Healthcare providers, be it your family physician or a nurse practitioner at your local urgent care clinic, are there for your benefit. They have pledged to serve each and every patient who visits them. You are entitled to empathy, competence, and caring. Often, if your provider is rude, dismissive, or discriminates against you, it says more about who the provider is than it says about you. So how do you talk to your doctor when you have a concern about your health or well-being? It’s important for every patient to know the best ways to advocate for their health when seeing a doctor or healthcare practitioner.

Most importantly, the best healthcare providers listen to the concerns and questions from patients. Research shows that doctors, often rushed with constant appointments, give patients 11 seconds to speak before interrupting them. The study out of the University of Florida concludes that just a third of physicians give patients adequate time to explain why they’re there.

A more recent study by the Kaiser Family Foundation (KFF), San Francisco, reports that almost half of women, ages 18 to 35, felt discriminated against, dismissed, doubted, or blamed by healthcare providers during the last two years. Of the approximately 2,900 women surveyed, 46 percent felt that the discrimination was based on their age, race, sexual orientation, gender, religion, or other personal traits. Many of the women who reported negative experiences live in low-income households, had no insurance, live with a disability, or have chronic health issues.

The most common types of negative interactions were healthcare providers dismissing the patient’s concerns, the provider not believing that the patient was telling the truth, or the provider discriminating against the patient during their visit.

“The vast majority of people feel they’re having good experiences with clinicians, but what we found was that this was not universal,” says Alina Salganicoff, PhD, Senior Vice President and Director of Women’s Health Policy at Kaiser Family Foundation. “It’s very unfortunate, but some of these things are not surprising.”

Salganicoff’s group found some demographic patterns in the responses. Poor interactions with providers overlapped low-income households (45%), being without insurance (46%), and living with a disability or ongoing health condition (45%).

The same demographic features were also associated with men who reported negative interactions with a healthcare provider, but women reported a higher percentage. The most common types of negative interactions were the same for both genders. 

The fallout from negative interactions

Patients who experience negative interactions may delay care or underuse some health services, which can lead to poorer health outcomes. Patients are going to be less likely to ask about the services that they need from a system in which they feel discriminated against. They are less likely to use financial resources and social services available to them. It can affect the entire family and its finances, access to care, and even patient outcomes and survival. Negative experiences with providers add to distrust of the healthcare system.

Advocate for yourself with your provider

• Go to your visit prepared. Jot down questions as they occur to you in between appointments. Don’t count on being able to pull them out of your memory during the visits. Include anything you want to include or think you should mention. Have a list of your medications with you, including those prescribed, over-the-counter, herbs, or supplements. Know if you need any of your prescriptions refilled.
• Bring a family member or friend to your appointment. Ask them to help take notes about what the provider is saying, and ask questions that you may not think to ask. It also slows down the conversation between you and your provider. 
• Repeat information back to your provider. You can start with, “Let me make sure I understand…” It allows you to clarify what you may not have fully understood.
• Ask your provider what he or she would do. You may see your provider soften and seem a little more human.
• Consider writing a note to your provider. It should explain how you feel and why. Tell your provider that you hope the problems can be worked out. Discuss it at your next appointment.

Finding a new healthcare provider

If negative interactions recur with the same healthcare provider, it could be time for you to find a new provider. 

• Research what providers and medical centers are available to you. Your insurance source can usually provide this information to you.
• If you have no insurance, call a university teaching health center associated with a medical school and residency programs, or the local public health department.
• Ask people you trust – friends, family, colleagues – for recommendations.
• There are websites with physician ratings and reviews. You may consider these, but their value is limited and uncertain. If you read something that scares you or makes you uncomfortable, move on. It would be very difficult to have a positive experience with a provider if you’ve read negative or alarming comments in advance of meeting him or her.    

No matter how much we rely on our healthcare providers and even our own support systems, no one should ever hesitate to advocate for their own health. You should never be afraid to ask any of the questions suggested above.