On Being a Difficult Patient

We need to talk about what we mean when we call someone a "good patient."

• Compliant.

• Grateful.

• Doesn't ask too many questions.

• Takes the first answer.

• Fills the prescription.

• Comes back in six weeks.

We treat this like a virtue. We reward it with smooth appointments and providers who find us pleasant to work with.

But a good patient — in the way we've defined it — is often just a patient who has been taught that their instincts don't count. That the authority in the room belongs to the person with the credentials. That asking for clarification is the same as being difficult.

I have been a difficult patient.

I have asked why. I have said I'd like a different approach. I have requested the longer taper, declined the blanket form, asked the follow-up question after the appointment was clearly meant to be over.

Every single time, it has served me.

Not because I'm combative. Because I understand that I am the only person in any medical encounter who is with me every moment of every day. I know this body. I know this history. My knowledge is not less valid because it doesn't come with initials after a name.

Here is what I want for every person who has ever left an appointment with less than they came in with:

• You are not required to perform gratitude for inadequate care.

• You are allowed to ask the question again.

• You are allowed to say — this isn't working for me.

Advocating for yourself is not difficult. It is necessary. And it is a skill — which means it can be learned.

That's not a criticism of providers. It's an indictment of a system that never taught either of you how to actually talk to each other.