Can You Really Trust Your Doctor?

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I Was Extremely Dissatisfied With My Doctor & Health Care

As I sat in one of the most vulnerable positions a woman can be in, on the table with my legs spread apart, my gynecologist asked me the inevitable question, “what type of birth control are you using?” Trying to sound casual, I responded, “The Fertility Awareness Method.” “Oh,” she responds “so you’re just playing Russian roulette?”

At the time of this visit I was 21, married for about 8 months, and was successfully practicing FAM to avoid pregnancy naturally. You might think that I would’ve been used to responses such as hers. I mean, I know FAM is alternative and “against the grain”. I’ve heard a lot of, “oh good luck with that”, or “I know a friend who tried that but now she’s pregnant”. Despite these comments I chose to do my research, learned how to track my cycles, and trust my body. After nearly 4 years of success, I can proudly say without a doubt that FAM works!

For some reason I expected my gynecologist, who was trained in how a woman’s body works, to have been at least somewhat familiar with FAM and say something like, “cool, glad that works for you.” But instead she continued, clearly surprised that I was not pregnant yet, “do you have any concern that you may struggle with infertility?” “NO! I track my fertility signs every month and I can say as a matter of fact that I am fertile and have data to prove it.” But of course I didn’t say that, because I was only 21, and at my first ever gynecologist appointment, and was not about to argue with a trained doctor twice my age. I managed a polite, “no, I’m not concerned.” She responded, “okay, well I want you to start taking a multivitamin that contains folic acid because it greatly helps reduce the chances of Spina Bifida in a baby if taken before conception.” I interpreted that to mean, “you’re bound to get pregnant any day now, better get on some folic acid!” For the icing on the cake she added, “have you ever heard of the Plan B pill?” I decided, “Ya, I’m never coming back here again.”

Can There be a Balance?

Here at Hana Wellness I write a lot about preventative health and natural living. I love taking my health in to my own hands and taking care of my body through food, sleep and fun; however, the reality is, we need a trained doctor when things are beyond us. I believe in balanced and rational living where preventative and natural health can coexist with a trusted doctor. Unfortunately, many have not found a doctor they trust, therefore go without seeking help when help is in fact needed. Or, like with my story, women feel shamed and ridiculed for the choices they make for their body, birth or their children’s care. This is NOT okay. With limited choices for doctors in your health insurance’s network or offices not taking new patients, it can feel like jumping over hurdles to find a doctor, let alone a doctor who you can trust and who respects your values. 

Dr. Wen and the Transparency Manifesto

Dr. Leana Wen spoke about this issue in a TED conference in 2014. Dr. Wen’s mother was battling Stage 4 breast cancer. After her third round of chemo she found out her mom’s oncologist was a highly paid speaker who spoke on behalf of a drug company who promoted the same chemo he had prescribed her. This discovery led Wen to ask herself, “is he treating my mom with what’s best for her, or is he treating her based on how much he will be paid?”

Dr. Wen saw such a need for transparency between doctors and patients that she started doing her own research. She sought out what patients really want to know about their health care and doctors. Besides wanting to know that their doctors are certified and competent, patients wanted to know things like: are they unbiased, are they making decisions based on evidence and science or on who pays them, are they comfortable with LGBT health, where do they stand with women’s reproductive choice and rights, and do they practice preventative health and alternative medicine?

“When you go to a doctor for back pain, you may want to know that he is getting $5,000 to perform spine surgery, or $25 to refer you to physical therapy.”

Dr. Wen decided to challenge her fellow colleagues in Who’s my Doctor? The Total Transparency Manifesto, asking doctors to volunteer to answer certain questions with full transparency. Many participated, however, Dr. Wen also experienced extreme backlash from doctors, accusing her of being a traitor.

