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I’ve recently been impressed by the ability of some people to be strong and advocate for themselves in healthcare—something that may not be easy for many of us to do. It’s important that we try, however, in order to get the care that is best suited to our needs, based on our symptoms, concerns, priorities, and medical condition.
Why might this be an issue? Some people fear confrontation and questioning or challenging those they see as authority figures, including physicians. But that’s not a helpful approach; our healthcare relationship should be a collaborative one where we are heard, respected, and have input.
While clinicians are knowledgeable experts in healthcare, patients should feel comfortable asking questions and having open communication with them as partners in our care. Approach it as a partnership without being adversarial or demanding. In addition to demonstrating sound professional skills and advice, you should expect that your healthcare provider listens and pays attention; is empathetic, understanding, and respectful; is not judgmental or dismissive; and engages in shared decision-making. Having this expectation may be a new concept for many people.
The success of any treatment, particularly in mental health, depends on good communication and building a trusting relationship with a provider who is a good fit for you. Not everyone will be a good match, so I encourage you to ask around and interview several clinicians until you find someone you think you can work with.
Strive to become more confident asking questions of your provider, especially in regards to your diagnosis, tests, treatments, and overall care. Your clinician will likely welcome it! Know that it’s OK to inquire about his or her professional training and background, areas of clinical interest and expertise, cultural and language issues, whether he will coordinate your care with other providers, his method of payment, and whether he accepts your health insurance.
I encourage you to speak up and ask questions when you don’t understand something—a process that is expected in shared decision-making. But doing this can be awkward for many for fear of appearing “stupid.” So you might say something like: “Help me understand the purpose of this test or medication and how it will make a difference.” The essence of shared decision-making is in having you, the patient, clearly understand, in plain language, your condition, recommended diagnostic tests, and therapeutic management of that condition—all in a way that is consistent with your preferences, values, and goals.
I encourage you to speak up and be more assertive to ensure that you receive desired services, something that is again awkward for many. This may be in the area of scheduling appointments to fit your work schedule; the consideration of brand vs. generic medications and affordable alternatives; making sure the clinician pays sincere attention to any symptoms of concern to you, even if they are anxiety-driven; acknowledging your symptoms, including pain, and arranging an appropriate evaluation and therapeutic management plan. This might mean both of you being open to seeking the input and recommendation of a specialist or consultant.
Advocating, or sticking up for yourself, may also become an issue if you’re admitted to a hospital for any reason, where the inpatient nurses, residents, and providers are working hard but do not know you as your primary doctor does. In advocating for yourself, you might have to explain to them in a straightforward way why you are taking a certain medication and not an alternative, how the timing of that medication might be important, and what’s important to you.
Don’t just assume that such things are always clear. Hospitals have certain procedures for ensuring efficiency and safety—yet there still is some room for discussion and negotiation of certain aspects of your care. Your job is to help your inpatient clinicians understand your valid reasons for a particular request or expectation.
One positive benefit of speaking up for yourself is that it tends to increase your sense of self-esteem, self-confidence, and personal empowerment. You can take pride in knowing that you were able to manage a complex situation successfully on your own behalf and that you are better off because of it.
Stay well!
