Dismissed by your doctor? How to advocate for yourself.

Has this happened to you?

You visit your health care provider because something hurts, or you don't feel right. The provider listens and then seems to dismiss your symptoms with a comment like:

• “You're too young for that.”

• “You're just tense. Have a glass of wine and relax.”

• “You just need to lose some weight.”

• “Does it really hurt that bad?”

Part of the problem is there is a power imbalance between patient and provider: The doctor or nurse practitioner or physician assistant has the education, training and experience. All you have on your side is what or how you're feeling. Women and people of color especially run into this. How many times has a woman had symptoms of indigestion dismissed, only to learn later that it was a heart attack symptom?

Such situations fall under the general definition of “medical gaslighting.” It's not gaslighting in the sense of the Ingrid Bergman, Charles Boyer movie — your doctor isn't lying in order to drive you crazy. But it is the feeling of not being believed or taken seriously.

And that's what keeps patient advocates in business. We balance the power equation by speaking on your behalf in terms the medical provider sees as more authoritative, and we can push for more information, testing or a second opinion. Nurses who become patient advocates bring that expertise to the table, and I'm pleased that more and more RNs are starting careers and businesses as advocates.

While it's good to have an advocate on your side, I also support people learning how to advocate for themselves. On June 16, I am organizing the first Chicago Patient Advocacy Conference in Glen Ellyn at Abbington Distinctive Banquets. It's open to the public, and I hope anyone who wants to learn more about how to advocate for themselves or others will want to be there. (For information, visit www.northshorern.com.)

If you've had the experience of feeling dismissed by a doctor, there are some actions you can take in order to advocate for yourself. It may feel uncomfortable — after all, you're challenging someone in authority — but don't let that stop you.

1.) Be very specific.

Prepare for your appointment by writing down your symptoms, the frequency, the duration and the level of discomfort. It's harder to dismiss something that's in black and white. You can say, “I kept a record of my symptoms, and I know my body. What I'm feeling isn't right.”

2.) Bring someone with you.

Particularly someone who can confirm what you're telling your health care provider. They can be a second set of ears, jot notes and review the appointment with you afterward, when you may be thinking, “Maybe nothing is wrong.” It's also harder to dismiss two people than one person.

3.) Write down questions ahead of time.

Having a written list of questions not only helps with remembering your concerns but also shows you've been thoughtful, again making it harder to brush you off. Review your questions and the answers before you leave to make sure everything was covered.

4.) Don't minimize your pain.

We have a habit of telling ourselves the pain or symptom isn't really “that bad.” Maybe you tell your doctor it's a 3 on a scale of 1 to 10, when it's really more like a 7. Also remember that pain is subjective. No two people experience pain the same way.

5.) Get dressed.

Part of that power dynamic is that you're covered in a paper sheet while the doctor is fully clothed. Before having the discussion about your symptoms, ask for time to put your clothes back on.

6.) Make sure to get the doctor's notes.

Medical providers are required to provide you with their notes, which include observations and recommendations for treatment.

7.) Get a second opinion.

You should leave your doctor's office feeling heard and validated. If you don't, seek a second opinion — or a new doctor.

Doctors are taught, “If you hear hoofbeats, look for horses, not zebras,” meaning they should look for common causes first rather than rare ones. Advocating for yourself may help you and your doctor see more quickly that you're the zebra.

• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her new book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is now available on Amazon. She is offering a free phone consultation to Daily Herald readers; call her at (847) 612-6684.