Red Flags in Healthcare Providers: When Do I Say 'No?'

Twelve years ago, I was diagnosed with Hidradenitis Suppurativa. In those years, I have seen six dermatologists, five primary care physicians, and countless other nurses and medical practitioners. Through experience, I have learned what qualities to look for in a doctor, and when to say no.

When do I say no to a doctor?

When they make me feel uncomfortable

I once had a surgeon ask me to take my pants off in front of him so he could see the HS on my thighs. When I seemed hesitant, he asked if he should get a nurse to join us. He clearly found this inconvenient. I said no and acted like I was okay when truthfully I felt very vulnerable. If this happened to me now, I would put a stop to the appointment and feel confident in refusing to see him again. At the time, I needed validation from my parents to see this was inappropriate. This was the first time I realized that I do not need to keep seeing a doctor who makes me feel uncomfortable.

When they do not listen to me

When I experienced problems with back pain last year, I saw a doctor who did not ask me one question about my symptoms. He did not listen to my concerns. He assumed he knew what was going on based on the notes from the nurse. I still have unresolved back pain and I will not return to this doctor as I do not believe he can help me.

A doctor that does not listen to me does not make me feel heard. I know I feel heard if someone uses active listening skills. Active listening includes paying attention, reflecting back, asking clarifying questions, allowing time for me to talk, and educating me. When doctors use active listening tactics, it helps both of us to understand the symptoms and come to a consensus on the next steps. It also helps me to understand what is going on with my body, which is especially important when I am managing multiple chronic illnesses.

When they ignore or invalidate my HS symptoms

Many physicians and nurses have told me during a cursory review of my skin, that my HS is not so bad because it is not very inflamed right now. It makes me feel patronized and invalidated. It invalidates my history with HS and the long, arduous journey that I have experienced. These doctors did not see my worst symptoms or my treatments. This is a red flag to me because if they are invalidating me, they are not listening to me. If I am not being listened to, how can I trust my doctor to provide appropriate medical care and treatment? How can I be an active participant in my treatment? These doctors see what is right in front of them at the time, not the entire picture.

When they bully me

After years of taking Humira, I decided to tell my doctor that I no longer wanted to take it. I was distraught because at the time, she had told me there were no other treatment options, and she took advantage of that. I was so upset that I could not accurately voice my concerns. Instead of calming me down or trying to hear me, she took that time to say that she felt I needed to keep taking Humira. She did not try to understand what I was saying. She condescendingly insisted that I was overreacting and needed to keep the same treatment plan.

This is not okay. I have since then learned to be a stronger advocate for myself, but this should not have happened in the first place. I should be an active participant in my treatment, not bullied into a treatment plan that I do not agree with.

Good hidradenitis suppurativa doctors DO exist

After 12 years, I now actively seek out good doctors. A competent and good doctor listens to me, enables me as a partner in my treatment, educates me on what I do not understand, and makes me feel comfortable. If a physician does the opposite of this, I see it as a red flag.

The best way to measure this is to trust my gut. I still doubt myself because I worry that I will seem too dramatic and needy, but I am learning to trust it more. Good doctors are out there. It may be challenging, but it is worth the time to find them.