Have Symptoms That Won’t Go Away?

Time for a Conversation with Your Doctor.

Dealing with chronic symptoms can be lonely and frustrating, especially when your physician does not appear to be listening or taking your complaints seriously. Unfortunately, this is a common patient experience. In a study published in the Journal of General Internal Medicine, researchers found patients were only given about 11 seconds to describe the reason for their visit before the doctor interrupted. Even more concerning is that that figure only included the 36% of patients who were actually asked that question by their doctor. Sadly, the results of the 2018 study have remained consistent with findings from earlier studies, which indicates this has been a persistent problem for decades.

When a nurse recently made a short video mocking patients who exaggerated their symptoms, the hashtag #PatientsAreNotFaking began trending, drawing over 77,000 responses in the first week alone from patients who had a delayed diagnosis because their medical care team did not properly consider the symptoms or the extent of the symptoms reported.

Implicit bias, which continues to plague the healthcare industry, just further compounds this issue. Implicit bias is an individual’s unconscious assumptions based on race, age, gender, and other factors. The implicit bias of providers tends to impact the young, women, minorities, and even newborns. The intersection of implicit bias and dismissing patient complaints generally results in missed or delayed diagnoses in a greater proportion of the young, women, and minorities.

Effective medical care can only happen in a mutually respectful and trusting relationship. As a patient, you instinctively know when something is not right with your body and rightfully expect your physician to properly and efficiently consider your reported symptoms and complaints in an effort to get the right diagnosis and treatment plan.

What can you do when your physician seems to dismiss or ignore your concerns? First and most importantly, you know your body best, so trust your instincts. Second, recognize that you are your own best advocate. Third, do not accept being dismissed or ignored by your doctor. If you believe your concerns are being dismissed, consider the following:

• Repeat your symptoms and health data again simply and factually. It can be stressful talking with a provider. By preparing ahead of time, you can ensure you are sharing all of the relevant information. If you have just seen your provider and your provider has an online portal, consider messaging them in a follow-up communication to reiterate your symptoms and questions. (This toolkit from the Society to Improve Diagnosis in Medicine can help organize your information.)
• Continue to ask questions. Do not accept your provider’s first answer if it does not address your concerns. Questions such as “What are some possible explanations for these symptoms?” or “What next steps should I take if these symptoms persist or worsen?” can be helpful in re-engaging.
• Request a referral. If your symptoms persist, ask your primary care provider to send you to a specialist or seek out another provider for a second opinion. (Before you do, read our blog on “When Your Physician Won’t Refer.”)

Ask yourself if you are with the right medical practice. Trust is essential. While your provider is often busy and under time pressure, it should not come at the cost of your care. If you do not feel you and your provider are connecting or that you are not being heard and understood, it may be time to find another provider.