Shana Payne knows that when she selects a doctor, she needs to be extra careful.
The Newark mom had for years been dealing with symptoms related to fibroids in her uterus, a common condition that affects many women – particularly African American women – in their childbearing years.
It wasn’t until Payne moved away from Delaware only to return as an adult that a female doctor even mentioned fibroids to her. It was indeed what had been plaguing Payne, and for the first time, she was able to get the help and surgery she needed.
“No one had ever told me anything about fibroids,” she said. “No one had told me that having heavy periods like that was abnormal.”
And it was all because her doctor took the time to ask her questions that others hadn’t, Payne said.
Asking simple screening tests on physicals is what Payne would like to see change. Those simple steps would help more African American women feel seen and heard, she said.
But there is more to it than just doctors being better, said Dr. Deborah Crabbe, a cardiologist and professor at the Heart and Vascular Institute within the Lewis Katz School of Medicine at Temple University.
“If you do get sick and you unfortunately have these problems, you’ve got to be able to advocate for yourself,” she said. “It's particularly poignantly true for low-income and underserved populations.”
Gaining health literacy is one of the biggest tips Crabbe has for Black women.
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Knowing how to weigh oneself and knowing how to read food and drug labels are all skills that, while seemingly simple, would make people healthier and doctor’s visits easier. If patients have this information at the ready at appointments, they can advocate for themselves, Crabbe said.
In an ideal world, doctors would be able to provide some of this health literacy, but they also are confined to spending 15 to 20 minutes on patients so they can see as many as possible, Crabbe said.
“It is a very daunting task to do it in the time allotments for clinic visits,” she said. “I'd argue that there needs to be a much more efficient way of getting it done.”
She added: “You don't get a lot of extra money either, reimbursement for doing this. So there's a financial disincentive to do it, on some part."
That's why she advocates for patients to look online and educate themselves as much as possible so they can speak up for themselves at the doctor's office.
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And when all else fails – when pain persists or doctors don’t listen – go somewhere else, Crabbe said. Health care is competitive, and if one doctor isn’t performing well or isn’t treating you right, go to another doctor until one does, she said.
“We've (doctors) all been in the position where you've had a patient that has come from another physician and for whatever reason, they want you,” she said.
Michelle Drew, a certified midwife and doula who ended up going to another hospital to get treated when she was 16, offers the same advice to Black women in Delaware.
“One of the things I usually tell people to do and we encourage everyone to do when they go into the health care system is one, to change your dynamic,” she said. “Health care in the United States was built as part of our free-market economy, and that means we're consumers, and they're providing a service. Even as a health care provider, I work for you, not the other way around.”
Her other main piece of advice for patients is to command the room.
“I encourage people to, No. 1, advocate for themselves and to ask questions and to keep asking questions until you get the answers that you're looking for in a way that's understandable for you, to center yourself in the space,” she said.
Like Crabbe, she is scheduled to see patients every 15 minutes because of the nature of the health care system. To get the time needed, she said a patient has to demand it.
Come in with all your questions written out, whether on a phone or on paper, she said.
“Sometimes I just give people permission to say: ‘I'm not done and I have questions and I need them to be answered. And if you aren't prepared to answer my questions today then tell me when you want me to come back.’”
Follow Marina Affo on Twitter at @marina_affo.
This article originally appeared on Delaware News Journal: Here's how doctors say to advocate for yourself at appointments