I’M SORRY MY BODY DOESN’T EXPERIENCE SYMPTOMS IN SEPARATE BILLING CODES
Since your doctor is running late and checking their watch, here is how to make your appointment count.
I’m annoyed that this article even needs to exist.
In an ideal world, you would go to the doctor, tell them all your problems and then like Dr. House, they would go through the full medical catalogue in their brain and bam! Figure out how to find/ fix the problem.
But in reality, you are sitting on that crinkly paper, the doctor is running late, barely taking their eyes off their screen and their job isn’t only to care for you - it is also to please the insurance overlords that somehow have inserted themselves into the room between you and your doctor - micro managing the 15 minutes you have.
How many times has it happened - you come in with symptoms that are probably related - fatigue, brain fog, joint pain, hair shedding, muscle aches … only to be told you can only discuss the fatigue in this appointment and make another one for the joint pain?
I don’t know about you but nn my body - my gut, hormones, food intake, medication, sleep, stress, weight changes, energy, and mood are all connected… but sure… Let’s just go one piece at time so you can’t actually see the patterns or actually diagnose me with something other than stress.
******end rant*****
Anyway - coming back to my point.
Now that we are in the position of having to basically make a great real life version of a tiktok video that makes the doctor STOP and PAY ATTENTION - here is my breakdown on how do actually do that.
Step 1: Mentally prepare to speak up
In the doctors office - we are walking into a space where we are on the lower end of the power imbalance. You are walking in knowing that something in wrong and you are hoping that someone (that you paid for) is going to help you fix your problem. At the same time - we don’t want to be labeled as the difficult, dramatic, demanding patient. Pair that with the stress/pain/symptoms we are experiencing, add in the time pressure and the pain of being dismissed in the past and it primes you for the feeling of wanting to be small, accept what the doctor says, want to ask no follow up questions even if you didn’t understand.
Now, we are going to change that.
Repeat after me: I AM ALLOWED TO TAKE UP SPACE
Your appointment is not a favor. You paid the fair price to be seen by a professional and you are a paying customer. You are not there to be an easy customer, you are there to get care.
For women, specially women of color - our concerns are so often brushed aside. Yes, the doctor is the one who studied medicine for years - but you have lived in your body your whole life. When something feels different or wrong - that is extremely important information. Just that to a doctor, you might just have to package it differently than “I don’t feel good” for them to notice.
So that’s where the next step comes in
Step 2: Do your homework
You don’t need to go in with a self diagnosis or 300 pages of 3AM google search results. What we are going to do is to prepare your medical case. (Yes, you are your own lawyer now).
We have just a few minutes to make our case so before you go in:
Ask yourself:
What is the main reason I made this appointment?
What symptom is affecting my life the most?
What am I most worried could be missed?
Which symptoms seem connected?
If you go in and list too many symptoms, or have an unclear goal - then the doctor will probably try to fix whatever they feel is important, possibly not what you feel is important.
Goal: Select your most important concern to discuss at this appointment.
List down symptoms related to the concern that you think may be related:
For example - If your fatigue, dizziness, nausea, and low appetite all started after you titrated up, bring them together.
Step 3: Build your case
Doctors are trained to look for patterns so - we are going to make sure they have access to all the details in the most clear format.
We are going to move from unclear symptoms to clear ones.
Use your notes app, or anything else to track your main symptoms before your appointment.
Focus on:
When did it start?
Was there a trigger?
Is it constant or does it come and go?
Does it happen at a specific time of day?
What makes it better?
What makes it worse?
What does it feel like?
How intense is it on a scale of 1 to 10?
How is it affecting your daily life? (Don’t forget this one!)
Instead of saying: “My back hurts.”
Say:
“My lower back pain reaches a 7 out of 10 by 4 PM, and it is stopping me from driving, exercising, and sleeping more than four hours.”
Instead of saying: “I’m tired all the time.”
Say:
“For the last six weeks, I’ve needed a nap after basic tasks, and I’m struggling to get through work even after eight hours in bed.”
Instead of saying: “I’m constipated.”
Say: “Since increasing my GLP-1 dose, I’m having a bowel movement every four to five days, with bloating and nausea. I’ve tried increasing water and fiber, but it has not improved.”
Step 4: Print it out
Bring your own copy of anything important.
That may include:
Your above created symptom log
Recent blood work
Imaging reports
Specialist notes
Medication lists
Supplement lists
Family history notes
Previous diagnoses
Current prescriptions
Over-the-counter medications
Vitamins, herbs, powders, teas, and supplements
Be specific.
Do not write: “Vitamin D.”
Write: “Vitamin D3, 5,000 IU, once daily.”
Do not write: “Magnesium.”
Write the form, dose, and frequency if you know it.
If you take GLP-1 medication, birth control, antidepressants, thyroid medication, fertility supplements, protein powders, herbal blends, laxatives, digestive enzymes, or anything else regularly, include it.
Print it out so that you don’t forget to say anything important during the appointment and that the doctor can have all the facts.
Step 4: Know what you want to know when you leave the appointment
The appointment should not end with you feeling confused about what just happened. Before you leave, try to get answers to these questions:
What is the working diagnosis, or the top three possibilities?
What are we ruling out?
What is the plan?
If this treatment does not work, what is the next step?
When should I follow up?
What symptoms would be urgent?
Are there any food, lifestyle, medication, or supplement changes I should make while I wait?
When and how will I get test results?
Who do I contact if symptoms get worse?
If the doctor is leaving quickly, say:
Before you go, I want to make sure I understand the plan… and then repeat the plan back as your understood it
Step 5: Plan your what you’ll say:
(maybe print it out or have notes on your phone)
What to say if you feel awkward about using your notes:
I’m nervous about this appointment, so I wrote down what I need to say.
I made a list because I don’t want to forget anything important.
If you feel uncomfortable asking for something directly, you can borrow someone else’s concern.
My family history has me worried about this. Can we rule it out?
My partner wanted me to check with you about this….
If you feel brushed off:
It sounds like you think this may be anxiety, but I want to make sure we are not missing a physical cause. What else could this be?”
I understand stress can contribute, but this symptom is new for me. What would make you want to investigate further?
If we are not testing today, can you explain what signs would mean I should come back or seek urgent care?
Step 6: Ask for Documentation
If you request a test, referral, or evaluation and your doctor says no, you can ask for the reasoning to be documented.
Can you note in my chart that we discussed this concern and decided not to test right now?
What would need to change for this test or referral to make sense?”
Step 7 (Optional): Bring Someone With You
If you tend to people-please or forget things - bring another person if you can. Their job is to help you remember your points, take notes, and make sure your main concern gets addressed - and to be a supporter for your concerns, back up your symptoms and just generally be a witness.
The Real Goal
What we are trying to do is to help the doctor listen to us, to have the data they need to apply their knowledge and to make it easy for them to fight for you with the insurance over lords.
That’s it from me this week folks, see you next week!
Comment if you have any topics you want me to research!
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