Healthcare Advocacy Partners on Facebook    Sima Kahn on LinkedIn  Visit the Blog 

Last month I talked about advocating for ourselves, whether or not we have a professional advocate with us. These were tactics dealing with gathering the information we care about at our medical appointments, and also giving complete and accurate information. Here are some tips to use once you have gathered the information, have been given an explanation of what is wrong, and hopefully some options for treatment. These are for the next step: getting the care for your medical problem.

1. Always ask, “What else could this be”?
Be sure your doctor has considered other options. In medicine we call this the differential diagnosis. Why have other options been ruled out? Why has this option been ruled in? Make sure you understand the thinking.

2. Never undergo a treatment unless you understand what it is, why it’s needed, and what the alternatives are. This is the corollary to number one above, but is critical if you are going to have a treatment such as surgery, or even a minor procedure. If you don’t feel convinced you need that treatment, hold off until you do or decide on a different modality.

3. When you are in the hospital, make sure everyone who enters your room washes their hands.
I mean everyone! No exceptions! It is okay to ask, and to demand this. Almost every hospital in America has a plan for 100% compliance with this. Think of yourself as just helping them achieve their goal. And improving your safety at the same time. A win-win.

4. If you are feeling uncomfortable, uncared for, not listened to, and talking about it doesn’t resolve these feelings, change doctors.
Yes, really. It is okay to change. It happens to all of us. You are far more important than the concern you might hurt your doctor’s feelings.

5. Be assertive (see 1-4 above).

6. Trust your gut.
This one comes with a caveat—sometimes your instinct is not accurate, its really fear rearing its ugly head. But if you think something is not right, trust yourself. Don’t go along with it if it doesn’t feel right (see number 5 above).
I hope these tactics help you get the most responsive and best and safest healthcare for you and your family members. Let me know if you have questions or comments.

Even if you don’t have a serious or life threatening illness, or don’t have access to a healthcare advocate any time of the day or night, there are tactics you and your family can use to advocate for yourself or your loved ones. Using these tactics will make your healthcare go more smoothly, with fewer missteps and hopefully fewer errors and delays of needed care. And these are things anyone can do! You just need to be prepared.

Here are 3 of the most important tips for advocating for yourself:

1. Have your important health information with you.
For most people this means having printed out your contact information, who to call in an emergency, your medical conditions, medications, and allergies. I have developed a Health Portfolio™ that has all this information in a loose leaf binder that is easy to carry with you, as well as a one page easily portable form that can be taken anywhere (contact me if you are interested in this service).

2. Make a list of questions for your doctor before you go to an appointment, and at the appointment, write down the answers.
This enables you to review what was said later, when you can think more clearly. You can then check with reliable sources to clarify, like a healthcare advocate, good internet sources, or the staff of your doctor’s office.

3. Have someone come with you and take notes.
 I can’t stress how important this is if you are going to an appointment to get results of tests, especially biopsy results when you are concerned about cancer. Once you hear the results, if they are not what you were hoping for, most people do not hear a word! Their brain goes into that altered dream state where they are aware that someone is talking but have no idea what is being said. They are too involved in the movie in their head where everything is going badly. And its hard to take notes yourself when you are in that state.

4. If you use the Internet, look at reliable sites.
For instance, use the Mayo Clinic site, Uptodate, WebMD. There are many more listed on my website under resources (

These tactics should help to insure that you have accurate information both to give to your doctor, and most importantly, that you get from your doctor. Having questions written down ahead of time means your concerns will be addressed, and having a friend or family member as a scribe makes sure that you have the information that was given to review.

Next blog: More tips on how to advocate for yourself and improve your healthcare.

One of the most satisfying aspects of providing medical care for more than 25 years has been helping my patients figure out what is wrong, how to address what’s wrong, and how to navigate the medical maze to get what they need. The satisfaction I’ve derived from solving healthcare puzzles while guiding people through an often complex decision-making process motivated my transition from clinical practitioner to fulltime healthcare advocate.

You are probably wondering what helping patients and their families through the medical maze looks like. The following story of some clients (names and some details changed to protect confidentiality) will help to paint the picture.

A while ago I saw two patients, young to middle-aged women, each of whom had had a back injury at work. I was struck by how all encompassing their symptoms were. Both experienced nearly constant pain of various degrees, limiting their ability to do previous activities in work and in leisure. Both had been treated with a variety of modalities—including physical therapy, chiropractic, and pain meds—with little relief. Both had been told they had reached maximal improvement despite their obvious disability. Although months to years passed before either received authorization for an MRI, the diagnostic procedure indicated that each woman had a bulging disc.

Most of us have experienced back pain at one time or another. In fact, an estimated 75 to 85% of Americans will have low back pain at some time in their lives. In fact, I was once among the walking wounded myself, living with chronic back and neck pain until it worsened enough that I sought medical care. I started to see a wonderful physical therapist who helped me become almost entirely pain free. So I know it is possible to find relief.

So, for these women to be told that they should live with their pain and disability for the rest of their lives is unacceptable. I didn’t believe they had reached maximal improvement and encouraged them not to give up. I advised them to start off by reading Robin McKenzie’s Treat Your Own Back and Treat Your Own Neck and suggested an evaluation by a physical therapist knowledgeable about Aston-Patterning, a form of physical therapy that combines ergonomics, fitness training, massage, and movement education.

The process of healthcare advocacy involves taking a health problem and finding a way around or through the medical maze to arrive at the most positive outcome possible.  My job is to provide information and tools that empower clients to confidently select and take the next steps.

If you or a family member are facing a healthcare issue and you don’t know what to do or where to turn, call a healthcare advocate!