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Woman patient standing firm and respectfully speaking to a doctor in their office.

Respect and Power at the Doc’s Office

Feeling powerless at the doctor’s office is something many in the community can relate to. From being misunderstood, to being outright disrespected, self-advocacy when it comes to wellness can be draining and scary. That feeling can be compounded with uncertainty when uneven power dynamics are at play. I wanted to share a few tips that have helped me along the way, in times that I felt my appointments were not serving me well.

Note how you feel and vocalize this to your doctor

Have you ever had the experience of saying something to someone, only to feel like it went straight past them? This is especially frustrating when this happens with a healthcare professional. I can’t tell you how many times I have shared details about dealing with migraine with my doctor, only to have them gloss right over it. In these moments, I feel a mixture of upset and a little bewildered…after all, the reason I go to get the care I do is because I expect to be helped.

There have been times when I’ve met with a new doctor, and they would not even acknowledge that I’d said anything about migraine! I have gotten in the habit of repeating myself, and moving the conversation back to my needs. Politely reiterating points that I feel are not considered has helped me to advocate for my own care

Be firm about your needs

Sometimes, it really is true that we know best. While having a trusting and productive relationship with our care providers means leaning on their expertise, sometimes we have to be firm in pushing for what we want and need. Once, I was prescribed medication for migraine that ended up making me very sick, things were worse than before I began taking it. I told my doctor that I could not be prescribed this medication any longer, and they agreed. We worked together to find an alternative for me to try. When I went to pick up my prescriptions the same day, I found out I had been prescribed the same old medication that I had spent so long talking to my doctor about not taking hours earlier. How frustrating!

I’d already spent hours advocating for myself, and I had to call the doctor up and get them to call in the right medication and then wait even longer to pick it up. While this was likely an honest mistake on the busy doctor’s part, it was also another indication of power imbalances (a few hours is no small inconvenience for working-class, chronically ill folks) at play and the need to be firm. I could have just taken that medication and assumed that I, the patient, was wrong. But I knew how I felt, and I knew I had to firmly set the record straight.

Be specific and keep a migraine journal

I have learned over the years to get specific about what it is I am wanting to convey. I might not always have the answers, but keeping a journal of my symptoms, potential triggers, and moods has helped me to be more specific with my care professionals, which in turn helps them to help me. I remember so many appointments in college where I would go to my university health center and the best I could articulate was ‘I am always in pain.’ Not really much more or less, and it was frustrating to both myself and my doctor.

Part of self-advocacy is being attentive and prepared, and this can be developed over time. Now, I am prepared to update on changes and responses to medication. I keep an eye on what I am consuming. I am attentive to my body, which has not only helped in communicating with my doctor, but has helped me identify what I can do with my own habits and behaviors to accommodate my health.

Know when to go and get a new doctor

Even with good communication, attention to detail, and a commitment to firmness, sometimes we can’t mitigate the negative implications of a patient-doctor relationship that isn’t working. Knowing when it is time to say goodbye can make a huge difference in treatment. If things have been the same for a very long time, or if you feel like you can’t advocate for yourself honestly and openly, it may be time to consider new care.

Do you feel powerful or powerless when visiting the doctor? Why? Let’s discuss in the comments!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Judy H
    2 months ago

    I have had migraines since I was 17. I am now 62. When my migraines began to become frequent enough to seek medical help, the doctors that I saw were dismissive or annoyed that I was taking up their time with something that they didn’t really understand enough to help me with. (My hindsight interpretation.) I went through 9 different doctors in the SW Ohio area over the years. (One was such a wacko that she told me to eat walnuts & chocolate at the same time because the glycemic index said it was good for you. -She totally didn’t hear that nuts were a major migraine trigger for me) Another neurologist prescribed something that had side effects that I objected to. He said he would take me off of it if my family doctor said to, but not just because I didn’t want to take it. Another neurologist’s practice, where I was an established patient, refused to let me return to their practice to resume treatment with Botox after I had legitimate orthodontic treatment for TMJ. The dentist who was administering the treatment for TMJ had requested that I stop Botox during his treatment to be able to tell that the TMJ treatment was fully effective. (Sounded legitimate to me.) However the neurologist’s office refused to let me resume my Botox treatments for migraine following the TMJ treatment even though I informed them what was taking place. They completely wrote me off. (They acted too important to consider me as a patient any longer, despite my hiatus for medical reasons!) I finally ended up traveling to Chicago (300 miles) for a doctor who actually listens to me and treats me like my opinion matters in decisions about my treatment. After retiring, my husband and I moved to Chicago so that I could be near this doctor and his practice. If I see the nurse practitioner, I am treated with the same respect. 🙂

