Do you ever feel like your doctors (and other practitioners) aren’t giving you the attention and care you really need? Have you wondered to yourself how to get your doctor to listen to you? I’m willing to bet that nearly every single reader at GFS has unfortunately felt ignored, dismissed, blown off or downright disrespected at some point when seeking help for their health.
Guess what? A lot of people are with us on feeling like their healthcare providers just simply aren’t giving their all to sick Americans. A 2012 Harvard research poll found that:
– 1 in 8 “believe they were given the wrong diagnosis, treatment, or test.”
– 1 in 6 “believe they did not get the tests they thought they needed.”
– 15% “were tested or treated for something they believed to be unnecessary.”
– 25% felt “a doctor, nurse, or other health professional did not provide all the needed information about their treatment or prescriptions.”
– 57% of Americans find “the quality of healthcare to be a very serious problem.”
Just last week, Dana Trentini and I talked about how and why so many women are misdiagnosed or undiagnosed with thyroid issues such as hypothyroidism and Hashimoto’s. This is a big problem when 1 in 8 women has a thyroid condition and having Celiac increases your likelihood of thyroid issues three to four-fold.
Even Dr. Terry Wahls expressed serious concern for the amount of health issues (including autoimmunity and gluten sensitivity) that are related to rampant micronutrient deficiencies largely ignored by conventional medicine.
Dr. Kelly Brogan shared how many women she sees who struggle with mental health issues (depression, anxiety, etc.) who are misdiagnosed and on meds that never address the root cause of the problem at a nutritional and hormonal level.
For all of these reasons (and more), I wanted to give you the tools you need to get the proper help in a shorter period of time. I want you to know exactly how to get your doctor to listen to you and work with you. It’s honestly not rocket science, but patients aren’t privy to a lot of the ins and outs of the healthcare system nor how to properly prepare for their visits (CLICK HERE to check out my step-by-step guide on how to do this!). You don’t know the rules, which makes it more likely that you’ll end up angry, answer-less and out money and time.
And speaking of saving money on healthcare, it’s possible to do that too. Every unnecessary office visit costs you money on copays, deductibles, coinsurance fees and maybe even a total out-of-pocket expense. It also means you could miss work and lose money on that front too waiting hours to see a doctor for 10 minutes. Testing (especially that done by functional practitioners) can cost thousands of dollars that’s not covered by insurance unless you know the options to reign in the cost (CLICK HERE to read how to do it!).
In continuing with my mission to help you become the best and most effective advocate that you can be, this interview with Randi Redmond Oster will give you even more insight into how to get your doctor to listen to you. And I’d love if you’d share this article on social media with your friends and family… it’s a very worthwhile cause to help everyone you know to get the proper health support they need in the shortest period of time and without spending an arm and a leg doing so.
How to Get Your Doctor to Listen to You with Randi Redmond Oster
Jennifer: Welcome back to the Gluten Free School Podcast.
I’m your host, Jennifer Fugo. And today, we are going to talk about advocacy and in this case, patient advocacy.
How do you talk to the doctor? How do you get your questions answered? How do you feel like you’re a part of the process and ultimately, how do you say no when you really don’t feel that what’s being advised for you is the right thing?
Today my guest, Randi Redmond Oster is the author of an amazing book called, Questioning Protocol, which just won an award and she can tell us about what that award entailed. The book helps patients navigate the healthcare systems and medical professionals as well to understand the patient perspective.
Randi spent the first 18 years of her career in GE working on complex aerospace systems and building profitable financial service businesses. She received a Black Belt in Six Sigma Quality and numerous leadership awards. The skills gained in GE empowered her to effectively navigate the healthcare system and find opportunities for process improvements as she advocates for her chronically ill son in the hospital.
Today, she is a Malcolm Baldrige Examiner focusing on Healthcare and a leading speaker on healthcare reform, shared decision making and patient engagement. She is on several advisory panels including the HIMSS, Society of Participatory Medicine and the National Association of Healthcare Advocacy Consultants. She holds a degree in electrical engineering and an MBA.
Welcome to the podcast Randi!
Randi: I’m so happy to be here!
Jennifer: So I just mentioned about your son because that was really how you got into this whole thing of questioning doctors and advocating for your son. Why don’t you give us a little bit of back story and what happened with your son and how you ended up now writing a book?
