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Key points
- There are many reasons why a doctor may dismiss a patient's symptoms.
- Implicit bias, stereotypes, and lack of experience can contribute to a provider dismissing a patient's concerns.
- Keeping a journal, advocating for oneself, and researching can help support the provider in seeing the big picture.
As patients, we expect our doctors to listen to our concerns and take them seriously. Unfortunately, this is not always the case. Many patients have experienced the frustration of having their symptoms dismissed by their doctor, leaving them feeling unheard, invalidated, even angry and let down.
However, there are steps that patients can take to advocate for their health and ensure that their symptoms are properly addressed.
When patients experience symptoms, their first step is often to visit their doctor to determine the cause. Determining the cause of symptoms can be a complex process that requires doctors to consider a wide range of factors, including the patient's medical history, physical examination, laboratory tests, and imaging studies.
Why Symptoms are Dismissed
There are many reasons why a doctor might dismiss a patient's symptoms. One possible reason is implicit bias in healthcare. Implicit biases are attitudes or stereotypes that people hold unconsciously, and they can affect the way that doctors interact with their patients. For example, a doctor might unconsciously assume that a patient is exaggerating symptoms or seeking attention because of their gender, race, or socioeconomic status.
Another reason why symptoms might be dismissed is the effect of stereotypes on healthcare outcomes. Stereotypes are preconceived notions or assumptions about a certain group of people, and they can have a significant impact on how patients are treated by their doctors. For example, a doctor might assume that a patient is drug-seeking because of their history of addiction or that a patient is exaggerating their symptoms because of their anxiety or depression.
Finally, lack of experience might also explain why symptoms are dismissed. A doctor may dismiss or invalidate a patient's symptoms or concerns because they have not experienced such concerns before, leading the patient to doubt their own experiences and beliefs. The effects can be incredibly damaging to a person's mental health, as they may prompt the person to question whether their symptoms are real or whether they are just imagining things.
Strategies for Advocating for Your Health
If your symptoms are being dismissed by your doctor, it is important to take action to ensure that your concerns are heard and addressed. Here are some strategies that you can use to advocate for your health:
- Keep a symptom journal: One of the best things you can do when your symptoms are being dismissed is to keep a detailed record of when they occur, what triggers them, and how severe they are. The record can help you identify patterns or triggers that you might not have noticed before, and it can also give you concrete evidence to show your doctor.
- Research your symptoms and possible diagnoses: Do your own research to understand what might be causing your symptoms. This can help you ask more informed questions and advocate for the tests or treatments that you need.
- Bring a trusted advocate to appointments: Having a trusted friend or family member with you during appointments can be incredibly helpful, especially if you are feeling overwhelmed or intimidated.
- Request a second opinion: If you are not getting the answers or treatment that you need from your current doctor, consider seeking a second opinion from another healthcare provider, perhaps one of a different specialty or one with more advanced training.
- Speak up and assert your concerns: Don't be afraid to speak up and assert your concerns. Remember that you are the expert on your own body and your own experience.
- Request further testing: If your doctor is not taking your symptoms seriously, ask for additional testing or referrals to specialists who might be better equipped to diagnose an underlying condition.
Determining the Cause of Symptoms
Throughout the diagnostic process, doctors work closely with patients to help determine the cause of their symptoms. This can involve taking a comprehensive approach that includes a detailed medical history, physical examination, laboratory tests, imaging studies, and specialized tests. By considering all of these factors, doctors can help diagnose the underlying condition and provide effective treatment for patients.
One of the first things that doctors do when a patient presents with symptoms is to take a detailed medical history. This includes asking about the symptoms, how long the person has been experiencing them, and whether they have any other medical conditions or take any medications. Doctors may also ask about the patient's family medical history, as some conditions can be inherited.
After taking a medical history, doctors will often perform a physical examination to look for any signs of illness or injury. This can involve checking vital signs such as blood pressure, heart rate, and temperature, as well as examining different parts of the body such as the lungs, heart, and abdomen.
In some cases, doctors may order laboratory tests to help determine the cause of symptoms. This can include blood tests, urine tests, and other types of tests that can help detect abnormalities in body function. For example, blood tests can be used to check for signs of infection, inflammation, or changes in organ function.
In addition to laboratory tests, imaging studies can help identify the cause of symptoms. X-rays, CT scans, MRI scans, and other types of imaging studies of different parts of the body can be particularly useful for identifying structural abnormalities or injuries.
Depending on the nature of the symptoms and the suspected cause, doctors may also order specialized tests to help diagnose an underlying condition—electrocardiograms (ECGs) to check for heart problems, pulmonary function tests to evaluate lung function, or endoscopic procedures to examine the digestive tract.
Once doctors determine the cause of symptoms, they work closely with a patient to discuss treatment options, providing education and support and working collaboratively to develop a plan of care that addresses the patient's needs and concerns.
Final Thoughts
In conclusion, determining the cause of symptoms can be a complex and challenging process that requires doctors to consider a wide range of factors and work collaboratively with patients. By taking a comprehensive approach that includes a detailed medical history, physical examination, laboratory tests, imaging studies, and specialized tests, doctors can help diagnose the underlying condition and provide effective treatment for patients.
Meanwhile, patients who experience symptoms that are dismissed by their doctor can take action to ensure that their concerns are heard and addressed—by keeping a symptom journal, researching their symptoms and possible diagnoses, bringing a trusted advocate to appointments, requesting a second opinion, speaking up and asserting their concerns, and requesting further testing if necessary.
Understanding the scientific process can be helpful to determining missteps in the process and provide oversight for the provider to ensure that they take a patient's concerns seriously. Consequently, advocating for one's health may be a stressful process, but it is necessary if one wants to get to the root cause.
References
Blumenthal, D. (2010). Quality of care—what is it?. New England Journal of Medicine, 363(8), 717-719.
Gask, L., Dowrick, C., Salmon, P., Peters, S., Morriss, R., Reevell, M., ... & Kendrick, T. (2011). Qualitative study of patients' perceptions of the quality of care in general practice. The British Journal of General Practice, 61(588), 128-135.
Schmid Mast, M., Kindlimann, A., Langewitz, W., & Keller, S. (2010). Conversational skills of physicians: building rapport during the medical interview. Swiss Medical Weekly, 140(25-26), w13146.