  • Peggy Artman moderator
    2 months ago

    @Judy H, I also had to get through with several doctors before finding the best one for me. I know it is such a frustrating process. I am so glad to hear that you now have found the right doctor for you! The last thing we need as migraine patients is a doctor that makes you feel worse. Wishing you a low pain day today. ~ Peggy (Migraine.com Team)

  • deedeevee1
    2 months ago

    I’m a firm believer in self advocacy. Sometimes I’ve been told I’m too vocal, lol but it’s my only life and body. When my migraines began, I was 32, and I went from none to chronic everyday all day pain. The first doctor I saw simply gave me a script for pain meds. (Oh how times have changed, but that’s a story for another day) That to me was unacceptable. I needed to know why my head was hurting so terribly. Why I couldn’t see properly or was so nauseated I couldn’t stand up straight. The next one simply stated that I was obese and I smoked so that’s why. Ummm….NO. I’ve been fat my whole life and zero to 10 overnight?? Unacceptable. It took me 6 tries to finally find a neurologist that listened and explained and worked at coming up with a plan. I’ve become a PRO at speaking with doctors, nurses, schedulers, and insurance companies. (the true evil) I’m even getting into talking with the general public and politicians. Nobody knows you and your body better than you do. It’s your right to ask questions, request explainations in laymen terms, inform them if treatments that have worked or failed in the past. The only stupid question is the one that isn’t asked, I say. Lol Hope y’all are having a better day than I am.

  • Peggy Artman moderator
    2 months ago

    @deedeevee1, thanks for sharing your story about migraine. You are absolutely correct in that we need to advocate for ourselves. You do have the right to ask questions and be taken seriously. Great attitude! ~ Peggy (Migraine.com Team)

  • dollarslice
    2 months ago

    I am lucky enough to live in NYC where there are a ton of doctors to choose from… when my PCP was dismissive of my migraines (and did some other things I was annoyed by, like refusing to renew prescriptions unless I came in to see him quarterly) I was able to find someone new immediately. But the best was when I got on a great insurance plan that didn’t require referrals. I was able to find my own migraine specialist and start seeing them without having to go through a gatekeeper. I found a practice where they listen, they care about my quality of life, they ask questions, they take notes, they pay attention. It’s been amazing.

  • Peggy Artman moderator
    2 months ago

    @dollarslice, you a very lucky to live in a city where there are so many Migraine specialists. But I know it can take a while to find the right one. It’s great that you have a caring doctor now! ~ Peggy (Migraine.com Team)

  • jems
    2 months ago

    My GP has told me on more than one occasion that my migraines are “psychological” – which I find very frustrating – as the real cause is hormonal.

  • Peggy Artman moderator
    2 months ago

    @jems
    Thanks for joining us here. As far as I know, Migraine is a neurological disorder. It could be inherited. I understand your frustration over your doctor calling them “psychological”. It’s possible your hormones may be triggering your attacks, but it’s possible to have other triggers.
    ~ Peggy (Migraine.com Team)

  • AmyF
    2 months ago

    A lot of people seem to think that “The doctor is the expert, and the patient should listen to them.” The insidious part of that is that it’s true to some extent. The doctor (hopefully) knows far more than you do about medicine. But you know far more than they do about your life – what your symptoms are, whether they’re getting better, whether you’re having side effects, what side effects are acceptable, what treatments you can afford. They’re the experts on medicine, you’re the expert on you.