Randi: My son has Crohn’s disease and many people understand that that can be very, very painful and very, very scary. And we didn’t even understand what it was.
My son had started down a path, really trying to stay healthy by watching what he eats and watching what medications they were recommending to him. He was doing fairly well, but about three years into this, when he was 15 years old, he ended up in the hospital. It was the first time that he was in the hospital, as well as me really having to care for him.
Well, I was in the hospital about five minutes. And after working on aircraft engines and also as you mentioned, working on complex aerospace programs where I even had a top secret security clearance for the stealth fighter, one thing I understood was process, and safety and the importance of communication.
And there we were in the hospital and I was noticing there were some gaps here. I started to get nervous because I said, “I don’t think they’re talking to each other.” I decided to just write everything down, not knowing what was going to be the outcome for son, but really with the idea that as long as I was in the hospital, I would come back and try to help them understand what our perspective was.
Jennifer: I worked in my father’s medical practice for 10 years, so I understand what it’s like to walk into a doctor’s office and a doctor present the situation to you, whatever it may be, they do their whole doctor’s peek thing thinking that somehow you have all the background information to know what they’re telling you in the context that it sits within. And then you just go and do whatever the instructions are.
And in reality, for a lot of us who have chronic health conditions, this is a scary place. It’s our health and we’re afraid that something horrible is going to happen. We don’t understand why we’re in pain, why symptoms won’t go away. And a lot of times we feel dismissed by physicians.
I mean, I myself have been to many doctors’ offices and have been totally blown off so I understand it personally, but also just seeing it having worked in a physician’s office and knowing that sometimes it is helpful to have somebody who’s going to boil down these complex topics into something that’s relatable.
So here’s the thing, a lot of women—I don’t know about men per se, I think men tend to be a little bit more straightforward with asking questions, but we women get nervous of asking and questioning medical authority.
Why don’t you tell us what you found in regards to why this happens? And maybe there are some tips you can offer in regards to how we can do question better.
Randi: One of the things that happen when I was in GE was I learned how to deal with powerful people. I wanted the skills that they gave me—I happened to be petite. I’m five foot three—is they said, whenever you’re negotiating especially with a man, do not do it standing up because instantly they’re looking down on you.
So what happens in the hospital—all of the sudden I’m there. My child’s regular physician was at a conference and some new person I’m supposed to talk to shows up. And you know what? He’s bigger than I am and not only…
Randi: He’s bigger and not only that. The truth is they have about ten minutes to speak with you. Ten minutes. And I am scared, confused, lost and he’s now in the hallway looking down on me.
So one of the first things that I have learned is when you’re dealing with, especially a new doctor, get a chair, look eye to eye and then use the elevator speech. An elevator speech is something we learned in Corporate in America which is, get your point out quickly and efficiently.
And the point we need to get out first is what are our patients’ values, what are our preferences, and what are our goals? Because what happens is we come into that moment from two different perspectives.
I am thinking in terms of the whole long journey, the life long journey of my son. And the doctor is thinking, “How do I fix the problem we have today?” If the visit was a train, the doctor is going to take care of that particular station stop, but we have to think larger. And to your point, that’s very hard to do because instantly, the doctor wants to get to solution even though we need a little bit more of discussion.
So one of the tips that I would recommend is to take a deep breath and think about what it is that you want to accomplish. And then, think in terms of this person is going to be on your team and you’re creating that high performing team.
And I can talk about some of the ways I was able to do that by giving some pretty quick feedback. And not everyone got the feedback that they really wanted. But when they understood what our goals were, and our preferences, and our values, we were able to accomplish that goal.
Jennifer: Are you saying that when the doctor comes in and he says, “Okay, what problem do we have today?” you literally will start off with, “Okay, this is a very condensed version of what’s going on and this is what is important to us.”
Randi: Yes. Exactly! So let me give you a really good example of that.
Some people are all about analytics and they want to have all the information. Some people are artistic and they like to just feel. So you know what, what of the first things I do is I explain what type of person we are in terms of how we like to make decisions and what kind of information we need and what our comfort level is.
