Have you ever heard of 'white coat syndrome'? This is also known as 'white coat hypertension'.
It describes a real phenomenon, where some patients experience elevated blood pressure in medical settings (i.e. doctor's office or hospital) compared to nonmedical settings (i.e. home).
Note: White coat hypertension isn't always due to the anxiety of being in a medical setting. Always discuss medical concerns with your doctor- remember, this is not a medical blog :)
Many of us associate medical settings with sickness and injury, which makes doctor-associated anxiety very understandable. However, this anxiety can get in the way of preventative care. We can only prevent certain diseases if patients are willing to undergo fairly uncomfortable procedures such as mammograms, colorectal exams, or regular physicals.
Doctors offices are usually where many of us begin our mental health journey as well. So this is an important place to feel empowered!
If your fear or anxiety about doctors or medical settings is preventing you from taking a more active role in your health care, this article is for you!
This article is also for you, who would like to learn how to get MORE out of your doctor's visits
And for you, who is learning how to advocate for a family member in the health care system
Let's get into it.
Healthcare Advocacy 101
Being a patient is often associated with passivity. This can be partially explained by the perceived heirarchy of a doctor and a patient. What is that heirarchy was more...horizontal?
Having a shared, or active role in either your or a close family member's health care (with their consent, of course) can be transformative.
You may even experience better health outcomes, simply from the act of engaging activity with healthcare providers and having open, honest conversations.
1. Find A Doctor You Trust
Gone are the days where your childhood doctor has to be your family doctor as an adult. It is perfectly okay to change your family doctor or find one who is better suited to your personal needs.
Read reviews, ask around, and don't be afraid to book initial appointments to get a feel for the person. This is an important relationship, and mutual respect + trust is vital.
2. Request Accommodations If You Need Them
Medicine is not one-size-fits-all and neither should your experience be in the healthcare system! If you need certain accommodations to feel comfortable prior to or during appointments, you can ask them to document these requests in your file.
For example, maybe you prefer not to be weighed at every appointment. Or you have experienced sexual trauma in the past and prefer to be talked through procedures and examinations thoroughly. Having these pieces of information on record and ensuring the requests are honoured can reduce anxiety about the appointment even before it begins.
3. Ask As Many Questions As You Need
You are not being "annoying", nor are you"burdening" a healthcare provider with your questions. It's important to ask follow-up questions or let a provider know you need further clarification.
If this feels difficult to do sometimes, remind yourself that doctors provide a service to you and they are in a helping profession- answering your questions is part of their job description!
4. Have Notes Ready
Write down what you want to talk about in the appointment. The simple act of doing this helps to organize your own thoughts and also gives you a safeguard in case your forget to mention something important- which happens a lot due to nerves + the difference in power dynamic.
Bringing notes about your particular health issue is also an excellent idea, and many health care providers will appreciate this. Here a few things to include in your notes:
- Bring a full list of your medications and dosages
- Write down your symptoms, how often they occur and makes them better or worse
- If you are discussing pain, try keeping notes on pain ratings (i.e. 1-10)
- Factors that may be impacting your symptoms (stressful life events, changes in diet etc.)
- Any questions you might have about diagnosis or treatment
5. Request Refusal Of Care Documentation In Your Chart
Many people may read this and think "well, that's a bit aggressive".
We beg to differ! It's important to document when you have a health concern that is not addressed or investigated in a reasonable manner, or a healthcare provider has not deemed it to be an issue worth further investigation.
This way, you have your concerns on record and if the problem shows up again, the doctor knows exactly how long it has gone unaddressed.
Moreover, many groups experience healthcare professionals dismissing or invalidating the severity of their symptoms. Having this officially on record also provides motivation for some healthcare providers to increase their quality of care.
6. Point Out When You Are Being Talked AT, Instead Of Talked TO
For those of us who accompany parents to their doctor's appointments to help with translation, we know all too well that healthcare professionals can sometimes make their patients feel invisible.
Many adult children of immigrants find that healthcare providers only speak to them, nearly ignoring their parent or grandparent who is the actual patient. This can be incredibly disempowering for the patient themselves.
Perhaps you have experienced this in a solo appointment too: a doctor seems to be rattling off their opinion and (sometimes jargon-filled) perspective without checking to see how you are processing all of this.
When this occurs, it's important to point it out. Doing so will help you take on a more active and shared role in your healthcare.
Try these phrases:
"My mom is the actual patient. Can you direct that question to her and I will help translate her answer to you?"
"Can you slow down, I would like to make sure I am understanding this information about my own health"
7. Don't Be Afraid To Get A Second Opinion
You are in charge of your health and your body. If you are not comfortable with a doctor's plan of action, you have a right to get a second opinion.
It's not disrespectful. If something doesn't feel right, follow your gut and get that second opinion.
8. You Have The Right To Request Interpretation
If you, or a family member, is going to an appointment and thinks they might benefit from a language interpreter, feel free to request it!
Many hospitals and clinics have access to telephone and video interpretation services such as Language Line.
Research has shown that professional language interpreters are under-utilized in health care settings. This is surprising, given how easy these services are to use, and the healthcare experiences patients with limited language proficiency have.
Patients with limited English-language proficiency encounter different access to acute and preventative care (i.e. mammograms), longer hospitalizations, and tend to possess an incomplete understanding of discharge instructions or how to take medications. They are also at an increased risk of medical errors, misdiagnoses, and adverse events resulting in physical harm.
Utilizing these services teaches healthcare providers that interpretation is a valuable part of the patient experience!
Doctors and healthcare settings in general can be intimidating! Many people put off seeing a medical professional because of the fear and anxiety and medical settings and white coats can induce. These fears are reinforced by the power dynamics between patient and doctor.
Levelling the playing field by taking on an active or even shared role with your healthcare provider is one way to empower yourself and even help improve certain health outcomes.
The white coat is only as scary as you make it!
I want to hear from you: What are your best healthcare advocacy success stories? Let me know in the comments below!
Until next time!