How to be Assertive with your Medical Healthcare from a Therapist’s Perspective
Kate Reichman, LPC
About me: Kate Reichman is a licensed professional counselor and certified addiction counselor. She has experience working with clients who have struggled with chronic illness and has helped several individuals to improve communication with medical professionals.
Note: this article is intended to help individuals get the most from their healthcare and feel empowered by communication with their care team. It is not intended to shame or talk ill of health care professionals, who often act in selfless ways to ensure the wellbeing of society. This article is not medical advice and is not intended to substitute any medical advice given by a healthcare professional.
1. Be assertive not aggressive
It can be hard to not feel angry, hurt, and invalidated when our medical needs are not being met or taken seriously. Our emotions are always valid, but that is not an excuse to act out irrationally at an individual who is trying to help. Instead of acting aggressively through hostile words , raised voice, and harsh tone; take a moment to practice accepting your feelings and emotions in the situation as understandable while working on communicating your concerns effectively.
By taking a deep breath and practicing grounding skills before replying or calling back, you can deactivate the flight/right response that can trigger aggressive habits. If you are in-office ask to go to the bathroom or get a sip of water before proceeding. Remember that healthcare workers/doctors are trying their best to help and it can be easy to blame one individual for frustrations you feel for the entire experience.
2. The right knowledge is power
With the internet at our fingertips, patients have access to increasingly more information about their own conditions. It is important to recognize, however, that misinformation and misguided medical advice can be rampant — which can put doctors off from taking a concern or point seriously when the phrase “I read on the internet…” is brought up. Still, that should not deter you from bringing up questions and concerns after doing your own research. Sticking to peer reviewed and accredited sources, even though smaller institutions who practice ethical research procedures, are likely to be the most scientifically valid (even if it is not widely accepted yet in the broader medical community).
This is especially true for rare chronic illnesses in which research from larger medical institutions is scarce. Despite the potential for misinformation, it is the job of a medical professional to listen and be open to communication about your research. After all, doctors should be lifelong learners. If you feel like your care team is not taking your concerns and information seriously, you have the right to a second opinion before making any decisions regarding your health.
3. Medicine is not as black and white as it can seem
When individuals start their health journey , it can be common to view facts as facts — which can deter people from getting a second opinion at times — erroneously thinking that another doctor would come to the same conclusion. While science operates on the basic principle of statistical significance and evidenced based conclusions, best treatment practices are fluid.
A doctor’s approach can be influenced based on many factors including their specialty, school of thought, and past experience. Don’t assume that an answer you received is the end all be all. A good doctor should respect your choice to pursue all possible perspectives.
4. Use your appointment time
There’s no doubt that doctors , medical professionals, and medical institutions are swamped. The COVID-19 pandemic has put even further pressure on our healthcare systems. This, however, does not mean that your needs have to be sacrificed. If a doctor’s office puts you down for a 30 minute appointment and you feel like you need that time to get your needs met, do not feel pressured to rush your questions and concerns because they are running behind or short on time.
It is the responsibility of the office to let you know if they can no longer accommodate the allotted time. Furthermore, the problem which is often systemic can never be addressed fully (which unfortunately hurts healthcare workers and patients alike) if you don’t speak up.
5. Don’t be afraid to ask medical professionals to advocate on your behalf
A very frustrating and unfortunate side effect of our managed care system is often getting refused coverage for medical care despite a doctor or healthcare professionals advice. This situation can feel hopeless and unfair , but you may be able to ask your doctor to appeal or write a statement of medical need to the insurance company.
It can feel awkward to ask, but remember most doctors want to help and may be willing to fight insurance to get proper care. It is also ok to ask your doctor for alternatives that may be just as medically effective but more likely to be covered /financially feasible.
6. Bring support if needed
With COVID-19, it is certainly understandable that many places have restrictions on visitors. However, asking about alternatives (such as having a loved one video chat or phone call in during appointment) cannot hurt. Doctors’ appointments can be anxiety provoking and nerve wracking to say the least, and sometimes having someone there to provide both moral support and to be objective when you are nervous, can be beneficial. Don’t feel ashamed for wanting or needing support.
7. If something seems “off” speak up
Doctors and healthcare professionals are not mind readers, and only know what we tell them through our experience. While it can be sometimes embarrassing to bring up something that turns out to be normal or not of concern, it is better to be safe than have something go unnoticed. This also goes for any lab results or reports you may get back that are of concern. Doctors look at several reports a day and are humans that can make mistakes.
That being said, it is never ok to feel like a burden or shamed for speaking up. As patients we often do not have extensive knowledge about what is normal and what is not and can only go by how we feel. If you encounter a doctor who is consistently dismissive about your concerns, it may be worth looking into someone who listens and validates your experience.
8. Your symptoms are valid
Many people with chronic illness or illnesses that are misunderstood can take years to find a proper explanation or diagnosis. It is important to recognize that medicine operates on science and doctors must make informed decisions based on concrete evidence. This can be very frustrating when you feel sick but don’t have a diagnosis to back it up. This does not however, mean your symptoms are not real. The number one frustration I hear from others dealing with medical concerns and illnesses, is having a normal test and being caught in a “dead end.”
A good doctor should be able to recognize that normal or non-indicative tests do not mean the patient is not in need of treatment or further exploration. If they have exhausted their resources, be insistent on asking for a referral. It can sometimes be helpful to utilize a “broken record” technique to repeat your continued concerns and need for further treatment so as not to be caught in a medical limbo. You deserve answers.
Overall communication with healthcare professionals does not have to be a stressful and invalidating experience if you stay clear with your objectives and practice assertiveness skills. Furthermore, it is never a bad idea to get additional support from a professional or people in your social circle if you feel overwhelmed or lost. You are not alone in your journey.