Your Doctor Works for You

You are in charge of your healthcare. When you choose a provider, you are hiring them. Even if you are following a referral — you are still choosing to schedule the appointment, fill out the paperwork, drive to the appointment, etc. You are choosing each step of the way.

You are paying them, therefore they work for you. Even if your insurance is paying—you still chose to use insurance, and literally signed paperwork that says you agree to the payment terms through your insurance carrier or to pay out of pocket.

If you hired them, they work for you.

So why do we allow ourselves to treat our relationship with a provider the other way around?

Our medical system is built as a hierarchy. Doctors go to med school, which is demanding and tumultuous and yes — they are smart! They know a lot! Whatever their role or credentials, they went through some form of higher education and have degree/s on the wall and certifications and maybe a name tag and a white coat. They are probably an expert in whatever you are choosing to see them for. It’s safe to assume that they know more than you do about the thing/organs/symptoms/body part/disease, which is why you are seeing them.

But they don’t know more about your body than you do.

If you imagine them as your employee or your contractor, does that change your perspective? You wouldn’t let an employee tell you how to run your business. You wouldn’t just do whatever they tell you to do without questioning whether it’s the best choice for your business. You can treat your medical visits the same way. Your body is your business.

You can say no in a medical visit. Full stop. If they are suggesting a treatment, a test, to take your blood pressure even — you can decline. You can choose to skip a pap smear if you just aren’t feeling it on that particular day. You can decline cervical checks during labor. You can actually leave the hospital against medical advice (it’s called AMA — you know it’s serious if it’s got its own acronym—and obviously you’re going to really think about that choice.)

You can ask for more information. What are the benefits of [fill in the blank]? What are the risks if I decline? What are some alternatives? Can I think about it and decide on my next visit?

I often start my visits with patients with the question “Where do you want to start today?” It’s not uncommon for someone to look at me like I grew a third eye and respond with some version of “You’re the doctor, you tell me.” We are so trained to follow doctor’s orders, that it’s a challenge to switch it around.

You are not here for me. Your appointment is not for my sake. You are the boss. I am working for you. You are paying me for my time, so you get to call the shots.

I had a patient once who would arrive at her early appointments and ask “Is it a pants-on or pants-off day?” (In case you’re new here, part of our work in pelvic floor physical therapy is assessing and treating the pelvic floor intravaginally — with pants off.) I would pause each time and turn the question back to her. It was her time, her visit, her choice. (Eventually, she got the hang of it and would sometimes arrive saying “It’s a pants-on day” before I even shut the door.) Interestingly, she was a physician. She was working under conditions that required short visits, getting to the point, ruling out the worst, and finding the source of whatever was ailing the person in front of her. And yet — I would argue that whatever she suggested for her patients was still optional.

Here is my invitation to you: Next time you go to an appointment, whether it is with your PCP, ND, OB, PT, IBCLC, EAMP, or [fill in the blank with the appropriate acronym], remind yourself that they are working for you. Before you head into the exam room/treatment room/office, stand tall, take a deep breath, and walk in like you’re the boss.

Because you are.