Let me start by saying I have worked with the most amazing and compassionate health care providers and staff throughout my career. Let me also say I have the utmost empathy for those providers who have had to provide care through the pandemic and fallout. They are typically understaffed, and budget cuts have created the need for shorter patient times. In addition, the insurance companies have become increasingly more difficult to work with.
In my current career (Integrative practice) I am providing consultations to people seeking answers, who simply need more. They might be struggling with weight management, hormone balance, digestive issues, fatigue, or mental health concerns. Most who come to see me have spent time seeking answers through traditional providers, PCP's, and specialists. I have had far too many clients in tears in our visits because not only did they not receive answers, some received disbelief, shaming, and quite frankly gaslighting. If the initial workup is not conclusive, they are told they are "fine" or that they have anxiety/depression. I have heard countless stories of women being told their symptoms would go away if they simply lost weight.
Recently I had a specialist that told my client (with very concerning symptoms) that "these things just happen to fat people." When they tell the provider they have been dieting and exercising, they are told to eat less and move more. It is not as simple as calories in/calories out. There are a host of factors that can predispose people to gain weight and struggle to get it off. And you can't always succeed at your goals doing the same "Weight Watchers" program that your friend at work is doing.
It is essential to figure out your individual barriers. I cannot tell you the number of women coming to see me basically starving themselves and watching the scale rise (while their hair is falling out and they are chronically fatigued). When they come see me and the dietitians I collaborate with, they start to "unlearn" the harmful diet culture messaging. They learn how to nourish their bodies and add simple habits/movement to improve sleep, energy. and reclaim vitality. What "worked" at 20, does not work after 40, ladies.
Recently I have an influx of women my age being told their symptoms of menopause are normal and will go away without discussing options for hormones. When I got out of school as a Nurse Practitioner (20+ yrs ago) we gave everyone hormones to help with symptoms of perimenopause/menopause. When a study concluded there was risk of cardiovascular disease and cancer associated with Hormone Replacement Therapy (HRT) that practice fell out of favor. However, the findings of that study have been debunked.
We know that HRT helps prevent osteoporosis, Alzheimer's, and helps with mood stability. It helps to support libido/sexual health, and treats hot flashes and night sweats. Yet, women are not routinely counseled about this. They show up crying at a visit because they can't sleep or remember things, have zero sex drive, and are exhausted. The default treatment offered is often antidepressants and sleeping pills.
When I meet with a client I encourage them to advocate for themselves and their needs. You should never feel "afraid" to see your providers. You should never leave feeling shamed. Your relationship with your Primary Care Provider should feel like a partnership. You should always feel like you have a voice and feel comfortable sharing. To make the most of your visits, I encourage you to book an appointment listing your concerns in advance. If you book a "quick visit for ear pain" and bring in a list of ten complaints, your provider cannot adequately address everything in 15 minutes. Letting them know ahead of time gives staff the chance to book enough time to address your concerns.
In addition, bring a list and write down your concerns and things that you would like to explore (labs, testing, medication options) so you can co-create a plan together that makes sense for you.
I don't have enough room in this post to get into the issues with healthcare costs and insurance companies. People pay astronomical amounts for their insurance and still have high deductibles and copays. I will briefly say, I am noticing a trend where people are opting into less expensive plans and instead funding their FSA/HSA accounts which allows you to use your money for things that actually support your wellness (gym memberships, yoga, acupuncture, chiropractic, Integrative health providers). I believe as more people are becoming informed consumers, this trend will continue. I also believe more providers will leave large medical systems and start small sustainable practices such as the Direct Patient Care model.
Always remember you have options, and your concerns and needs matter. One piece of advice I give all my clients is this "Listen to your gut." If you think something is wrong, you should always speak up and advocate for yourself/your child/loved one, etc.
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