Now that COVID protocols are easing and face-to-face consultations with our regular physicians are returning, it is a good time for doctors and patients to refresh their commitment to the same vows of care. It is a well-studied adage that patients and doctors are not congruent in their views about what should happen during their consultations – especially in women’s health. There is a lot of information circulating about initial contact experiences with physicians, but not much about the long-term relationship. 

A monosodium glutamate consultation is when you feel filled by the consultation, but later you realize you are still hungry

We know relationships are never fixed; the doctor-patient relationship evolves over time and changes with the fluctuating biorhythms of care and the ebb and flow of illness and familiarity. Most patients shift from having acute and fair-weather consultations, for example for immunisations, preventive check-ups and the flu to more sustained care for chronic illnesses, such as diabetes, heart disease and menopause.  At that time, a clinical shift also occurs – most obviously when a condition can no longer be cured.  This opens the way for hidden issues to ferment and irreconcilable differences to arise, especially when it comes to the treatment of common medical conditions that women experience. 

Like any relationship the doctor patient relationship can benefit from some couples counselling. Visiting a health care provider is stressful, even for a physician. We are not operating at top mental capacity and all our best negotiating skills can go out the window. Here are some tips:

1. When you first meet your clinician, consider it as if you were buying a pair of new shoes. Do they fit your current needs? There be many shoes in your size but not all of them fit. So, consider the first consultation with a physician that you are going to have an ongoing relationship a bit like a first date. You don’t have to go into a therapeutic bedroom with them.
2. If they start asking invasive questions that make you uncomfortable during this consultation, such as probing your alcohol intake or sexual activity – ask them why they are doing so or call “time out.” Filling in the boxes in preventive guidelines can make authentic consults difficult. 
3. When you find the right fit relationship-wise, you might feel more comfortable to move on to the more day-to-day medical issues. Moving the blinders that either narrow consultations to women’s reproductive issues or avoid them is a first step. Beyond reproduction, menopause and depression, we have other common complaints and a lot of the treatments of these problems can cause a cascade of new problems. A telling question might be: do you know which of the drugs I am taking causes side effects specifically for women/men?
4. Run regular relationship checks with your physician. Are you both still on the same page? When you leave the consultation is it a bit like the monosodium glutamate phenomenon – you feel full, but one hour later you realize you are still hungry for information?

We know that any relationship benefits when the two parties can sort things out between themselves. That is not always possible. So, if you have to leave your doctor – do it safely. Get help to find a new physician and make sure your records are transmitted in a safe  manner and you have worked out why the relationship didn’t work. Many institutions are now introducing patient advocates to help patients negotiate the complex nature of health care. They are a good start.