I’m Penny and I’ve been working to empower patients in the UK with the words, skills and confidence to make the most of their (often rushed) doctor’s appointments – perhaps you are one of the many, many women who have come away feeling unheard, frustrated or dismissed - wondering how to do things differently to get the healthcare that you need and deserve?
As the NHS crumbles around us, learning to navigate the system we have by building our self-advocacy skills is crucial and can make a life-changing, and indeed life-saving, difference. So, in this post I wanted to take you on a whistle-stop tour through some of the building blocks of communication that have helped so many other patients finally get the most from their hospital and doctor’s appointments.
Research shows you have an average of 23 seconds before your doctor interrupts, so making sure that you have come prepared and can give ‘My Headlines’ is vital. If you are offering useful, valid and actionable information you are less likely to be interrupted, so save the ‘story’ of the issue for later – this is all about impact.
My Headlines is a short, informative statement that should include your main issue first – this is crucial because your doctor is trained to believe that’s exactly what you will do.
Serious issues require serious attention, so be very clear if your symptoms are
- new and severe,
- have happened or escalated quickly,
- or are simply not a normal presentation of your existing condition.
(This is especially true for headaches.)
You also need to include how this is affecting your life – not just your ability to work, but also your ability to exercise, take care of your children, drive safely or have sex etc. Try to be as candid as you can to put your issue into context. Context also includes any family history or pre-existing conditions – please don’t assume that your GP has read your entire file, as there often isn’t time. So, if you don’t tell them, important considerations may well be missed.
It’s also very persuasive to include everything that you have already tried – from the medicine cabinet at home, to your pharmacist, to your local physio. This can be extremely helpful in moving your request up the triage ladder to get that crucial appointment in the first place. It also shows that you are proactive in managing your healthcare and working in partnership with our doctors, rather than in opposition to them, is genuinely the best way forward – for that reason I always encourage patients to use inclusive language. Using ‘we’ builds that shared ownership in the outcome. ‘What should we be testing for?’
The limits that GP surgeries are placing on ‘one issue per appointment’ may be fine for a simple earache, but for anything complex or multi-systemic, it makes a diagnosis almost impossible. So, it’s really important that you are clear from the outset that you believe your multiple symptoms are ‘interrelated’ or ‘all part of the same problem’.
Remembering that doctors are, by trade, scientists is helpful when presenting them with undeniable data – a picture truly is worth a thousand words in healthcare, as is a symptom diary tailored to one specific issue (I’ve included much more guidance about presenting your data in the book). Knowing your own baseline also makes this data easier to present – it’s hard to measure changes in blood pressure, weight, heart rate etc if you don’t know what your normal readings are!
Always make sure you have a safety net before you leave – this is the signposting your doctor should offer you at the end of your appointment. What to do and where to go if things get worse. It’s also worth noting that recent research showed that around half of doctors and patients disagree about the ‘main reason’ for their appointment, so it’s definitely worth summing up what you understand the outcome, treatment and next steps are before you leave.
While it is your doctor’s job to interpret your symptoms, it is our job - as patients - to present them effectively (and persuasively) – we all know it shouldn’t be this way and your doctor does too, which is why so many doctors support my work in improving patient communication skills.
In my book ‘How to Talk So Your Doctor Will Listen’ there is much greater guidance and support about how to self-advocate - including how to advocate for your baby or child, troubleshooting when things go wrong, living with chronic and rare illness, and of course, how to recognise and address medical gaslighting and misogyny.
You can also join the vibrant How to Talk community on Instagram and TikTok at @how2talktoyourdoctor
Got a question about something Penny has mentioned above? She'll be returning later in the week to answer your questions so please do post them below.