I also explain, in our case, we want to avoid medications as much as possible, which is hard to do with Crohn’s disease because many times the solutions are medicinal based. I get that out right up front.
And then the other thing that I said at this point, to this particular doctor that I had 10 minutes with, I said, “Listen, whatever decisions you’re going to make, I want to be involved.”
And so what ended up happening the next day, my son was still in the hospital and she had put him on steroids. She never called me. She never called the pediatrician. She made no effort.
When I was able to come back that next day and I said, “Look, I only had 10 minutes with you that first meeting, but I was pretty clear that I want to be involved and I want to be informed. What happened?” and she had to apologize. She had to say, “You know what? I might have followed medical protocol, but I didn’t meet customer satisfaction. I didn’t meet your needs.” And I think we need to stand up and say what is important to us. And also, there will be times where I’m going to say “No.” And let me tell you something, saying no is so scary.
And I discovered also this incredibly powerful because — I’ll give a quick example. My son had seizures. He kept having seizures and every time he’d have a seizure, we have to go to another emergency room. And he had six seizures.
Well, by the third one, I saw the process. You go into the emergency room, they do a CT scan and the CT scan doesn’t show anything and then eventually they gave him some fluid and he was fine. So I think by the fourth round of this they were going to give the CT scan and you know what I said? No!
Jennifer: Yeah. Just give him some fluids and let’s see what happens.
Randi: Right, right. And what I found was, when you say ‘No’ something incredible happens. Plan B. It’s amazing! They go, “Oh, well if we’re not going to do that, we can do this.”
Now, there were many times where saying no was the right thing because Plan B happened to be better for my son. There were also times where I said no and I was wrong. And you know I should have listened more. I put my son through maybe a little bit more pain because we didn’t implement what they had suggested to begin with.
But what I learned was it’s okay to say no and one of the tips I have for the audience is ask why. And if you’re not 100% confident and comfortable, then say no.
Jennifer: I will share too, with my own experience in going to the doctors and having some really strange conditions and problems.
One of the biggest things that’s helped me because as you said, having that very succinct story or blurb to tell the physician upfront is important, but I think what happens to most people is they walk into the doctor’s office without any thought of what’s going to happen. And they forget that there’s this whole story that has transpired and as you said that, in that 10 minutes in trying to tell all the baggage and share the baggage thinking that the doctor’s going to suss through it all in that one 10 minute session. The reality is that, a lot gets lost.
So what I’ve done is I will list out on a piece of paper, all of my symptoms, all of my complaints: How often does this happen? When did it start? How severe is the pain? Does something aggravate it? What makes it better? So that I can hand that to them and alleviate because the doctor can look at that and go “Oh, okay.”And I don’t get lost in my story. So, that for me has been really helpful.
And I love what you were saying about saying ‘No’ because it is hard to say ‘No’ to someone who is probably not used to people saying ‘No’ to them.
I’ll be honest. I’ve had doctors actually tell me that I was a very difficult patient because I said ‘No’ and they don’t want to deal with me. However, I’m willing to find a compromise. I know going in what I am willing to get and willing to take and what I’m not. And that I think speaks to your value.
So why don’t you tell us how can we say ‘No’ in such a way that we’re not going to invite a super negative reaction, that the physician or the practitioner is not going to get offended, but it’s a way that it will invite the conversation?
Randi: Oh, I love the answer to how do you say ‘No’ and still not offend someone. It is called the sandwich method. And what that method is, is you sandwich the ‘No’ between two ‘Yeses’.
So for example, you can say, “Doctor, I really like the fact that you’re thinking this approach and that you’ve told me how it’s worked over and over again. However for me, I have this concern and I’m not comfortable, but what I’d like to do is figure out is there some way that we can use your experience? And what will work for me to come up with a solution.”
And so that whenever—and this works with your husband, this works with your children, but it’s hard because we just want to say ‘No!’ right? But if you take the time to sandwich the ‘No’ between two ‘Yeses’, first of all it’s easier for us ‘cause us women, we try to be pleasers. Not everyone but many of us grow up trying to be pleasers. Hopefully as we get older we stop that, but it does make you more comfortable and it does work.