See first hand how Dr. Wen shook up the medical community in a pursuit to advocate on behalf of patients: 

Finding a Doctor & Health Care You Trust

I love this discussion that Dr. Wen begins. I feel so fortunate to have now found a doctor who respects my values, believes in preventative care and alternative medicine, and who has earned my trust with honesty and transparency. How did I find this doctor? I was referred by a good friend, but learned that this particular doctor didn’t take my insurance. I had been paying a substantial amount for insurance yet was highly dissatisfied with the limited list of doctors in my network and dissatisfied with the care I had received from the ones I’d chosen (hence the story above). I  felt stuck and was looking for a better-suited solution. After much research, I decided to leave my traditional health insurance, and f*** the system, so to speak.

I decided to join a non-profit cost sharing program through Christian Health Care Ministries (I get no kick back from sharing this, just am a happy member). I’ve since cut my monthly payment in half, and haven’t had to make any compromises on coverage. I pay my monthly “premium”, and then pay out of pocket for any basic health costs, such as seeing the doctor of my choice. I make sure to put away savings every month to draw from for when I need to pay out of pocket to see my doctor. Then, if I ever have an issue that is over $500, my “health insurance” kicks in they will cover it, ALL of it, no matter how big.

This may not be the answer for everyone, but this has give me so much freedom and peace. Not only can I choose the doctor I trust, but I can also have the birth I want when that time comes. My traditional health insurance wouldn’t pay for a home birth or midwife, but Christian Health Care Ministries does. As a doula, I’ve seen many women not get the kind of birth they want because their insurance won’t cover it and they can’t afford to pay out of pocket. This is not acceptable to me and I believe

“every women should have total freedom in choosing what is best for her.”

I don’t have the exact answer for how to find the best health care and doctor for you, but I write all this to encourage you to SEARCH and NOT SETTLE. Ask for referrals from friends, ask doctors tough questions, and find a health insurance and a doctor who works for your best interest. You deserve to have your body, values, and beliefs respected. You deserve to have both great care and what is best for you, whether it be for a flu or cancer, a home or hospital birth, alternative or traditional care.


If you are in the San Luis Obispo area and are looking for a doctor, my doctor is Dr. Susan Lundgren at Ptera Wellness and her amazing partner, Dr. Terra Dallman is taking new patients. 

Have you found a doctor you trust? Share with me how you found them!

  • Abby B.

    Hi Hana!

    Loved most the TEDTalk you linked to. I believe wholeheartedly in the democratization of health data and health decisions and love that you promote body autonomy. Preventive medicine is the best medicine and a lot of my grad school research has been on how we can leverage technology and our communities to know more about ourselves and maximize our health potential. I love the idea of knowing if our health care providers have our best interests at heart but I feel like she could have done a better job about acknowledging the very real crisis we have in this country with how doctors are compensated for their work. Her general thesis is admirable, but being a doctor isn’t as lucrative as it once was and instead of condemning those who feel like they need to take money from seedy sources in order to survive, she should instead encourage a conversation about fair pay (especially for community health workers).

    Aside from that, I’d like to have a discussion about the experience you described in your post and FAM in general. While I do not personally practice FAM, I do understand its attractive qualities. There are many personal health factors that essentially bar me from practicing FAM and I am instead using the implant and have relatively few complaints. I’m not about to try and convince anyone to change their method if what they’re doing is working, but I do take issue with advocating for a particular method without a comprehensive discussion of the facts and drawbacks.

    First, to ask about your first gynecological exam. I am truly sorry you had a difficult experience. I know how uncomfortable the appointment can be for some people and even the most experienced can still get anxious. But I want to perhaps add some background to the questions your doctor asked to provide clarity for you or others.

    In regards to folic acid, I hope your doctor did not ask about it in a condescending way because it is SO important. Folic acid has been proven to reduce the risk of serious birth defects like spina bifida and the Centers for Disease Control and Prevention (CDC) actually recommends taking it as a supplement for ANY woman of childbearing age (ages 15-45) regardless if they are using birth control or are even sexually active. Half of all US pregnancies are unintentional and most birth defects occur very early in pregnancy, often before most women know they are pregnant so starting early, in your case 21, is more of a preventive measure and not a way that your doctor was judging you. I am on the implant with has a typical use failure rate of <1% and even I am asked about folic acid.

