Have you ever sat in a doctor’s office and felt unseen or unheard?

I have.

I remember seeing one of my doctors when I was about 21 years old. He was extremely smart, a leader in his field, and had several residents following him around. During the course of our 2 minute visit, he spoke more to his residents than he did to me. He was out the door before I could even start asking him questions.

Ever since then, I have promised myself that I would always help to empower my patients, especially my female patients, in navigating the health care system to ensure they get the support, information and answers they deserve.

Let me ask you… have you ever:

Felt intimidated to speak to your health care provider or specialist?

Been surprised when they start to wrap up the meeting after only a few minutes, but can’t think of the right questions to ask to get what you need?

Been worried that you’re “taking up too much of their time” and find yourself rushing through your own appointment?

Felt so nervous that you forgot the list of questions you wanted to ask?

Minimized yourself or made yourself small so as not to be perceived as a “bothersome patient” or a “burden”?

Felt like you should just sit there and listen quietly, because “they’re the doctor”?

Found yourself apologizing to them, for some reason?

Firstly, let me say this. As women, we are more conditioned to “be nice and be polite” than we are to advocate for ourselves. We are conditioned to think that figures of authority are better experts of our bodies and experiences that we are. We may not realize that our health care providers are here to just that – PROVIDE health care. They are here to offer advice, guidance, testing and support to help us make our own informed decisions about our care.

I grew up in a family of medical professionals. As a teen and young adult, my mom (a clinical pharmacist) would join me in my appointments, when possible. She would always ask detailed, probing questions to thoroughly understand what might be causing my symptoms, what tests should be performed, what OTHER tests should be performed, what the various treatment options are, their alternatives, and what other specialists might we visit for more advice or insight. From an early age, I watched and learned how to ask for what I needed and how to “navigate the system” of blood tests, specialist referrals, and the various types of health care professionals.

I didn’t realize it at the time, but looking back, I now realize the privilege this has afforded me: I was taught how to be an active participant in my health care. I was taught how to ask doctors for things that I felt I needed. I was taught how to advocate for myself.

This is NOT part of any education that most people receive growing up, especially as women.

Many of my patients express hesitation or even fear of visiting their doctor to ask about their symptoms or for testing.

This article is not about complaining about doctors or the health care system. I am incredibly grateful and proud to be Canadian and have universal health care, even though it has its flaws and limitations. I think that family doctors are the most important, yet one of the most under-appreciated professionals in our health care system (in addition to nurses and nurse practitioners, to name a few). I believe that family doctors are not adequately compensated for the important role they play in Canadians’ lives. In fact, the system is unfortunately structured to encourage family doctors to see lots of patients, quickly, in order to make ends meet and pay clinic overhead costs, and often work many unpaid hours doing so (family doctors work about 14 hours more per week than the average Canadian). It’s no wonder there is a massive shortage of family doctors in Canada. Approximately 15% of BC residents don’t have a family doctor, and residents often prefer to take on roles at hospitals where they don’t have any overhead and can bill for their time by the hour.

So if you’ve had a frustrating experience with your family doctor, it’s (probably) not their fault.

The purpose of this article is to educate and inform you in how to be your own best health care advocate, and how to better navigate the system to get your needs met.

Here are the tips I pass on to all of my patients when working with their various health care providers. This includes not only your family doctor, but also your specialists, naturopathic doctor, chiropractor, or any other type of health care provider.

Tips for Making the Most of Your Appointments with Doctors and Healthcare Providers

Get access to your own blood test results. Did you know that (in BC) there is a service called My EHealth that you can sign up for an log into to view all of your own blood test results? I highly recommend that you get access to your own records. It’s your data and your information. This way, when you go see your various doctors, you can log in, print a copy of your records, and bring them to your appointments to ensure expedited care.

• Tip: Next time you go to Life Labs for a blood draw, ask the lab tech for directions on how to get registered on "My Care Compass."

