When that feels safe or appropriate, it may be helpful to bring someone with you who can advocate on your behalf and/or help you question or name some assumptions that you feel may be guiding the care you are receiving.
It might happen that you feel there is a disconnect between the concerns you are bringing to your health care provider and how you are being received. This is a real thing that happens to some of us and so, it is important to feel informed and prepared about the possibility of it happening. Gender stereotypes (“women are melodramatic, exaggerate, seek attention, etc.”) often result in women and feminine presenting people experiencing degrees of disbelief when they access health care. In the study The Girl Who Cried Pain, the author identifies ways gender bias tends to play out in clinical pain management. Women are “more likely to be treated less aggressively in their initial encounters with the health-care system until they ‘prove that they are as sick as male patients,’” the study concludes—a phenomenon referred to in the medical community as “Yentl Syndrome.”
In a nutshell, female pain might be perceived as constructed or exaggerated. While most people may physically recover from instances where they were dismissed or brushed off, it can delay care, it can impact diagnoses, treatment plans, it fuels mistrust and, for many, it might mean dealing with the trauma of “not being seen.”
This vulnerability can be compounded by a person’s race, disability, drug use, etc. When we talk of racial disparity in health, one important factor is the racial empathy gap. A recent study shows that people, including medical personnel, assume black people feel less pain than white people. For people who use drugs, who use opioids for chronic pain and/or “look the part” of what a drug user could look like, this can mean being labeled a “drug seeker” and not being believed and/or treated for pain. In the cases of Indigenous people, a study by Dr. Janet Smylie of the Centre for Research on Inner City Health at St. Michael’s Hospital shows the impact of differential decision-making and how it comes from what she calls ‘unintentional racism’ by well meaning care practitioners.
Tips to get your doctor to listen to you
Bring a list of your symptoms, the questions you want to ask and what you’d like to discuss during your appointment. Then, try and answer the doctor’s pressing questions first. Many health care providers rely on check lists and may want to get through some standard questions first before they veer off script. When that has been done, mention that you have a list of topics that you’d like to check in about.
If your health care provider only asks close ended question and is not giving you much space to give context, add a narrative response at the end of the yes/no answers.
Interrupt when interrupted. If your doctor cuts you off when you try to give them a full answer, feel free to interrupt. Pretend you’re having a conversation, even when it feels like you’re being interrogated. This may help make sure that answers can’t be taken out of context and that your entire answer is heard.
Focus on your concerns. If you get the sense that they are being brushed over, speak up, “Excuse me, I have tried to answer all your questions, but I am still not sure my concerns have been addressed. Can you please help me understand why it is that I have been feeling (this and that symptom)”
Ask for explanations about decisions being made to make the thinking behind a diagnosis or a treatment more evident.
Some hospitals, clinics and health care centers have patient advocates or patient ombudsman if you are interested in making a complaint.
On a larger scale, since the provinces and territories are responsible for the administration and delivery of health care services and the management of health human resources, you can also contact your local provincial/territorial Ministry of Health – the phone numbers and websites can be found on the back cover of the Canada Health Act Annual Report. You can also contact your province or territory’s College of Physicians and Surgeons. Links to each provincial and territorial medical regulatory authority can be found on the College of Physicians and Surgeons of Canada website.
Facing discrimination in the health care system: taking care of yourself
Many things can either make it easier or more difficult to access health care or affect the quality of the care we get. There are barriers that may be outside of our immediate control.
If or when we face discrimination or stigma while accessing health care, it takes a toll and might make it more difficult to engage in relationships with health care providers in the future or even to follow-up on treatment or care. Sometimes we may need to go back to places where we may have not been treated well or we may need to advocate for ourselves in places that have felt hostile or where we may have felt hurt, misunderstood or neglected.
Here are some things we can do to take care of ourselves when that happens:
Pay attention to your body
One basic way that can help our ability to cope with tough situations is to pay attention to our surroundings, how much sleep we are getting and what our diet is. We may not always have control over our housing, our food and our sleep but when we can take care of our body in some of those ways, we may be able to feel a greater sense of security and calm, which may help us deal with challenges.
Share your stories
Breaking the silence is a great way to increase our resiliency when we face discrimination. Turn to friends or family, someone you can trust, who will support you and validate your feelings and experiences.
Find your community
Belonging is an important part of resilience-building. Especially if you feel alone and isolated or after having been mistreated, you can find support in your community, through community groups, online networks, drop-ins, etc. Connect with likeminded individuals who may share similar experiences, who can offer guidance, resources and support when you are facing a difficult situation. Connecting with others who are dealing with the same issue is a powerful tool for building strength. And by making connections, you’re not just helping yourself, you’re helping others in your community. It breaks the cycle of isolation.
Keep relationships going
Maintaining good and healthy relationships (from intimate relationships to friendships to the important connections we have in our communities and in services we access) can help with a sense of stability and constancy in our lives. This in turn helps us feel more resilient.
Educate and connect
Learning about yourself and your community/ies may help make sense of an incident, of a pattern you are noticing in how people interact with you, and can normalize feelings and validate impressions you may have. It is important to learn about the intricacies of prejudice and discrimination. The Internet and/or local social networks can be good starting points with lots of possibilities for information and for connection. Learning can help us recognize biases as well as support the building of a positive identity to fight against discrimination or prejudice. Understanding our cultural contexts can help us to understand interpersonal problems that may come up with care providers as well as develop the necessary skills to address these issues.
Find some good comebacks
Brainstorm savvy ways of addressing difficult situations and advocating for yourself when it feels possible/safe. We can learn to identify our own stress levels, locate that stress in the body, communicate our feelings and find ways to face tense situations more calmly when we want to make our views known.
Be brave but also learn how to lean on others
Being brave means facing uncomfortable feelings, and figuring out how to actively work with them. By being brave we can experience and confront our personal power. Explore what being brave means to you, things to do that could help you feel braver and how this could help you feel more resilient in the face of adversity. This may mean being able to point bad behavior out, fill out a complaint form, talk about how we have been treated, talk it through with health care providers who may or may not be aware of how they come across, or educate people around you. Being brave also means being able to make yourself vulnerable and seek the support we all need. Maybe someone can take on some of the follow-up when you have been mistreated, validate your feelings about what you went through, or help you find somewhere else to go. Learn how to lean on people around you and trust that others can help and support us when needed. It’s important to identify who we can go to when we need support.
Seek professional support
In some instances, trained counsellors can provide you with needed support and help you develop ways to cope and thrive as well as identify how you have been affected and help you address the ways in which it has impacted you.
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