's availability, ensure they are on track to receive their medication(s) on time, run interference between their physician's office and their insurer, and keep track of countless minor items such as lab tests. This type of coordination can be its own stressor for a person who has to do this by themselves. You can minimize this stress by walking into the office with the three M's: medications, money, and me.
Medications - Print or write down a list of your medications and their dosage levels. If possible, bring them with you. If you have an iPhone or any app that tracks health, it likely has a place where you can include these medications. I recommend updating this on an ongoing basis so that you always have a list of your medications with you.
Money - Before stepping foot in those doors you should have an understanding of how this visit will be paid for. If this is a regular office visit, you might not have to do any extra work outside of bringing your insurance card. If this is a unique circumstance, try giving your insurer a call to be sure you took all the steps necessary to avoid high costs on your end. I cannot count how many times I have had to come out of pocket for a visit or exam because I missed one simple step in the process. If you do not have insurance, start here.
Me - Summarize your current situation. This exercise might include jotting down the tests you have recently gotten done and what you need to accomplish with this visit based on your intention.
THM: Stay Ready bag contents: Medications, insurance card/money, pen, and paper
*Bonus: Bring any questions you have about your individual health and anything you have researched prior to the visit. This is the time to get clarification.
(3) Speak. Speak. Speak.
Now that you are prepared for your visit, be sure to voice your concerns as clearly as possible. Most physicians begin the visit with the phrase "Hello Patient, what brings you to my office today?" Use that moment to let them know what's going on and that you have questions you would like answered during the visit. During my aforementioned visit with the new neurologist, he did not start with that, but jumped right into what he assumed was the reason for my visit. He even skipped an introduction with himself. So when he finished his statement, I directed him towards the purpose of my visit and the goals I wanted to meet before leaving. I even asked how much time he had so that I knew which priorities to focus on first.
THM: State your health issues and goals for the visit towards the beginning to make sure you leave with what you need.
(4) Finish Strong: Summarize
Take the last minute or two of your visit to make sure you understand what the next steps are. Will your doctor be ordering a lab exam for you? Do you need to schedule an appointment with anyone else on your care team (i.e. primary care physician, nutritionist, other specialists)? How should you contact your physician if the follow-up steps do not work? Clarify these details before leaving and write them down so you can refer back to them if necessary.
THM: Wrap up with the game plan.
(5) Do the Work
Follow-Ups - Do any of your follow ups as close to the end of the visit as possible. Try making all your appointments with other physicians and lab technicians while you are still in the doctor's office to make sure it doesn't get buried at the bottom of your other priorities.
Research - If there was anything said during the visit that you did not understand and could not get to at the time, be sure to research it afterwards. Should you not be able to find the answer, call the doctor's office back and get your question answered.
Access your network - Remember that you are not alone on your path toward optimal health. Outside of this professional care team is your network of loved ones who want to see you live your best life. Ask them for help if you need someone to take you to an appointment that may impact your ability to operate a vehicle. See if your friends have had great care experiences with other hospitals if you feel your current care team is not a good fit.
THM: Finish off strong by following through on what you need to do to be healthy.
Your life matters. Your health matters. The health system is extremely complicated and confusing, even to those of us working as healthcare professionals, so do not be afraid to take up space and time when it comes to your health.