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Doctor Patient Relationships in Women’s Health

Updated: Mar 22

Receiving medical treatment for women’s health-related conditions is an admittedly vulnerable experience. Whether you are in the early stages of seeking answers about infertility, struggling with chronic conditions or entering menopause, many women feel frustrated by their relationship with their practitioners.

The reality is, there are still a limited number of options for women to receive optimal care. Numerous factors impact this predicament. You may or may not have insurance, you may or may not have a preference regarding medicine or drug therapies, you may or may not have previous negative experiences that make you feel anxious.

And then there is the healthcare system.

A bioethicist speaking to the New York Times explained that women’s health issues are frequently dismissed or downplayed by practitioners. Even when overt symptoms are present—like unexplained weight loss or changes in a period—practitioners may not have or take the time to dig deeper. The American College of Physicians (ACP) issued a position paper in which is detailed the issues of underrepresentation and even discriminatory policies in U.S. healthcare towards women.

But women do require different treatment. According to the ACP’s position, there is ample evidence that women differ from men in:

  • Disease expression

  • Medication reactions

  • Care management

Women are more likely to have chronic or autoimmune diseases and different risk factors. Women also have unique health issues, including:

  • Postpartum depression

  • Perimenopausal depression

  • Fertility issues related to underlying, female-specific conditions

With the reality of these glaring differences, and the fact that most women can attest to challenges in seeking or receiving satisfactory medical care, what should be done to improve doctor patient relationships? Here are some ideas populated by women in the Fertility4Me community.

Fewer Assumptions and Clear Communication

First, practitioners shouldn’t make assumptions based on what the woman says on the surface. Some practitioners may be quick to rush to solutions or treatments, especially given the limited time allocated to each visit in today’s healthcare and reimbursement environment. A part of this is due to the evolution from small, private practices to large practice groups with staff who manage the bottom line. Unfortunately, this is an increasingly prevalent dynamic in healthcare that can negatively impact a woman’s clarity and effective course of treatment.

As a result, we must face the reality that there are two sides to the doctor patient relationship, both of which require effort. First, practitioners have to strive to understand women and spend time understanding the way their symptoms manifest that is unique to them. Second, women need to take ownership of their own health and strive to find providers who listen well and address all of the symptoms and unique needs.

Providers Should Ask the Right Questions

While it is important for the right questions to be asked, what might those be? Questions about women’s health should include things like:

  • What kind of symptoms are you exhibiting?

  • What are your periods like: what color and how heavy are they?

  • Have your cycles changed since I last saw you?

  • What do you eat on a typical day?

  • What medications, including over-the-counter and supplements, are you taking?

  • What are your treatment goals today? Is there anything on your mind?

Frequently, if you go to a specialist, naturopath or acupuncturist, the number of questions you’ll be asked will be dramatically more detailed, especially during your first appointment. A function of this is often due to how reimbursement works for healthcare services, meaning that some practitioner types are often out-of-network. While the lack of (or limited) reimbursement when using such a practitioner only puts the financial burden on the patient, in the long run—if your condition is not being solved by the traditional route—this may be worth investigating.

Women's Roles in Doctor-Patient Communication

Let’s dive deeper into women’s role in their healthcare. If a practitioner doesn’t ask insightful and detailed questions, women can take the lead. Each woman understands better than anyone what her medical concerns are. Even the best practitioners can’t read patients’ minds. Women can take initiative by finding out what suspicious symptoms are and identify them, leveraging networks they are already comfortable with, which often include other women. Reporting on these can give even a hurried practitioner a far better understanding of your body and potential issues.

The catch-all answer of birth control, “wait till you are trying to conceive,” or other generic courses of treatment may be insufficient. If there is far more to your condition and you are facing a broader scope of symptoms, you should dive further into what the root cause could be. The best case scenario is to do this with your practitioner. If that partnership is not available to you, you absolutely have the right and even responsibility to look into things yourself. You can bring these directly to the ultimate practitioner you choose and have the right discussion that addresses you as a whole person.

Honesty and Openness from Practitioners

The reality is, there are some knowns about women’s health, but also a lot of unknowns. Some general points of knowledge every woman should know include the fact that:

  • If your period is over 35 days, there may be concerns about PCOS or other conditions

  • When it comes to fertility treatments, on average it takes three IVFs to get pregnant

  • Some insurances require a certain number IUIs for fertility treatment before you can do an IVF

However, there are also disagreements among medical professionals like whether endometriosis impacts fertility or what a normal TSH level is, which impacts proper diagnosis of thyroid disease.

Chronic conditions may manifest in different ways. Much of medicine is built toward acute care, however. In other words, if you have a definitive illness with a specific treatment, it’s simple. When it comes to digging deeper, our medical system isn’t designed to handle that as well.

Practitioners who either don’t explain it or try to present themselves as miracle-workers do more damage in the long run. As a woman, you will have various symptoms. In one woman, a symptom could present as one disease or condition, whereas in another woman, it is another disease or condition. There is a landscape of the unknown behind what practitioners do know.

An Illustration of Excellent Doctor-Patient Communication

It would also be immensely helpful if the doctor plays the role of a supportive human. No doctor knows everything.

Dr. Braverman, who treated Fertility4Me founder Georgie Kovacs, was the guy you went to when nothing else worked. He has since passed away but his treatment of her was unforgettable. When he told her she had endometriosis and other underlying issues, he was available to consistently provide guidance.

One element of her treatment was to cut out gluten entirely. His admission was that the medical community didn’t have thorough understanding of the role of gluten, but there is enough data to know that it should be avoided in her case. That statement both admission of incomplete knowledge and strong recommendations based on the best grasp of that knowledge won her trust.

Understanding the Nature of Medical Culture

The reality is, as impressive as medical innovation is, much of it is not directed to address women’s health issues. For example, heart disease is the number one killer of women in the United States. However, many clinical trials are being done predominantly on men. For example, a clinical trial was recently conducted by the Food and Drug Administration on cardiovascular disease. In this trial, only 34% of the participants were women. There is a gap here that could alter the relevance of results for women’s health.

If any medical provider is making assumptions about your health without asking you the right questions or asking you enough questions, that could be a sign that you are not receiving the best care. The takeaway from all of these ideas and understanding is that improvement is needed on both ends:

  1. Doctors need to be honest and invest in each female patient

  2. Women need to be proactive and seek answers

Even with this, gaps will remain. Nobody knows it all. And legitimate gaps in knowledge themselves are unknown. It can take a lifetime to associate symptoms with causes and get to the root of the way your body works. Yet we must continue to try.

Whether you are a practitioner seeking to provide better care or a woman investigating your own health issues, there is grace for the journey. If we are honest about the reality that this is a fluid field with new discoveries every day, we will pursue truth, not just dollars or glib answers. The partnership between practitioners and patients in women’s health can be a positive one. If it improves, women everywhere will receive the higher quality of care that they need.

Fertility4Me Women’s Health Survey and Online Community

If this rings true to you, we want your voice! Fertility4Me has created a survey with the goal of capturing enough data from women’s personal experiences to catch the attention of larger influencers in the women’s healthcare space. Click here to take the survey and join our social communities on Facebook and Instagram. Other helpful resources include:

  1. Go here to join our Women 4 Reproductive Health community, where we get real about all that women face to advocate for our own health issues every day.

  2. Listen to the Fertility4Me Podcast or follow us on Stitcher, Spotify, Google Podcast, and Apple Podcast.

  3. Follow this blog for more articles like this!

You matter! We’re here to create a collective impact that improves all of our medical experiences.