Heather Cass More Content Now

In the 19th century, women’s health problems were frequently labeled hysteria. This was especially true if the symptoms were vague, infrequent or included any form of psychological stress. Once diagnosed as hysterical, women were often committed to an asylum for the rest of their lives.

We’ve come a long way since then. And, yet, if you talk to any adult woman today, it’s likely that she can recount at least one time that she felt her health concerns were ignored, dismissed or misdiagnosed.

Pam Farrell, 44, of Edinboro, Pennsylvania, experienced menorrhagia, abnormally heavy periods, for more than 10 years.

“It was so bad that I had to call off work because I couldn’t leave the house,” she said. “All the tests the doctor did came back normal and he suggested a partial hysterectomy. My insurance wouldn’t cover it, though, so I just learned to live with it.”

Farrell lived with it for five more years until she saw a new doctor who scheduled an internal sonogram and found a large polyp in her uterus. Two weeks later, she had minor surgery to remove it and her problem was solved — after 15 years.
How to be heard

Unfortunately, Farrell’s story is not an anomaly. Women are far more likely to live with long-term health issues, suffer from chronic pain and wait longer for a proper diagnosis.

The reasons for this are numerous and complicated. Some studies have shown that a gender bias may exist in treating women’s pain, but deeper, cultural issues come into play, too.

“Many women are strong champions for their kids, their partner, their parents, their pets, but not themselves,” said Debbie DeAngelo, R.N.C., B.S.N., an Erie, Pennsylvania, holistic health coach. “They don’t make their needs a priority, and this can delay them from seeking early treatment and prohibit thorough communication with clinicians.”

And when it comes to successful treatment, it all boils down to effective communication with health-care providers. Women must be advocates for their own health.

“You cannot take care of someone else or a whole family unless you’re well in terms of mind, body and spirit,” said Danielle Hansen, D.O., geriatrician at LECOM Institute for Successful Aging.

Here are some tips for effective appointments with health-care providers

Don’t delay treatment. “I often hear women say they have allowed an issue to persist for weeks or months before coming to my office,” said Dr. Lydia Travnik, a family physician at Allegheny Health Network Health + Wellness Pavilion: West Side in Erie. It’s understandable. Women have so many time constraints, especially during the middle ages of life. But, Travnik says, “unaddressed issues often compound with time, causing further complications. It’s important for women to be proactive.”

Understand how appointments work. “The way appointments are organized fall into several categories, including preventative (physicals), acute (problem-based concerns) or follow-up visits,” Travnik said. “Don’t expect to cover preventive topics and problems in one visit, as it makes it difficult to thoroughly address all aspects of preventative medicine.” As a guideline, Travnik said you can expect to address about three issues during one visit.

Ask for the time you need. “When you call your doctor to schedule an appointment, let the office staff know if you have more than one concern or if you have significant medical decisions or options to be discussed, so they can allot more time,” DeAngelo said.

Bring an extra set of ears. If you’re anxious, overwhelmed, or have difficulty communicating in a healthcare setting, bring a friend or family member with you. Even if you have no trouble talking with your doctor, it can be helpful to have another person there who can help you remember or understand what your provider said.

Organize your thoughts. Communicating succinctly requires some pre-appointment work. “Write down pertinent information like specific symptoms, when they began and what aggravates or improves them,” DeAngelo said. “Bring an updated medication and allergy list as well as the names and contact info for other healthcare providers who are treating you.”

Streamline and prioritize questions. “Show your written list of questions to your doctor at the beginning of the appointment, so he or she understands the nature of your concerns and knows how to address them,” DeAngelo said. Be prepared to write down the answers and ask for educational handouts you can review when you get home.

Be honest. Share all your symptoms and answer your physician’s questions honestly. “Don’t hide anything, even if you think it doesn’t matter, may not be related, or it makes you uncomfortable to discuss,” Hansen said. Doctors need to know all the details to make an accurate diagnosis.

Summarize. “At the end of your appointment, summarize what you think your doctor has told you by saying something like, ‘OK, let me see if I’ve understood you correctly,’ ” DeAngelo said.

Use the tools they offer you. Nearly every health care provider or facility has a patient portal where patients can access test results, refill medication, and email physicians or office staff.

Get a second opinion. It’s your right and, in many cases, advisable to get a second opinion on any procedures or treatments, especially if you’re uncertain about whether it’s the best course of action.

Be persistent. If your provider hasn’t gotten back to you, don’t wait. Call, fax or email. It’s your health and your life. Take control.

Trust your gut

Health care providers may be the experts in their fields, but patients are the experts about their individual bodies, Hansen said.

Women often know when something is not right, even if they don’t know what exactly it is.

“I believe we all have an intuitive sense that can guide us,” DeAngelo said. “It’s just that we often let our brain override our gut, and we ignore it.”

DeAngelo’s intuition saved her life, propelling her to seek help for a seemingly benign health issue.

“Ultimately, this led to a very early stage ovarian cancer diagnosis, despite test results and medical opinions to the contrary,” she said. “I’m so grateful I followed my gut and overrode my nurse-brain that was telling me it was probably nothing.”

The moral of DeAngelo’s story: Trust your gut and don’t stop until it’s satisfied.
Do you need an advocate?

The healthcare system can be complex, confusing and intimidating. This has given rise to the role of a health advocate.

“Health advocates can be as informal as an appointed friend or relative who attends appointments and coordinates your medical care or as formal as a paid independent professional to manage your care,” DeAngelo said. “From accompanying you to medical appointments and documenting questions and answers to locating a specialist to disputing bills, they act on your behalf.”

Health advocates are typically individuals with a nursing or other health background, and prices vary according to their role and responsibilities.

“Look for someone who is trustworthy, detail-oriented, and has a calm demeanor and diplomatic communication skills,” DeAngelo said.

Today, many hospitals employ patient advocates or representatives to enhance the patient care experience and quality. These advocates often handle complaints and intervene to bridge the gap between patient and hospital staff. Their services are free to patients.
Should you break up with your doctor?

Switching providers is always an option, but is it the best one?

DeAngelo suggests that you first identify the source of your dissatisfaction. “Many patients cite the lack of time with their doctor during an appointment as their biggest complaint,” she said. “This is usually the result of overscheduling, which may not be very different elsewhere. Another challenge is computers in the exam room, which can lead to a lack of eye contact that makes patients feel they’re not being listened to.”

Before changing doctors, consider voicing your concerns about what is bothering you. If you don’t feel comfortable doing it directly to the doctor, write him or her a letter, or ask to speak with the office manager.

“Also, keep in mind that you aren’t the only one who may feel frustrated by the time constraints surrounding your appointment,” DeAngelo said. “Often, clinicians wish they could spend more time with their patients, too.”

— Heather Cass is a freelance writer and publications manager at Penn State Behrend in Erie, Pennsylvania.