Medical Self Advocacy
Fall 2024 Issue
By Deann Zampelli
A few months ago, I had a diagnostic test for G.I. issues. Just to clarify, I’m not referencing a broken romance with a soldier on leave, but something a little less sexy: gastrointestinal issues.
I was introduced to my doctor about ten minutes before the procedure. As always, I had a million questions, so I was happy to finally meet her. After we exchanged a few words, it became clear she wasn’t interested in answering my questions. Rather, she wanted to chat with her colleague, anesthetize me – not an uncommon response upon meeting me, from what I understand – and complete the 15-minute procedure.
Just before I went under, I asked her what she thought about two seemingly unrelated symptoms I’d been having. She looked at me with the most neutral expression I had ever seen and uttered a phrase not commonly used in her profession, “I don’t know.”
On one hand, I applauded her honesty. But my concern was that it wasn’t followed up by any intellectual curiosity, like “I can check into it” or “It doesn’t sound like it, but I can do some research and get back to you.” My observation was valid and somewhat insightful if I do say so myself but as I waited for a response, the drugs kicked in and I fell asleep with quippy and acerbic remarks dancing on my fuzzy tongue.
After speaking with some friends, I began to see a pattern emerging in our interactions with medical experts. Each one felt a little like going to battle – leaving home with notes and files with details of every procedure and diagnostic test we had ever done, armed with information and determination.
Yet no matter how prepared we were, we each found ourselves leaving appointments with unanswered questions. This got me thinking – if it happens to me, a research fanatic and health coach whose middle name is Advocacy, how many others are experiencing the same thing?
I have quite a few friends and family members who are doctors, so I understand the pressure they are under each day and greatly appreciate the work they do. This isn’t an attack on the medical profession, it is a call to advocacy. Self-Advocacy.
In my health coaching program, I heard the statistic that most Western practitioners spend an average of three minutes listening to a patient before offering a diagnosis and treatment plan. While I don’t know if this is accurate, I will say that it can be challenging to be heard, really heard.
Many people get anxious at even the idea of going to the doctor, so much that it can affect their vital signs. This is called White Coat Syndrome. Some get intimidated by authority figures while others are just fatigued and overwhelmed.
With this in mind, here are some strategies for better outcomes in the future:
Go in with a list of written questions, the most important ones first in case you run out of time. Do not move on to the next one until you are comfortable with the answer to the last.
You guide the appointment. This is your time. You can do it in a respectful way but be clear about your needs. For example, I say, “I have quite a few questions and want to be clear on each point before we move onto the next.” If they get touchy, I pretend I am Olivia Pope from Scandal about to tell them why they are going to do it my way and why they will regret it if they don’t.
Take notes. You might think you are clear on what’s been said but depending on the nature and seriousness of your visit, there is a good chance you will forget something.
If possible, bring someone with you. Two people hear information better than one, especially if you are suffering from a serious illness or under other stresses. The human mind can only take in so much at once.
This is a big one: before the doctor leaves the room, tell them you want to go over your list again to make sure you got all your questions answered. Doing this can give you a chance to take a breath and may uncover a few more questions. Don’t feel bad and go at your own pace. Remember this is your time, and it’s just as valuable as theirs. You are not a bother, a nuisance, or an inconvenience. This is the reason they come to work each day: to help us.
One of my favorite quotes is by the late Vietnamese peace activist, Thich Nhat Hanh, and it never seemed more powerful than it does now. “The most precious gift we can offer anyone is our attention.”
Health practitioners can be the most knowledgeable in their field but until they learn to really see and hear their patients, offer their true attention, they will never be true healers. Through self-advocacy, we may be able to change that.
Deann Zampelli is a Duke Integrative Medicine Certified Health and Wellness Coach and the owner of Montecito Coaching and Nutrition. She has her master’s in clinical psychology, and writes a column in the Montecito Journal, The Montecito Health Coach. Her focus is healthy aging, and she is a speaker on medical self-advocacy.