    Which leads me to another point of concern. Again, I love that you advocate for natural cycle family planning. For those that are able to keep detailed records, and wow I am not one of those people, it provides a sense of control and empowerment. But the metric you cite is the success rate in a perfect system and accidents happen. The more transparent way to present the statistic for how effective the practice is would be to say that the efficacy of FAM ranges from 76% to 99.6% depending on the method you adhere to and how meticulous your recording is. The typical use failure rate is closer to 20% and can be as high as 24%, much higher than the perfect use numbers that you provide.

    Any birth control that is sensitive to user error (barriers, withdrawal, the pill, NuvaRing, FAM, etc.) has a larger range of efficacy than those that do not rely on regular human intervention (implant, IUD*, hormone shot, sterilization, etc.). Because of this, most GYNs will ask patients who are using the former what their “back up” plan is in case of plan A failure. In this case, when your doctor asked you about Plan B, she was doing her due diligence as a health care provider to present all of the options to you, especially since this appointment was your first. I have been asked about my knowledge of Plan B during every GYN appointment I have had and I have been on some sort of birth control, ranging from the pill, to the implant, to an attempt to get the IUD.

    I hope this clears some of things up either for you or for any of your readers who may feel like their doctor does not have their best interests at heart. I know many GYNs that practice FAM and it is a great way to empower women to be more in tune with their bodies. But your doctor must also be realistic and provide you with all of the information at her disposal.

    Anyway, I understand if you do not agree with me. Your doctor should have explained why she was asking certain questions and I can understand why you felt the way you did. A woman's relationship with her GYN is incredibly personal and that relationship does not come easy.

    I am so happy to see you doing well. I admire your joie de vivre and your dedication to healthy living and female body empowerment, keep on rocking! 🙂
    Abby

    *note: there are some IUDs that do not use hormones so they do not interfere with your natural cycle

    • Hana Wellness

      Hi Abby!

      Thank you so much for taking the time to comment. I love the conversation you have started because it truly adds to complete the picture. It also gives me an opportunity to make sure my intended message comes across clearly, and I can’t be sure of that unless I get feedback 🙂 One of my biggest hopes for my blog is to start a conversation and have other women share their stories. Thank you for sharing yours. The more women share about their experiences, the more they can learn about what’s normal and not feel alone.

      I’m so glad your birth control method is working for you with few complaints. I totally understand your reasons for not practicing FAM and that it’s not for everyone. I’m grateful to have your voice here so that women know that there are so many options. I did not mention the many other traditional options such as the non-hormonal and hormonal IUD, the ring, the implant and the pill etc., because I assumed (maybe incorrectly) that most women know of these traditional options because they are the most advertised and recommended by doctors. My point is, that because of this, it makes it difficult to choose FAM. One of my main goals for my blog is to simply grow awareness that FAM is a viable option and to encourage women to take a further look into it, in case it truly is the right option for them.

      I really appreciate your very realistic input that doctors are simply doing their job and have a responsibility to their patients to provide them with all the information at their disposal. I 100% agree. Your point on the importance of folic acid and the realness of spina bifida is spot on. Thank you for your sensitivity to my experience and my feeling shamed but also sharing the reality of what doctors have to ask. One thing I failed to add in this post, which I wanted to, was that I really don’t blame doctors for not recommending FAM because they usually do not have the time to teach their patients how it works nor have resources to send their patients to, for them to learn more. That is why I am trying to create resources, so that one day, FAM is on the list of options that are suggested.

      Love your suggestion of how to present the statistic for FAM efficacy. I will look over my copy and seriously take your suggestion into consideration.

      Miss you Abby and I love that you are such a strong woman who is also into empowering women!
      Grateful to stay connected over the years and good wishes on your new career!

      Hana