Doctors, Treatment

Effective Advocates

When I’m asked about making sure a doctor’s visit is helpful for the patient, my primary suggestion is to take a family member or friend along as an advocate. Overattentive Families May Be Underrated, from the New York Times, illustrates how important it is for a patient to have an effective advocate.

I’m using the term “effective advocate” intentionally. Overaggressive, rude or otherwise irritating family members can harm more than they help.

Trying to help a friend who had been in a car accident, I overstepped that boundary — at least the doctor thought I did. We waited more than two hours for her to have a cast removed. She had a head injury, so was sensitive to sound and bright lights, and she couldn’t stay upright for long without nausea. The waiting room, practically floodlit with fluorescents, was full of patients and, thus, noise.

No rooms were available, so we moved to the bathroom across the hall. There we stayed, lying on the tile floor with the lights out. Periodically I checked on the doctor’s schedule. By the time he got to the room, I was furious and he was none too pleased by my pushiness.

He barely acknowledged her and began to saw the cast off with little explanation. His answers to our questions were curt. When I pressed for more information, he repeated previous answers, closed the chart and bolted out the door.

He was angry with me, but seemed to be and egotistical jerk anyway. What he saw as belligerent another doc could have called assertive. Nonetheless, it was the wrong move in this situation.

I can’t imagine any of my doctors being as rude as my friend’s doc, but Hart is a great advocate. Faking it is my default mode in public. Hart’s assessment of my pain levels are more accurate than mine and he knows I underestimate on pain scales. He also thinks to ask questions that I have forgotten or not even thought of.

Take someone to your appointments if you can, but be sure to choose carefully. While your mom may know you best, a friend can advocate for you without the clouded judgment of a mother who wants her baby “fixed.” The person you take should have accurate knowledge of your pain levels, know what your goals for the appointment are and be able to talk to you about what they got from the appointment.

4 thoughts on “Effective Advocates”

  1. Great advice. It can be hard not to be pushy and intense when you are worried, but it certainly doesn’t do anyone any good.

    If we could draw clear lines between assertive and pushy we’d be in business!


  2. Another point: if you think you might be too impaired to call your physician’s office during a headache, and you are going to want a family member to call on your behalf, please sign a consent form for that person to talk to the physician when you are in the office. We really are not trying to be difficult about this–it’s federal law intended to protect your confidentiality.

  3. There is no excuse for doctors or other health care providers to be jerks. However, please be aware that under current HIPAA laws we are somewhat restricted regarding how much information we are allowed to release to anyone who is not the patient without the patient’s written permission. If you are in the room, obviously there is a level of implied consent–unless there is reason to suspect an abusive relationship, which we are also obligated by law to report. And…between 1/5 to 1/3 of women reporting to Emergency Departments have been victims of some sort of sexual or domestic violence or abuse. So–it becomes complicated.

    In today’s deteriorating health care environment, the Emergency Department has become something of a war zone, inundated by trauma victims. And with the general lack of awareness and poor attitude regarding the headache sufferer, we tend to fare poorly in the Emergency Department and are treated, at best, as a nuisance, and more often, as a drug seeker. This is why I try to give my patients the tools they need to manage their headaches on their own without resorting to Emergency Department treatment unless they have become dehydrated and require IV hydration.

    If you do go to an ER, take an advocate who can remain calm but persistent, while keeping these points in mind–and someone who can educate regarding headache/migraine wouldn’t hurt!

  4. This is great advice. A big part of why I always take someone with me to the doctor and ER is that, when I’m migraining, I don’t think clearly. I need someone, my level-headed mother or my level-headed husband, to explain exactly what is going on.

    Taking along someone who is reasonable but protective is the best advice I can give anyway.

    Great point about the person being reasonable and protective. I agree that that’s the perfect combination.



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