If You Always Get Tongue-Tied at the Doctor, It's Time to Work on Self-Advocacy—Here's How

Speaking up in health care settings is a crucial part of prioritizing your health—here's how to get better at it.

Speaking up and self-advocating can be tough. But in health care situations, it's important to cultivate confidence to get the care you need and deserve. "Health care workers choose to work in health care because we want to help and serve you," says Shideh Shafie, M.D., an assistant professor of emergency medicine at Brown University. "For us to be able to do that well, we need to know as much as we can from you." For doctors and health care workers, every patient visit is a perfect "help me help you" opportunity.

Self-advocacy at the doctor makes it easier for your care provider to understand exactly what you're experiencing and provide you with care you feel confident in—and comfortable with. But how, exactly, should you do it? Doctor visits can be intimidating. Maybe you're shy; maybe you feel like you "don't want to bother anybody" or that your symptoms "don't deserve their attention"; or maybe you just forget everything you were going to say the second you sit on the exam table. We talked to a few experts to find out how to become a better, savvier self-advocate during health care visits.

What is self-advocacy?

Self-advocacy is exactly what it sounds like: It's the practice of vouching for yourself. In a health care setting, it means speaking up about your symptoms, voicing your concerns, and raising any questions you have.

"Good self-advocacy puts the needs of the patient first," says Cedrek McFadden, M.D., a South Carolina–based surgeon. "It involves listening to the doctor, but at the same time ensuring whatever the doctor may be proposing or suggesting is an appropriate fit."

Advocating for yourself may mean voicing concerns about a proposed course of treatment, asking about alternatives to a given procedure or surgery, or asking your doctor to summarize what they've told you to make sure you understand next steps.

Why does it matter?

Speaking up can be a challenge in any situation, but it can be especially tough when you're talking to an expert. After all, your doctor spent years mastering a specific field of study. Surely they know more about it than you do—right? Well, yes, but it's more layered than that.

The thing is, you're also an expert in this situation. You know more about your own symptoms, your experiences, your body, and your medical history than your doctor does. Since they can't read your mind, they'll only be able to help you if you communicate clearly and honestly with them. Remember, both of you have the same goal: helping you feel better. You're more likely to achieve that goal if you combine your respective expertise and work together.

"As physicians, we want to help and serve our patients, and understanding your symptoms and concerns fully is vital to that process," Dr. Shafie says. "We can't address what we don't know about, so please advocate for yourself, explain to us if we're not hearing one of your concerns, and give us the chance to address them."

How to be a better self-advocate

Knowing that self-advocacy is important doesn't necessarily make it any easier. Take these steps to start getting in the habit of advocating for yourself and your health.

01 of 09

Find a care provider you can count on.

Step 1 is simple: "Find a doctor you trust and can relate to," Dr. McFadden says. This may seem straightforward, but the truth is, 25 percent of Americans don't have a primary care provider—meaning they don't have a go-to doctor they turn to every time they need medical care. "Many folks don't have primary care providers and will only take the time to establish that relationship once something comes up," Dr. Shafie says. "And that can make you feel stuck with whoever can get you in for an appointment."

Establishing a relationship with a primary care provider can help you build trust over time and feel more confident in and comfortable with the care you're receiving. Plus, if you ever have a concern that falls outside your care provider's purview, they can refer you to a specialist they recommend.

02 of 09

Get to your appointments early.

You can be a good self-advocate without showing up early—but that extra time helps ensure you're calm and composed by the time you talk to your doctor. "Arrive early for the visit so you are more relaxed and not rushing," Dr. McFadden says. Again, this can help you center yourself so you feel confident bringing up questions and concerns as they arise.

RELATED: How to Navigate the World of Telemedicine and Get the Virtual Care You Need

03 of 09

Clearly communicate what you're experiencing.

Whether you're at a routine check-up or an appointment with a specialist, try to give your doctor all the information they could possibly need to help you. Are you experiencing any pain? If so, where—and how long have you been experiencing it? Have you noticed any changes in your body that you're curious about? If so, when did things change, what were they like before, and what are they like now?

If you're at all concerned about something, feel free to bring it up. Your care provider is there to help you. So remember that you're the expert about your own experiences, and confidently share anything you've found notable.

