I have heard so many stories from clients through the years about being mistreated by providers and read many charts notes that left me in shock. So, for the last seven years, I have been attending appointments with clients. Attending medical meetings, taking notes, and advocating has been part of my day job.
It isn't easy to advocate for oneself, tell a provider "no," or hear judgments or stigmatizing language. There is a power imbalance present, and overall it can often feel scary.
I collected some tips that have worked both with my clients solo and when I joined them at appointments.
Before the Appointment
Write things down. Prioritize what your goals are. For example, is it a medication refill? Concerns about new or worsening symptoms or side effects? Include dates; how long has this been going on? Has it gotten worse? Bring this with you; providers appreciate organization.
Choose an appointment time and date that works best for you. Additionally, I find providers will have more time during morning appointments before things get too busy and not right before lunch.
During the Appointment
Be on time- this may seem obvious, but the later you arrive, the less time you have with your provider.
Practice mindfulness- Remain calm, or at least try to do so. Do some breathing exercises first. This will also help you remember what you want to say.
If things aren't going the way you hoped, try to remain calm. Remember, if this isn't the right provider for you, there may be other options. This is your appointment, your body, and you have the right to be listened to, to ask for your needs to be met, and to choose what you put in your body.
Be skillful- you know this is a DBT blog. So I use the Interpersonal Effectiveness skill DEAR MAN all day every day and often write it down in advance.
Describe the situation
Express your needs
Assert yourself with body language and words.
Reinforce with nods, smiles, and verbal feedback.
(stay) Mindful by using skills like breathing
Appear confident by making eye contact if possible
Negotiate without compromising your goals and self-respect
Describe: I have been having bad headaches all day for the last two weeks. As a result, I called out of work three times last week.
Express: It's essential for me to feel better soon, get back to work, and figure this out.
Assert: (open body language) "Thanks for listening; it's been a rough week."
Reinforce: I know you are busy, and I hope you can help me with this pain.
(stay) Mindful: practice Square Breathing.
Appear confident: Make eye contact and square your shoulders.
Negotiate: Agree to try something the provider suggests if you feel comfortable.
After the Appointment:
Write things down after. Use your notes app on your phone if needed. Often, you will get an "after visit summary" printed from the doctor's office but I also find it helpful to take your notes in your own words.
Get the details about follow up appointments or actions. Make the follow-up appointment, write down the specialist's name the provider mentioned, be sure you have a plan of where to go for any labs or assessments, and get the name of any new medications.
If there are any lingering questions, call or message your provider. I know contacting your provider can be complicated and challenging but it's worth pushing through in order to get your needs met.
One last quick tip: if you are having issues coordinating your care, you have lots of appointments to track, providers are not listening to you, or you are confused about why your needs are not being met- call your insurance and ask for a "care coordinator." This role is often called "navigator" and is typically staffed by social workers, counselors, or nurses. Our work is similar to case managers and can help you talk to providers, attend appointments, and advocate for your needs.
Good luck; it's hard to be assertive, so congrats on doing so!