How to advocate for yourself as a patient

This story is part two of a three-part series called: From Exclusion to Inclusion: A Black Medical Student chronicles his efforts to bring health disparities to light. Read parts one and three.

Two years ago, while sitting in my dermatology class, I recall learning about different types of skin cancers. Most of the images that we were shown in class were pictures of patients with lighter skin tones.

“What would skin cancer look like in people who looked like me,” I remember asking myself.

After class that day, I rushed home, dove into my own research, and came across a specific type of cancer called acral lentiginous melanoma (ALM). ALM is the least common type of melanoma, but the most prevalent in African American and Asian populations. It’s typically found in unique places like the palms of the hands, the soles of feet, and under the nail beds, and can be mistaken for a bruise.

Determined to spread awareness, I decided to make a 60 second video specifically focusing on how it presented on skin of color then uploaded it on TikTok and Instagram.

A few weeks later, I received a comment on an entirely unrelated video that stopped me in my tracks.

The message read: “Your ABCDE of melanoma (video) saved my life… I had the mole removed from the bottom of my foot earlier this year.”
My heart skipped a beat, as I realized the significance that one video had in encouraging a patient to seek treatment for a problem they had thought was benign. It’s moments like those that I love most; When I can help patients advocate for themselves or their loved ones.

In a world where health care can be complex and hard to navigate, patients can often feel helpless when interacting with their doctors. However, there are several steps that you as a patient can take to advocate for yourself and ensure that you receive the best possible care:

1. Write down any questions you have before you go to the doctor: Before your appointment, make a list of your symptoms, concerns about your health, as well as any other questions that you want to ask your doctor. In the moment, it can be difficult to remember questions, especially if you’re nervous or have received some unexpected news. If your doctor doesn’t have the time to answer all your questions, be sure to prioritize the questions you want to ask at your current visit, and other questions that could be asked at a future appointment or via an electronic medical record.

2. Bring a friend or family member with you: A second set of ears can help make sure that you don’t miss anything important that is said. It’s also great to have another person with you to be able to provide support, take any notes, or ask follow-up questions that you may not have thought of yourself. If you can’t bring someone with you to the appointment, you always have the option to phone a friend or family member during the visit. Some doctors, depending on the state you live in, may even let you record the conversation to listen back to it later. Be sure to ask if it would be appropriate to record.

3. Have your provider document your concerns in the chart: If you feel like you aren’t being listened to, you can ask your provider to document your concerns in your medical chart. This ensures that there’s a record of your conversation and can be referenced at future visits.

4. Ask the doctor, “what is your differential diagnosis and why?” A differential diagnosis is the process of determining a medical condition by comparing and eliminating potential causes of an individual’s symptoms, medical history, and exam. It’s one of the first things that medical students learn in medical school. By asking a physician about their differential diagnosis, you give the physician an opportunity to walk you through a systematic and analytical approach of what may or may not be happening to you. It’s a great question to start or end with.

5. Do your research: Medicine is meant to be a relationship between a patient and their doctor. You should always feel empowered to be able to get a second opinion and work with a physician that you feel that you can openly communicate with and trust. Your voice should also be a part of the conversation.

By following these tips, patients can play a more active role in their health care and ensure that they receive the best possible care. As I tell my followers in my videos, remember that your health is your responsibility and it’s up to you to speak up and advocate for yourself.

This story is part two of a three-part series, From exclusion to inclusion: A Black medical student chronicles his efforts to bring health disparities to light. Read parts one and three.

Joel Bervell is a Ghanaian-American medical student studying at Washington State University, Elson S. Floyd College of Medicine. Across social media, Joel is better known to his over 800K followers as the ‘‘Medical Mythbuster” for creating content that is tackling biases in healthcare and other industries. Follow him on Instagram, Twitter and TikTok @joelbervell.

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