Jennifer: Offering that advice or that feedback, as you said you gave feedback to that doctor that gave your son the steroids without consulting with you. And rather than not telling them “you did this and you’re a bad doctor.” You instead said, “Hey, I expressed these values to you. I don’t feel that they were met. I’m not happy about this. What can we do moving forward that will be different and that will match my goals because I’m very serious about that.”
I think that that’s a really important thing because a lot of patients will just leave the practice and not actually tell the doctor or the practitioner what’s going on. So they get no feedback to know where they may have gone off track and they have no ability to maybe say, “Oh, you know what, I’m really sorry. You’re right. I should’ve listened” to keep the conversation going.
So what happens when you’re sitting there in the chair and your son was in the hospital bed and they present to you options that seem so far apart? They’re very complex. You’re confused. How do you handle that? I mean, we’re not medical doctors. Most of us have not been in medical school. We have no background information. What do we do? How do we pick between things that are not anywhere near our comfort zone?
Randi: Right. And it’s very hard because I know I wanted to go in trusting. I just really wanted a hug. I wanted to believe that everything will be fine and it will all work out and I really would have preferred to been passive, right?
There have been studies that have shown that patients that have high activation levels—and what they mean by activation is, they have knowledge, skills, and confidence to interact with the doctor—have better health outcomes, less cost, and their expectations are met better.
And yet at that same time, that’s a very clinical study that was done. I’m like, “Are these people for real? I’m an emotional basket case, right? How am I supposed to do this?” And I think the answer that has to come out is we’re in charge of our journey. And at that time, when they’re presenting all these options, as long as it’s not life threatening, it’s ok to say, “I need more information,” or “I need more time.”
And the other thing that I will recommend is you sit down and you say, “Walk me through our options.” And the doctors will say, “Well, you could this, or this, or this.” Many times they already have the answer in their head. And then you go back to the doctor and go, “Here are my preferences, here are my goals, and here are my values. And you need to know what those are.”
An example would be, if you hate taking pills or you hate shots, that’s important to state. If you’re really concerned about long term effects about medications and you’re willing to try alternatives, which maybe don’t have the same evidence-base, you need to say that. And then what you do is you say, “We’re going to sit down and we’re going to go through each of these options and weigh them against what I’ve just told you is important to me.” And what you’ll find is a really good dialogue and what you’ll also discover is whatever you decide, you’ll feel more comfortable.
And I just want to say sometimes in healthcare, sometimes we have the choice between a bad choice or a worst choice. Sometimes there’s no good choice and what we just have to know is that we did our best.
Jennifer: Now, to your point, what happens if you have a physician that does not believe in alternative treatments? Things as you said that might not be quite as evidence based or aren’t as conventionally recognized for certain conditions. And the doctor literally just dismisses you and your needs.
Is it okay at that point to be like, “You’re fired.”?
Randi: Well, yes.
I think that at anytime you have to find someone you feel comfortable with. I had a case where I brought in a book about Crohn’s disease, and about diet, and about gluten-free diet and I had lent it to this one doctor and she came back like the next day and she threw the book on the bed and she just said, “Yeah, I’ve heard about this book there’s no evidence about this particular book.
Well, I will tell you, it’s been five years since my son had his operation and he’s been on a nutritional approach for the last five years and he’s doing phenomenally well. And I’ll also tell you that the hospital where he had the surgery just about in the last month, found a study that was done overseas about this particular nutritional approach and in teenage boys, the study said it works 78% of the time.
Randi: I know.
Now, I also want to share, this is not an easy lifestyle. Twice a year my son does not eat any food for month and he takes nutritional supplement and just drinks that. But he’s not on any medications. Some of these medications have the risk of lymphoma, although it can be a very small risk. For him that worked.
And answer to your question, if a doctor is not willing to listen to what your preferences are, your values and your goals, you know what, it’s not a fit. The challenge is, when you’re in that hospital sometime you don’t have a choice. What are you going to do? And it’s just important than to say, I really want to discuss all options. And the one thing we have that we didn’t have years ago was the internet. You can look it up. You can say, “What do you know about this”
And so I just really want to emphasize—unfortunately while I just wanted a hug and I wanted to trust—the value of being an activated patient is so important so that’s how we can improve our outcomes and get the care that we need.
