3 Rules for How to Productively Disagree with your Diabetes Healthcare Provider

By Gary Scheiner MS, CDE and Alicia Downs, RN, MSN, CDE

Anyone who’s been in a long-term relationship will tell you that the most important communication skill is knowing how to disagree in a productive, non-confrontational way. This is just as true with your healthcare providers.

Disagreements are inevitable between patients and healthcare providers. How you navigate those disagreements with your provider could have a big impact on your diabetes care.

From my experience as both a diabetes educator and as a person with type 1 diabetes, I can share three rules for how to get the answers to the questions you may have about your treatment plan when you and your provider don’t see eye to eye.

1. Questions work better than statements.

Asking a doctor, “Why do you feel this would be the best option for me personally?” opens up dialogue about the pros and cons of the treatment without making the conversation contentious or defensive.  If you have a different treatment option, ask “What do you think about (fill in the blank) for me personally?”

This approach shows the doctor that you’re invested in your care and are doing your homework. And using the word “personally” gives your healthcare team a clue that you are asking them to think about you specifically, and not as a generic person with diabetes.

“What would I gain or lose if we were to try another option before going in that direction?” is another good question that lets your doctor know that you might be willing to give up some short-term gains in to try alternatives to what was suggested.

The most important part of asking a question is to be open to the answer. Your healthcare provider likely may have legitimate concerns driving their decision-making. Be prepared to listen to the information that comes after your question, even if it’s not what you thought you would hear, or even wanted to hear.

2. Never assume what another person is thinking or feeling.

It’s easy to assume that we know the motivations behind the actions of others, and to fill in the blanks when something goes wrong. These fill-in-the-blank motivations can sound a bit paranoid if you write them down.

Example 1. “My doctor won’t put me on a pump because he thinks I can’t handle it.”

Example 2. “My educator tells me the same thing at every visit because they think I’m lying.”

Example 3. (my personal favorite) “She just doesn’t like me, so she’s trying to get me out of the office.”

Sound familiar? If you find your brain filling in blanks in conversations, think about asking your healthcare provider their reasoning for a decision instead.

If you feel you cannot communicate effectively with your healthcare provider on an issue, seek a second opinion. If the second opinion matches, or comes very close to matching, the first one, you can probably trust what the first one said.

3. If you feel unsafe, be direct and concise, and repeat your question until you get an answer.

When we, or someone we love, is fighting for survival, speak as directly as possible about your concern.. The phrase “Stop, we will not move forward without clarification” works very well.

There is almost no situation in which 30 seconds of clear, concise communication will cause damage to a patient-provider relationship, but there are many times when not taking that 30 seconds could be extremely harmful. If you are still in doubt after your first question, ask a follow-up question right way. And repeat.

Remember, it’s always okay to ask questions about your health and your treatment plan. Your healthcare provider works for you, and not the other way around.

And if you practice these rules and you still aren’t getting the answers you need, consider looking for another healthcare provider.

Gary Scheiner is Owner and Clinical Director of Integrated Diabetes Services, a private practice specializing in intensive insulin therapy for children and adults. Visit www.integrateddiabetes.com for more information.  

Alicia Downs RN, MSN, CDE is the Director of Patient Care and Education at Integrated Diabetes Services, specializing in managing diabetes with co-occurring diagnoses. Both have type 1 diabetes and use insulin pump & CGM technology, as well as non-insulin options for management.

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