“Anxiety can have lots of physical symptoms. Have you been feeling anxious recently?”
“Have you tried losing weight?”
“Maybe the pain is psychological.”
These are examples of medical gaslighting: Dismissing your symptoms and providing no real solutions. It’s a sadly common experience for people with chronic pain.
Here are 5 tips to get your doctor to take you seriously.
1. Keep Notes on Your Symptoms
Patient advocacy begins with expressing yourself loud and clear. Of course, this is easier said than done when you’re 1:1 with a doctor. Sometimes it’s hard to say everything you want to. So take careful notes to help lay out the big picture in a way that makes doctors take it seriously. Consider taking notes that include:
- The time each episode occurs
- How long each episode lasts
- Description and location of the pain
- The peak and average severity of the pain from 1-10 (Here’s our chronic pain scale for reference)
- Any patterns in timing or triggers
(li)What you’ve already tried to manage it
Try to also take notes during your appointment, so you can refer to everything that was said in future communications.
2. Prepare a List of Questions
When doctors get dismissive, it’s hard to stay on track. Keep in mind that you’re there to solve your pain, not to make their days easier. Write down a list of questions you want to ask (like those in our next tip!)
3. Bring a Trusted Friend
Talking with doctors can be intimidating. If you feel comfortable, ask a loved one to come with you. They can be great sources of support to help you feel more confident sharing your experience and advocating for yourself. They can also help validate your symptoms and come up with questions you don’t think to ask.
4. Ask for a Differential Diagnosis (DDx)
If your doctor dismisses your symptoms, ask them for a differential diagnosis (DDx). That’s the medical term for listing all possible causes.
Basically, it’s the professional way to tell the doctor to do their job.
Begin by asking your doctor, “What’s my differential diagnosis?”
Once they list all your options, go through each possible diagnosis and ask, “How did you rule out this one for me?”
If it wasn’t ruled out, ask, “What’s the evidence for and against this one?”
These questions will force your doctor to really consider your symptoms and give all your options.
Hat tip to Dr. Dorender Gray for this tip. You can check out more of her insights @Dor_the_grayt
5. Insist on Noting Refusals in Your Chart
If the doctor doesn’t have clear evidence against a diagnosis, ask, “What tests could be run to rule this one out?”
Ask if the test carries any risks, so you can make an informed decision.
If you want the test, ask for it. If the doctor says no, say, “OK. Please note my request and your refusal in my chart. I’ll wait while you note it.”
If they don’t want to, insist. This can be uncomfortable, but it’s your right. Don’t let them note it after you leave (and maybe forget to do so). Sit there and watch them do it.
The reason for all this is simple: Noting they refused the test creates liability for the doctor.
Usually, when pressed to note their refusal, doctors will change their mind and order the test.