Jennifer: And I want to say something more about the hospital settings where you do not have a lot of control and that’s true. I’ve known many people who’ve been in the hospital because of say, Celiac disease, really, really bad problems. And the staff doesn’t listen to them that they need to be gluten-free, is handing to them toasts, and oatmeal for breakfast that’s not gluten-free. And their meals are not being prepared properly. This is a legitimate problem. I’ve talked to hospital administrators about this.
You have to be—I don’t want to say on guard like you’re going to be attacked at any minute, because I think that that is the flip side of being your “I want to be hugged” mentality is “I’m going to be attacked so I’m going to be hyper vigilant.” We have to find a balance between the two, but I think what I am hearing from you is also having extra people around to help advocate for you that also know your needs, and your goals, and your values, is important because they can also help reinforce that especially if say, your son was under anesthesia, or you are incapacitated in some respect. You have someone that can speak to your needs.
Randi: Yes. And I think that’s so important because when you’re the patient, you’re especially need to have a voice in the system, but you’re in pain and you’re scared. And so, having a friend or a loved one that can understand your point of view and speak for you is so critical.
Jennifer: And I would say even too, if you have trouble going to the doctor about a particular condition and you feel like you are so emotional about it that you really can’t sit there and listen and be an actively engaged member, perhaps that’s the time to ask someone in your life as you said, to come with you and be a second pair of ears and maybe to ask questions.
I always write down questions ahead of time that I may forget, but I go with my mother to her cardiologist appointments because she has congenital defects and it’s a really big deal because the next stop is open heart surgery.
So she needs a second set of ears or someone listening for her and asking questions as she might not think of it. She’s like, “Oh my gosh! They’re going to have to cut my chest open.” So I think having a support system is important and having a plan is important.
And so, you wrote this book, Questioning Protocol, which I have to say is a phenomenal book and you just won an award, correct?
Randi: It’s the USA best book in health, the general category. It just won.
Jennifer: What can someone get out of this? I think this is an excellent resource for everybody to check out because many of us advocating for our own health. So, what can we expect to get out of reading your book?
Randi: The first thing people say it, it’s a fast-read, it’s a humorous read and then it provides the insight to how you can navigate for yourself.
The book is really a story about what I did for my son using the tools I had from my executive leadership positions in GE, but those same skills are transferable to families. And people write to me and they go, “I never thought of doing this.” And at the end of each chapter, what I do is I say ‘What you can do now’. And so people are saying it’s a great book to read when you’re not sick because it sort of prepares you. And even if you are in the middle of a healthcare crisis, it helps reinforce that what’s going on the system around you is not personally attacking you. It’s the system. And then how do you win at that system.
So I believe you can’t win at a game if you don’t know the rules. And what Questioning Protocol does is it tells you how to play the game.
Jennifer: And that’s a really valid point, Randi and thank you for bringing that up that it really is like a game. And if you don’t know the rules, and you don’t know what to ask, and you don’t how to show up prepared, you are going to be the loser at the end of the day.
Some of the stories I’ve heard of the things that have happened to women in this community and just people I know. It’s really a shame. It breaks my heart because I know that there are many physicians out there and other health practitioners that have good intentions.
And I do want to give this warning just because you go to functional medicine or an integrative practitioner doesn’t necessarily mean that there isn’t this “healthcare game” in place because there are plenty of people that have gone to functional medicine practitioners and paid out of pocket $3000, $5000, $10,000 and they’re still left with nothing. No answers, not feeling like their needs were met so this is applicable to any type of practitioner that you see.
And that’s why I highly suggest checking out the book, Questioning Protocol. So thank you Randi, so much for your time and expertise.
Go and stay in touch with Randi through the links below!
And remember to rate, subscribe, and review the podcast for Gluten Free School and head on over to the website. Leave your questions and comments below.
Have you had a bad experience at the doctors’? And maybe you’ve had a different experience. Maybe you’ve advocated for yourself and you’ve had an interesting turn of faith that was positive. Love to hear all those stories, especially the any questions or concerns that you may have. Please leave them below in the comments.
Thank you guys again, so much for joining us and I look forward to seeing you the next time. Bye, bye!
Buy Randi’s amazing book –> CLICK HERE
Randi’s website – www.RandiRedmondOster.com