Women’s Health Week: Advocating for Yourself & Your Kids
Alexa Fiffick, DO, MBS, MSCP
CEO/Founder of Concierge Medicine of Westlake
May 12th marks an important day for moms and their kids and signals that Spring is eventually coming to Cleveland. Yes, May 12, 2024, is Mother’s Day, but it is also the beginning of National Women’s Health Week. This week was initiated in 2010 as an impetus for women and girls to prioritize their health. If the term “Women’s Health” conjures thoughts of pap smears, birth control, and mammograms for you, you’re not alone. However, women are so much more than “bikini medicine” and having babies. If fact, the most common cause of death in women is heart disease, though most people would assume the primary cause is breast cancer.
Our society’s emphasis on procreation and youth has caused a significant disparity in research funding for women’s health issues. This is likely familiar to you if you have ever struggled with infertility, endometriosis, PCOS, PMDD, perimenopause, menopause, lupus, migraines, or many other female-only or female-predominant conditions. It may still be a surprise to you, though, that there was no law to require female participation in all clinical trials until 1993. Think that was a fairly long time ago? Think again: as of 2020, only 38% of participants in cardiovascular studies were women. So, what was being done before 1993? Historically, clinical studies included only male test subjects and generalized the reported data to women.
If science is still playing catch up on women’s health, how do I begin to advocate for myself and my children? Great question! Below are some of the things I’ve shared with my patients to help them advocate for their needs and the needs of their loved ones:
- Find a doctor that specializes in your concern. Many medical societies (i.e., the American Academy of Pediatrics, American College of Obstetricians and Gynecologists) and hospital systems (Cleveland Clinic, University Hospitals) have websites with search features to find a specialist near you. For example, a society I belong to, The Menopause Society, has a “find a practitioner near you” feature that you can input your zip code into and out pops a list of doctors near your home. If that and Google do not yield your desired results, ask your PCP or Gynecologist to write a referral to a specialist who treats that problem.
- If you have a symptom or problem to discuss, book a “problem visit” appointment. Many patients try to get detailed questions answered during their wellness exams, which makes sense when it takes many weeks to months to get an appointment with their doctor. However, tagging those symptoms onto a “wellness” or “annual” appointment will likely leave you frustrated and still symptomatic. Unless you see a physician who uses a cash-pay model (i.e., concierge or direct primary care), insurance will charge you extra (often hundreds of dollars) for asking about that symptom while you get your yearly checkup. Additionally, allowing the doctor to address a separate issue on its own likely leads to a more thorough exam/evaluation and unrushed answers to your questions.
- Write your questions down in advance. Women and mothers have millions of things running through their heads all day every day. Depending on your memory to make sure you ask your doctor everything that is concerning you is likely to leave some questions unanswered. Whether it’s in your notes app on your phone or scratched quickly onto the back of your grocery list, write them down and take them with you. If you write it on paper, I recommend screenshotting it with your phone so that if you forget or lose the paper, the list is still with you at the doctor’s office.
- Ask your doctor to explain “why?”. Whether it’s the reasoning behind a lab test or image, a new medication, or a cancer screening, it’s ok to ask why. If their recommendation is different than you expected or you don’t understand the reasoning, ask them to explain their thought process to you. Specifically, ask your doctor to translate things into terms you understand (as opposed to their medical jargon based in Latin) and explain how things work. Take it a step further than why, and clarify how/when to take those new medications and why seemingly simple things like morning versus evening dosing or taking pills with/without food would matter.
- Don’t be afraid to disagree. If the doctor explains their reasoning behind something, and it doesn’t align with your goals for yourself or your children, ask them to discuss alternatives.For example, if you take your preteen daughter to her pediatrician to discuss heavy/painful periods, ask the doctor to discuss all of the options for treatment. This list should include everything from lifestyle changes, supplements/nutraceuticals, non-hormonal medications, hormonal medications/implants/devices, all the way up to surgery. If the doctor walks you through all the options, and you still are unsure how to proceed, ask for time to think or even a second opinion. Unless you are having a true emergency, usually you have time to process the options.
While this is by no means an exhaustive list, and the research has a long way to go before all our questions are answered, I think this is a solid start. Women are commonly the decision-makers regarding their children’s/family’s healthcare. Let’s use these tools not only to improve the health of our families but, for once, our own health.