Come to your appointments prepared. Write out a list of questions in advance. I LOVE when my patients come to my office with a list of questions (isn’t crossing things off a list so satisfying?!) This will help you in case you feel nervous and forget what you wanted to ask. You can even ask your other health care team members for advice. Sometimes my patients will come see me before they see their family doctor or specialist to get extra advice and input on what questions to ask.

Ask specific questions. I always suggest asking the following questions (where applicable) to help further your understanding of your diagnosis, treatment options or care:

• What caused this disease/condition?
• Is there something else that could be causing my symptoms? If so, are there any tests that would help us to ensure this is the correct diagnosis?
• Are there other options for testing/treatment, and if so, what are they?
• How safe and accurate is this test?
• How well does this treatment/medication work?
• What are the side effects of this treatment/medication? How likely are they to occur?
• How do I monitor this condition? Are there tests I can do to monitor my progression or improvement? How often should I do these tests? How often should I see you for check ins?

Take notes. If your doctor uses words you don’t understand or mentions medications you haven’t heard of, ask them to write it down on a piece of paper. Start by asking them to explain or clarify; but if they are short on time or you’re still unclear, write it down. This way, you can research from home or speak to your other health care providers for more clarification and input.

Bring a friend or family member. Sometimes they will ask good questions that you didn’t think of, or their presence will help you feel more calm. If you have a family member or friend who works in the health care system and are willing to join you, even better.

Ask for copies of your results. Ask for a copy of your imaging results (ex. ultrasound or MRI report) or blood work, for you own personal records. Did you know that your medical records actually belong to you, too? You are entitled to ask for copies. I highly recommend keeping a binder at home of all your own health records. This way, you can bring copies to other health care providers, when needed.

Understand what your family doctor can’t do it all. Did you know that family doctors have limitations and rules around the types of testing they are able to offer you at any given time? If you’ve had a frustrating experience asking for blood work and they say “no,” it’s (likely) not their fault. The health care system regulates what kind/when/how much testing can be done for you. If you’ve had this experience, speak to your Naturopathic Doctor about additional testing options. As an ND, I can write requisitions for additional blood work that family doctors may not be able to provide. The cost of these tests are often covered by extended health care plans.

Develop your health care TEAM. This includes your family doctor, naturopathic doctor, physiotherapist, chiropractor, clinical counsellor, massage therapist – to name a few. Each health care provider has a difference area of expertise, and NONE of them will have “all” of the answers for you. Take the advice you get from one provider, and seek additional opinions for more informed decisions and care.

Be generous in your assumptions, but don’t settle. Sometimes people, including doctors, have bad days. If you had an unsatisfactory experience, it might help to assume they were having a bad day. This doesn’t mean you should settle; you can ask for a referral to someone else, seek another opinion or support elsewhere, if possible.

Seek other opinions and input, if necessary. If you don’t agree with or feel comfortable with a suggested treatment, you can speak with your GP about this and ask for a referral for a second opinion. Or, speak to your naturopathic doctor or other trusted health care team members for additional input on the recommendations you’ve been given.

For example, many of my female patients come to me with their hormone replacement therapy prescriptions in hand. They often received these prescriptions in a short visit with their GP, but didn’t have time to get their questions answered in order to feel safe and confident in their treatment plan. In our 30 to 60 minute visit, we can thoroughly review the pro’s, con’s, additional testing and/or other treatment options. As a naturopathic doctor, I am able to provide the space and time for a thorough conversation to ensure that your questions are answered, your concerns are addressed, and that you feel that you can make an informed decision about your treatment plan.

My take-home message to you is this:

You are worthy.

You deserve good care.

You deserve to feel heard and understood.

Be kind, make generous assumptions, but take up space. Ask questions.

Your health care team (including me) are here to help YOU make the best choice for YOUR health and for your life.

I hope this article helps to empower you in your relationships with your health care team.

Yours in health,

Dr. Kathleen Mahannah ND

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