Dr. Erika Schwartz, M.D., is a leading national expert in wellness, disease prevention, and bioidentical hormone therapies. Dr. Schwartz has written four best-selling books, testified before Congress, hosted her own PBS special on bioidentical hormones, and is a frequent guest on network TV shows.

Dr. Erika Schwartz, M.D

Finding Your Voice in Healthcare

Tuesday, 05 Nov 2013 11:01 AM

By Dr. Schwartz

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If we all had voices, medical care would be a lot better for us and the outcomes would be more positive and far less fear-driven.
 
It’s a pretty big statement, but I have been practicing medicine for too many decades, and am a woman to boot, so I know all too well how true the statement is.
 
When I first ran the trauma center at Westchester Medical Center in Valhalla, N.Y., the patients we saw in most dire straits were the ones without voices. They were very sick and most often unable to speak. So much of the treatment we gave them was guessing based on what happened or what a relative or friend told us. In these cases, we had no choice and neither did the patients. This is the only situation in medicine in which it’s OK not to have a voice.
 
In the day-to-day doctor-patient interaction that occurs in clinics and offices all over the country, the circumstances are not dire, the opportunity to speak is there, and the need to speak is imperative. But the problem is most people just don’t speak and the results are disastrous.
 
How often do you go to the doctor and, out of fear or sheer embarrassment, you don’t tell the doctor the truth about what is bothering you, or what medication, supplements, or hormones you are taking? You just wait for the doctor to guess.
 
One of my first patients in private practice told me in no uncertain terms when I asked what was wrong with him: “You are the doctor. You should know.” How could I know? I don’t live in anyone’s body but my own.
I can assure you most women do not speak their minds when they are sitting on the examining table or across the desk from the doctor. They do not have the courage. They tell me they’re afraid the doctor will disagree with their course of action or yell at them. Really, who is this doctor? And why are you still going to see him or her? The only thing you will get out of that type of relationship is bad care.
 
So they can’t find their voices and represent their own best interest in the relationship with the doctor. If they don’t, do you think the doctor will? I’m not so sure about that.
 
This is a sad state of affairs in 2013 in the U.S., where we profess to be equal and have voices that are heard.
 
Since all I do is listen to patients all day long, I can tell you without a doubt that they don’t have voices and if they do, they don’t use them in a way that they can best benefit from them. I don’t want to say all doctors are uncaring and all patients have no voices, but unfortunately there are more who don’t than do.
 
Think back to your last visit to the doctor. I bet one of two things happened — either you didn’t tell the doctor what you felt because the doctor bullied you or didn’t even notice you, or you thought there was no use in telling him or her what you really thought, because the outcome would not be affected by what you said. How sad it is to think so little of yourself to allow the doctor, who doesn’t live inside your body and certainly has no clue how you feel, to decide what is right for you.
 
We aren’t little girls. These are our lives and health we are putting on the line when we become shrinking violets with little-girlish voices.
 
The other option is that you decided to confront the situation and make yourself heard. That usually happens as women age and wisdom brings them to a more outspoken and less fear-driven place. The problem there is that instead of you coming across as your own advocate, the doctor, who has no training whatsoever in how to communicate with patients, becomes either scared of you or swats you away by telling you that you are being unreasonable, confrontational, and bothersome, just to get you out of the office.
 
And then you leave with a prescription you probably don’t need anyway.
 
How often have you gone to the doctor and found yourself leaving intimidated and frustrated, not feeling heard? 
 
When I first started to realize that doctors were treating women so badly, I became a patient advocate, because I recognized this happens when women are too quick to accept status quo.
 
How about my friend who tells me she’s going to the gynecologist with the problem of low libido, and the doctor pats her on the shoulder paternalistically, saying “What do you expect, honey, you are menopausal. It’s normal. You are getting older.”
 
So she leaves, feeling old and useless. That is unacceptable. There are many things she can do to feel sexier and one of them is find a better doctor to help her with medical and hormone support, and the other is to get a partner who turns her on.
 
When I started working with bioidentical hormones, many women told me they loved how they felt on the hormones but were afraid to tell their gynecologists, because the doctors didn’t agree with them. So they told the doctors they were feeling great but omitted to tell them why. The doctors in their ignorance didn’t care and didn’t learn. By lacking courage and keeping their doctors in the dark, the women deprived many other women from getting access to the hormones that made them feel better.
 
That story comes from almost two decades ago. Unfortunately, it’s still true today.
How sad that is.
 
It may sound harsh and tough to absorb, but the truth is, unless you find your voice and use it now, time flies and the next generation of women will get only worse medical care and you will have missed the opportunity to make yourself heard.
 
It’s really all your choice.
 
 

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