  • Peggy Artman moderator
    2 months ago

    @AmyF, I agree with you on this issue. The truth is that there still is a shortage of migraine specialists. It has taken me a long time, but I have found it helpful to have a doctor that is willing to partner with me in making decisions about my health. Some doctors are better listeners than others.
    ~ Peggy (Migraine.com Team)

  • Stephen
    2 months ago

    My doctor, a lady doctor and a mother of a 10-year-old, is fantastic. She advised me to actually keep a journal, and together we’re trying to pinpoint the problem.
    When I’m in the grips of an attack, she injects me with prescribed medication there and then. We are trying together to narrow down the cause.
    If a doctor is not working with you, you’re wasting your time.

  • Peggy Artman moderator
    2 months ago

    @Stephen, it sounds like you have a great doctor! I’m happy for you!! It makes all the difference when coping with migraine.
    Peggy (Migraine.com Team)

  • Stephen
    2 months ago

    Yes, she is the first doctor in about 25 years who actually realizes migraine is not just a pesky headache. She has indicated that we’re working together towards a way to cope/solution.

  • glassmind
    2 months ago

    Sooo often. Too often. Thankfully, I have had a few rare providers who considered me the expert on my condition, genuinely listened and asked targeted questions and collaborated with me as a peer regarding my treatment plan.

    I have just applied to change my primary doctor though as this person was dismissive, corrossive and inept (miswrote a prescription leaving me without medication as the script could not be filled.)

    Your tips are good. I use them all. As you also said sometimes one just has to leave a provider.

    Thank you for raising awareness of the added challenge of provider power struggles that is sometimes added to an already challenging situation: having Migraine.

    May we each and all find and keep good healthcare providers.

  • Peggy Artman moderator
    2 months ago

    @glassmind, your doctor sounds great. People with migraine really need an empathetic doctor who really listens. It’s great that you have this type of doctor!
    ~ Peggy (Migraine.com Team)

  • glassmind
    2 months ago

    I had good doctors previously. My current doctor is dismissive, corrossive, and inept. I have requested a new doctor.

  • tonytoshiba
    2 months ago

    A nice article and it seems as if your journal and other works have helped you.
    I have kept a journal, one for my special needs adult epileptic son, one for my special needs adult daughter for her seizures, asthma and migraines, one for me, migraines, emphysema and asthma, there is more but I’ll only mention those.
    My internal medicine Doctor moved to another city so I had to change doctors. The new quack I was assigned, (he was the only one available), took a glance at my journal and threw it toward a chair, it hit the floor and he left it there. The after visit report stated he saw me for neuropathy and COPD. He asked how I was breathing and if my feet tingled. I had made the appointment for my migraines, debilitating. For some strange reason my prescriptions which keep me breathing were being removed from my list so I was not able to obtain them, probably just coincidence. This caused my blood-pressure to rise as I was trying to get them reinstated and finding it was difficult.
    My Botox injections became Lidocaine, which did not work. I was told the injections were still Botox, I brought up the medication and the charges which really irritated the doctor as he was caught in a lie. This doctor was teaching the new prospective doctors how to treat patients and be certified. Each appointment was the same. I finally got another doctor in a city further away. I am now being taken care of and we have greatly reduced my arthritis so I can now walk or drive without a lot of foreboding.
    If you cannot get your Doctor or facility to help you please don’t hesitate to leave and search for one which will help. I do not want drugs that are addictive. I will not use them for more than very short periods. This is all in my charts. I only want solutions, and I am willing to be a guiney pig again. Tetracycline was used on me as a child when it was experimental, there have been other medications and treatments in which I was one of the medicated group, not the control group.
    Please don’t let the ACA keep you from treatment.

  • Peggy Artman moderator
    2 months ago

    @tonytoshiba, I’m really glad you found a better doctor. It sounds like you went through a really confusing, frustrating situation with your last doctor. Throwing your diary on the floor is just unacceptable because it shows the doctor whether you have 15 or more migraine days. 15 or more headache days means your headaches are chronic and open up your eligibility for certain treatments. I’m glad you are getting better care now. ~Peggy (Migraine.com Team)

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