"When you first meet the doctor, it is always a good idea to explain exactly why you made the appointment with all of your concerns," Dr. Shafie says. "So instead of 'I am here for abdominal pain on and off for the past two months,' you might say something like, 'I am here for abdominal pain on and off for the past two months and am concerned because my cousin had Crohn's disease and I heard it's hereditary, and also I am trying to get pregnant and I don't want it to interfere with that.'" This level of specificity can help the doctor ensure they thoroughly understand your symptoms and your concerns—which will get you closer to receiving care you feel comfortable with.

04 of 09

Bring a list of questions with you.

Your doctor is there to care for you—and part of that care is giving you information about what you're experiencing, potential treatment options, and more. So if—at any moment along the way—you have a question, ask it.

In fact, you might want to consider bringing a list of questions with you. "Prepare for the appointment ahead of time by creating a list of questions," Dr. McFadden says. "It is easier to read the questions than to think of them on the spot."

Teri Dreher, RN, owner and CEO of NShore Patient Advocates, recommends bringing a list of three to five questions you can ask in five to seven minutes. She also recommends coming prepared with other documents, like your current medication list, your medical history, and your power of attorney for health care (if you have one).

05 of 09

Push back when you have concerns.

Disagreeing with anyone can be uncomfortable. But remember that your care provider is there for you. So if you feel concerned about something, bring it up. Your doctor may be able to give you information that eases your anxiety and clears up confusion. Or they may be able to propose a different treatment option.

"[Letting us know] that you disagree with something we think you should do gives us the opportunity to either change the plan because we understand the reasons it might not be right for you, or to explain why we think that plan is actually a good one," Dr. Shafie says.

Remember that you're both experts here—and that you're both working toward the same goal. So if you don't feel comfortable with how that goal is being met, mention it.

06 of 09

Take notes.

Bring a notebook with you and take notes during each appointment. You may want to jot down notes about potential treatment options, medications, next steps, and anything else that comes up during your appointment. And if you're interacting with multiple nurses, doctors, and specialists, it may be helpful to make a note of everyone who's caring for you, too.

"The care teams in hospitals are made up of many members, technicians, nurses, therapists, [and more] … [and] it can be very confusing for patients to identify who's who and what their roles are," Dr. Shafie says. "I encourage my patients (as well as my friends and family) to ask any person who walks into their room what their role is, and if they don't understand to ask for an explanation." This can help you understand who to speak to when you have specific questions and concerns.

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Confirm next steps with your doctor.

At the end of an appointment, take a moment to summarize what you've learned—and what you understand the next steps to be. This can help you ensure you and your doctor are on the same page. And if any questions or concerns are still lingering, it can help bring them to light.

"An example of this would be: 'So you are going to send me for bloodwork and an ultrasound of my abdomen. If that's normal, you think this abdominal pain is related to G.E.R.D. and you will refer me to a gastroenterologist for endoscopy. But if it's abnormal, it may be related to my gallbladder?'" Dr. Shafie says. "This allows you and the doctor to make sure you are on the same page. You'd be surprised how many details are missed sometimes without this step." Confirm the action plan, which ball is in whose court, and any other expectations.

08 of 09

Be confident and persistent.

If you have a question that hasn't been answered or a concern that hasn't been addressed, bring it up. "Your visit to the doctor should entail a two-way conversation and not one where the doctor is doing all of the talking," Dr. McFadden says.

If you're confused about something, ask a question. And if you're concerned about a particular course of treatment, ask about alternatives. "Remain consistent and persistent in what is important to you," he adds.

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Consider switching providers if you feel unsupported.

If you've expressed yourself confidently and clearly and you still feel like you aren't being heard, or leaving with more questions than answers, consider going elsewhere for care. A great first step is to get a second opinion, especially on more serious health issues. "One of the most under-utilized patient privileges is that of a second opinion," Dr. McFadden says. "If the care provider does not seem to be listening, ask for a second opinion from a different provider."

And remember, you can always switch primary care providers. "Health care providers are human. Like all humans, sometimes we click and sometimes we don't," Dr. Shafie says. "Finding a doctor who makes you feel listened to is part of the therapeutic process."

RELATED: 8 Signs You Need to Get a New Doctor

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