Patients as Self-Advocates by Dr. Julie Radico
May is Mental Health Awareness Month and a great time to encourage all individuals to be their own advocate when meeting with their medical providers. Individuals with mental health concerns often present them in primary care and this can be an important first step in receiving the right treatment. Feeling comfortable and confident talking to your physician about all types of medical concerns can have a positive impact on your treatment. You and your physician are on a team, with the mutual goal of you being in good health. Advocating for yourself as a patient is an important step toward having a good working relationship with your physician, feeling heard, and setting personalized treatment goals.
The Teach-Back Model has been used in medical education to help physicians ensure patient understanding of the treatment plan. This includes the physician asking the patient to explain back to them what they are being asked to do to manage their health (e.g. start a new medication, exercise three days a week). This allows the physician to ensure that they explained the health concepts and treatment plan in an understandable way. Patients can also take an active role in facilitating this type of collaborative communication by stating their understanding of the plan without physician prompting.
The following are some additional ways you can be your own advocate at your medical appointments:
- Write down your health concerns before your appointment. You can do this at home, while in the waiting room, or in the exam room before seeing the physician. Visits are often short in length and can go by quickly. If you have several medical concerns you may forget one or two of the issues once you are with the physician. Take time to identify and write down your health concerns as this may help you remember to express the information during the appointment. The physician may only be able to address one or two of the concerns in that visit, but they can schedule you to come back to address the remainder.
- Be sure you understand the behavior changes encouraged in the treatment plan and why they are being recommended. Physicians may speak quickly or explain the treatment plan with a lot of medical terminology (or jargon). The physician may ask you to Teach-Back the plan, at which time you could address items of which you feel uncertain, but if they don’t ask you can take the initiative to explain your understanding of the plan and ask for more clarification. There are no “stupid” questions when it comes to your health. It is always a good idea to ask the physician why they prescribed a medication, how it works, and how it will help. If you understand your treatment plan you may find that it’s easier to stick to it.
- Help your physician create a plan with steps you feel are realistic and manageable. Both you and the physician can start to feel frustrated if you don’t see health improvement during visits. It is important for you to take ownership of your health improvement goals; however the goals need to feasibly fit into your life. Tell the physician if you don’t think a goal is realistic and let them know what changes you feel able to make and what barriers may get in the way.
- If the physician encourages you to start a new medication, but you know that your insurance will not cover it and you cannot afford to fill the prescription, let them know. The physician may be able to put you on the generic version of the medication or switch you to a more affordable medication.
- If the treatment plan for weight loss includes walking outside 30 minutes, three days a week but you don’t feel comfortable walking around your neighborhood, you should let your physician know. You can suggest a different activity or ask the physician what you could try instead.
Additionally, be sure the physician knows what health treatments you have tried in the past (e.g. medications, exercise, physical therapy, etc.) and if those treatments helped. This may help the physician in their decision making and aid in forming a targeted treatment plan.
- Keep your cool. While you are being a self-advocate it is important to express yourself as a member of the team. It can sometimes be easy to feel frustrated when you do not feel understood. Expressing yourself calmly can help facilitate your appointment and save more time for your concerns to be addressed.
Beyond this list, there are many more ways that you can be a positive advocate for yourself when meeting with your physician. In summary, advocate for your health by being organized, asking questions, being honest about the feasibility of the treatment plan, and engaging in positive communication.
Agency for Healthcare Research and Quality (AHRQ). (2010). The teachback method: Tool 5. Retrieved from www.nchealthliteracy.org/toolkit/ tool5.pdf
Julie Radico, PsyD, completed her doctoral degree in clinical psychology at the Philadelphia College of Osteopathic Medicine (PCOM) in 2013. She completed an internship in clinical psychology and integrated primary care at the PCOM Center for Brief Therapy. Dr. Radico completed her health psychology postdoctoral fellowship in the Department of Family Medicine at the University of Mississippi Medical Center in 2015, where she was involved in teaching residents. She currently serves as the Membership and Governance Chair on the Committee for Early Career Psychologists for the American Psychological Association.