Dear Chronically Ill Young Women: How to Be Assertive in a Medical Space

A few days ago, I ran a poll on Twitter, asking my followers what they would like me to do a “thread” on. I included four options: 1) How to deal with blood draws, 2) How to deal with an IV placement, 3) How to be assertive with your doctor and 4) How to manage swallowing large amounts of medication/large pills.

I was not exactly surprised to see that the third option – how to be assertive with your doctor – got the overwhelming majority of votes. Clearly, this was something a lot of young women just beginning to enter the medical world without the help of a parent (or even with the help of a parent) needed some tips on.

I can relate. Since I was diagnosed with Crohn’s disease at age 17, I was frequently emotionally overwhelmed in a hospital bed, on an exam table or just for a talk-through with my doctor(s). I felt inexperienced, and felt that a lot of things were being thrown on the table that I didn’t necessarily know much about. Sometimes, I felt (and sometimes still feel) pressured to go ahead with procedures, medications, certain types of sedation or infusions I don’t feel comfortable with.

As young women, we are taught by society to “be nice.” We are taught it’s better to be “polite” and comply out of fear of being thought of as rude. However, being assertive with your doctor(s) and nurse(s) is not “rude.” Your life may be at stake here. It is imperative you do everything you can to feel like you are in control of the situation. It is empowering, it provides you with more confidence and it may even benefit you medically.

This isn’t to say that all doctors or nurses (or other medical professionals) are bad people. However, it is important for us, as chronically ill young women, to know our rights as a patient, to be assertive, to know it’s OK to refuse treatment and to know it is not “rude” to do those things. You may feel scared of hurting someone’s feelings. However, this is your health. If you don’t feel comfortable with what someone is doing with your body, you’re not rude for telling them you want them to stop. No matter what, your body will always be your own, and you have the right to stand up for it and stand up for yourself.

So, without further ado, here are some tips for young women on how to be assertive, knowing your rights and remembering that your well-being, both mental and physical, is of utmost importance.

1. I must start with the fact that it is totally normal for you (a chronically ill young woman) to be intimidated by your doctor. Usually, they’re quite a bit older than you, may use unfamiliar medical terms, and, if they are male, may sometimes take you less seriously. Remember your own symptoms that are very real and present may be disregarded. It has been proven in many studies and articles (here, here) that chronically ill young women are (intentionally or unintentionally) mistreated by their doctors. So, you have every reason to be scared or feel like it is too hard to stand up for yourself even when you really need to.

2. Try to adopt an assertive stance and attitude while in an appointment. I find that “man-spreading” makes me feel like I take up more space. This makes me feel more in control of my situation, even if I’m nervous or scared. If you’re in a hospital bed and “man-spreading” isn’t physical possible, never take your eyes off the medical professional talking to you. Eye contact also makes you feel in control; it makes it look like you’re paying close attention to every word they’re saying. Eye contact in clinic appointments also is a huge help.

3. If you’re able, try to dress/do your make-up (if you wear any) in a way that makes you feel more powerful. Sometimes I like wearing “boyish” clothes; sometimes I put on a full face of make-up with dark lips and red eyeshadow. It all depends on how I’m feeling that day and what kind of vibe I feel most powerful with.

 

4. It also always helps to have an advocate with you if you’re too overwhelmed or simply physically unable to speak for yourself. Mom, dad, friend, cousin – it doesn’t matter! Just give them your agenda before the appointment, so that if you suddenly become overwhelmed, they can take over without being confused about what you want out of the appointment.

5. This one is very important: write down a list of questions/concerns you have. You can do it on a piece of paper, in a notebook you have, on your iPhone notes – whatever works for you. A list keeps you on track, keeps you feeling professional and reminds you why you’re there. I easily get distracted in appointments because I sometimes get bad memories or feelings. Having notes really helps me with that. I can focus on the problem I want fixed, rather than dwell on negative experiences in my past.

6. It is OK to tell your doctor “no!” if you feel like whatever they are suggesting is not in your best interest. If you feel like you’re not ready for it yet, if you don’t feel safe doing it, you can say no. That is not a rude thing to say. You have the right to decide what will be happening to your body. It is your body, not theirs – remember that. It really is so important to remember that you can always refuse treatment, that you can always walk out of an appointment or a hospital “against medical advice.” Don’t think or worry about what your doctor might feel. It’s your health and your life. You have the right to make your own decisions, even if your doctor is annoyed by them.

7. However, if you do want the treatment/procedure/etc., remember: you’re a patient, but you are also a customer of sorts. By visiting their clinic, by going to their practice, you are putting money in their pocket. If they’re making you feel uncomfortable, if they’re going too fast, if they start suggesting options you don’t want, tell them: “Hey! Could we slow down a little? I am getting overwhelmed.” Continue if you wish – but you can leave it at that, too, and that’s OK.

8. If you feel tears coming, it’s a good time to step out of the room or have your advocate speak for you. If you’re emotionally compromised (angry, sad, upset, etc.) you might make a spur of the moment decision that is not in your best interest. It might be a decision you could seriously regret later.

9. You can and should tell your doctor if something they’re doing hurts. You don’t have to silently tolerate unnecessary pain. I’m not talking about a needle poke for an IV or a blood draw; I’m talking about a physical exam they could make more comfortable. Tell them to slow down if you’re not feeling right. Again, that is completely OK.

10. You have the right to ask for a second opinion! Even if you feel like the first doctor you visit is the one for you, something might still feel off. It is not only OK to get a second opinion – it is a very good idea to get one. You may have more treatment options and may feel more comfortable with a different doctor. And again – don’t worry about hurting anyone’s feelings. Your health and life are at stake here. Your doctor’s feelings don’t matter in this situation.

11. One last thing: walk into check-in, walk into the exam room, walk out of your exam room like you’re strutting a runway. That will give you confidence. An assertive walk and “resting bitch face” will help your doctor see right from the get-go that you’re there for you, not them.

It’s difficult to read these things and feel like it’s “OK” to say this to a licensed medical professional. However, discrimination in the medical community is very much an issue, and young women are often pushed into corners because they feel like someone else’s feelings are more important than their own health.

This isn’t me trying to blame young women who have been in this situation, by the way – I myself have experienced several instances like this. These “tips and tricks” are things I’ve collected in my two years of being officially diagnosed and skipping around from various treatments and doctors. They’re things that take work to pull off, but in the end, it will be worth it.

Yes, you’re chronically ill – but that doesn’t make you a silent body on an exam table. You have the right to question your medical professionals, you have the right to tell them you’re feeling uncomfortable and you have the right to say no.

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Thinkstock photo via heckmannoleg.