As an athlete, I’ve always been someone who likes to be in charge of my body. I’m also a nurse practitioner who works in a primary healthcare setting, managing patient care. When I was diagnosed with rheumatoid arthritis a few years ago, I looked for a specialist who would provide the medical care I needed but would also partner with me in medical decision making. In the early days of my diagnosis, I was more passive as a patient, letting my doctor order medications and treatments she deemed necessary. As time passed, I did the necessary homework — reading up on my disease and treatments and asking questions.
I took a more active role in my treatment plan when a serious side effect occurred with one of the medications I was taking. My doctor wanted to continue the medication, but at a lower dose. We debated the pros and cons and in the end, she discontinued the medication. With my most recent disease flare, during which I had severe fatigue, we discussed options of how to best manage my symptoms. I agreed to a trial of a new medication. After six weeks of the medication, there was no improvement and I developed tinnitus, a non-reversible side effect. During those six weeks, I combed through the medical literature on my condition and symptoms. When I returned to see my doctor, armed with knowledge, I was prepared to discuss my perspective, as an athlete and as a patient. While she stopped the tinnitus — causing medication, alternative medications she wanted me to start would have further impacted my ability to exercise. There was an alternative medication I had learned about and when I presented it to her, she liked it. Several months later, I can say that I am feeling and doing much better.
Related: How I Took Walking for Granted
I see a lot of posts on social media from fellow athletes who have health problems, ranging from injuries to chronic illnesses like mine. As a health care provider myself, I can say with all honesty that not all medical providers are willing to partner with their patients to develop a plan of care that is customized to their needs. There are also patients who are willing to take a passive role in their health care and follow whatever their physician tells them. I am also amazed at people who refuse to follow conventional, proven treatments for health conditions. While there is a place for alternative medicine, it is as an adjunct to conventional medicine, not as a replacement. There has to be a happy medium here.
How do we partner with our doctors (and nurse practitioners) and still take charge of our health?
1. Find a provider who listens to you. To me, this is the most important quality in a medical provider. People always ask me why I see the doctors I see. I chose my doctors because they listen to me. My internist is my favorite medical provider because she “gets me”. When I was struggling with fatigue this spring, I scheduled an appointment with her in addition to seeing my rheumatologist. When I discussed my issues and talked about what I was thinking with her, she was very supportive. On the other hand, if you don’t like what you hear from a medical provider, move on. Years ago, I saw an orthopedic surgeon for a knee issue and he told me that I run “too much”. I left him for another doctor and found a real solution and resolution to my knee issue.
2. Arrive early for your appointment. But be prepared to wait. To be sure, I always have to wait to see my doctors. As a medical provider, I can tell you from “the other side” that there are a couple of reasons for the wait to see the provider. Quite often, patients arrive late and providers will still see them. Unfortunately, the time your provider spends with a late arrival can often bleed into your appointment time. Sometimes a visit isn’t so straightforward. Providers are given 15-20 minutes to solve all the problems. We all do our best but know that a good provider who runs behind will give you the same attention they are giving to the patients before you.
3. Put your phone on silent and put it away. As a medical provider, there is nothing more irritating than someone’s phone ringing while I’m seeing the patient. If you want to alienate your provider, take the call. When this happens to me, I excuse myself from the room, telling the family that I am going to see another patient while they take their call. This is just so disrespectful. And it happens to me more often than you can imagine.
4. Do your homework but use reputable sources for information. My favorite mantra and one that I repeat throughout my day is that, “Dr. Google is not your friend.” If you’re “googling” information about your condition, include the words “evidence-based” or “scientific literature” in your search. This ensures that you will pull reputable articles, guidelines and other information. If you’re going to partner with your doctor, you want to sound educated. Whenever patients tell me that they “read something on Facebook,” I want to roll my eyes. Guys, how would you feel if your doctor based their care on something they read on Facebook?
5. Prepare a list of questions ahead of time. Sitting on the exam table in a flimsy gown can suck the confidence out of the most self-assured person. It’s intimidating! It happens to me when I see my doctors. I write down questions before I go in. A lot of my patients do that as well. When your doctor discusses a treatment or medication with you, ask them what to expect and ask about alternatives. There’s nothing wrong with taking notes, too. While seeing patients, I’ve been put on speakerphone to talk with trusted family members and there have been times I’ve been recorded. If your provider doesn’t like any of this, it’s time to look for a new provider.
6. Be open and forthcoming with your medical information. How can you expect to get the best care if you don’t share everything with your doctor? Even in pediatrics (where I work) I’m always amazed at the things parents and patients don’t tell me. My job is part detective work as I try to obtain the information I need to sort out the medical mysteries that appear at my door. Even if you think a symptom isn’t relevant, bring it up! You never know. Be truthful about your lifestyle, too. We can only do our best with the information we are given.
7. Remember that the doctor isn’t always right. Trust your gut. If what your doctor is proposing doesn’t sound right to you, you may want to get a second opinion. Not all doctors treat patients equally, and not all of them keep up with the latest medical developments. When I was diagnosed with RA, I asked for a referral to a rheumatologist who would still let me run. There are many who won’t, even though there is plenty of research to support vigorous exercise and RA.
8. Keep an open mind. Remember that your doctor is most likely more educated than you are. They’ve been trained to review research and interpret the data. If your provider is suggesting a new treatment for you but you’re not sure about it, unless it’s a life or death situation, ask them if they have more information for you to review before starting. You might not like what you’re hearing, but most providers are in the profession because they want you to feel better.
What are some ways you have worked together with your healthcare provider? Tell us in the comments.