little more for wealthier nations (twenty minutes in the USA).3 Imagine that. Ten minutes—including prescreening by a nurse or medical assistant—to have an in-depth discussion with your doctor about your symptoms, possible causes, and treatment options and to think of and ask intelligent follow-up questions. That’s a tall order even for the most self-assured, articulate person.
So What Can I Do?
1. Be Prepared
This is the one best single, practical thing you can do to ensure your appointment is productive and your health care provider is put in the best position to help you. Before you attend your appointment, write down everything you need to say. List your symptoms (this is where the pain profile you worked on in the last chapter can help) clearly and simply. Include specifics such as the nature of the pain, duration, intensity, location, associated factors—even if you are not sure if they are relevant. If you are not a doctor, you may not know which factors are relevant and which aren’t, so let your doctor make that judgment call. List your medications and include any over-the-counter pain meds you take, how often and what dosage, how effective they are. List any therapies you have tried and their efficacy. If serious, include effects on your mood, routine, ability to work, sex drive, appetite, exercise, etc. You are the person experiencing the problem; the onus is on you to properly describe it.
2. Be Direct
Neither you nor your doctor has time to waste. Be clear and direct about why you have come in, what the problem is, and what you are hoping to achieve from the appointment. Have a goal in mind: a new medication, suggestions for alternative therapies, a referral to a specialist. This may or may not end up being the result, but if you do not have an intention for the appointment, you risk leaving without having made any progress.
3. Do Not Take Your Doctor’s Harried Nature or Brusque Attitude Personally
Do not interpret their attitude as a commentary on your medical situation. Your health care provider is a person, just like you, not a magical all-knowing being with endless capacity for patience and kindness. We might want them to be that, but they’re not. If they’re having a crappy day, they may well show it. Don’t personalize that. If it’s bad, if you feel they’re not listening to you, say so. You are allowed to do that! You have come in with a potentially tricky, difficult-to-diagnose-or-treat problem, and you should have their full attention.
4. Consider Asking for More Time
Pain is a complicated issue, and it is reasonable to expect a discussion of it to take longer than that of a cold or a sprained ankle. When making your appointment (especially with a general practitioner), consider asking for a longer appointment or an appointment at the end of the day—tell the receptionist you feel you need more time to speak with your doctor. They may not be able to help you, but most will appreciate your desire to avoid messing up their schedule by running long in the middle of the day.
5. Ask for a Referral
You may not be able to get the help you need from your family doctor or a specialist for a specific illness. Chronic pain specialists exist and focus purely on the understanding and treatment of physical pain. They have a wealth of knowledge your regular doctor does not and can be valuable resources. Consider asking your doctor for a referral, if this is an option near you.
6. Take Notes during Your Appointment
This may feel silly, but you probably have a lot of doctors’ appointments, regularly, and keeping track of it all can be an important diagnostic and treatment tool. Writing down your doctors’ suggestions, medication advice, and thoughts prevents you from forgetting anything, helps clear up confusion about instructions, and will strengthen the dialogue between you.
7. Take Suggestions Seriously
Your doctor may suggest a medication or treatment that you are uncomfortable with. You are well within your right to say so at the time—but do not discount everything. Doing so will discourage your doctor from trying to problem-solve with you and leave you even more on your own. Take their advice on board and, if possible, take notes on what you have tried and its efficacy.
Your relationship with your doctor is a partnership and should be treated as such. They are not gods who can wave their hands and solve every problem, and neither are you. You can and should demand time, attention, and respect from your doctor and for your pain, but do so realizing that they, like you, may be doing their best to fix an unfixable problem. It is your responsibility to be your own advocate for your health.
Misunderstanding Pain
Pain is a deeply misunderstood issue, and it can be very difficult to get a health care professional to take you seriously. All too often, we hear, “I told my doctor about the pain, but he said it was normal” or, “She said everyone gets that, I just have to suck it up and deal with it like everyone else.” Yes, everyone experiences pain at one time or another. And yes, it is all too common for doctors to try to explain pain away as a temporary symptom of something else, or even imaginary. The most heard (and most offensive) phrase for chronic pain sufferers is “It’s all in your head.” This dismissiveness and ignorance make a formal diagnosis incredibly difficult to come by. Those of you who have one probably had to see multiple doctors, maybe over a long period of time, before you were taken seriously.
Unfortunately, this is a problem that disproportionately affects women, who are perceived as having a lower pain tolerance and being more prone to complaint. This is simply false, and any doctor who tries to dismiss your legitimate pain for any reason, let alone gender, is wasting your time.
Not being taken seriously is the number one complaint those with pain disorders register when dealing with the medical profession. This is not necessarily anyone’s fault—an overworked, stressed doctor who has seen twenty people in a row with trifling complaints may be dismissive by habit rather than through callousness—but it does affect you, your health, and the management of your pain. Your pain is not secondary to your doctor’s mood (or timekeeping), and the single most effective way to ensure it is not treated as such is by not letting it be.
Sounds easy, right? Sure, I won’t let it. I’ll just snap my fingers and hey! presto, the doctor will take me seriously. And when the doctor I’ve been waiting three months to see dismisses my pain with a wave of his hand and declares I’m just “being dramatic,” I won’t take it personally and collapse into tears, thereby validating his assumption that I’m overly emotional or attention-seeking. I’ll be completely stoic, an emotionless robot who ignores her pain as callously as the doctor in front of me does.
Well, no. Expecting heroic displays of objectivity from ourselves, or high levels of compassion from every doctor, will lead to disappointment. But you can say, “I don’t think you’re taking me seriously.” Call them on it. See how they respond. Or, how about: “Here is a list of recent instances of pain, with extensive details of intensity, duration, et cetera. I would appreciate it if you tried to hear what I’m telling you, and I thought this list would help you understand.” Make it their problem—they were clearly unable to understand you the first time, so you’ve provided an idiot’s guide. Or how about simply: “This is not a problem I am willing to walk out of here without solving.”
These are difficult things to say. We are taught to respect our doctors, to listen to them, to defer to them. Being your own advocate is not easy and may not always make you friends. But what’s your alternative? Bow your head, nod, agree, and leave with the problem unsolved? It’s okay, I’ll just keep using this medication that does nothing. It’s alright, I can live with this pain by myself with no medical support. If you think that’s a realistic option, you
