13 techniques to help handle health conversations

1. Be assertive rather than aggressive

Women in particular often worry that expressing their wishes will see them labelled as bossy or aggressive.

It’s important to understand that this is often based in gender stereotypes and prejudices which aren’t true or helpful. We have just as much right to have our healthcare needs met as anyone. Sometimes this means we have to question attitudes which see our experiences and voices dismissed or silenced. However, we can do this in a way which is clear and confident without getting being confrontational and causing ourselves and others to be angry or upset.

Being assertive can help you to get your point across in healthcare conversations and appointments. It can enable you to come out of them feeling more confident that you’ve said what you needed to say, and achieved the outcomes you wanted to achieve.

There are key communication strategies that can help you be more confident and assertive when discussing your health needs which we’ve described below. Some of these techniques might be new and unfamiliar to you, so you might wish to try them out and practise with a friend, family member, or someone else you trust!

2. Listen to yourself first

Your inner noise – anxieties, distrust, previous frustrations – can swamp what you want to say and the goals you have for the appointment. Accept that it’s OK to feel like this. Take a breath and before engaging, pause.

Top Tip: To help master your breathing, you can watch FTWW’s ‘Box-Breathing’ exercise:

3. Be present

Focus your attention on the person in front of you – it’s difficult but you can practise grounding techniques to help you, including ‘box breathing’ or ‘tapping’ to keep yourself focused on the conversation rather than your inner noise.

4. Hold the gaze

Eye contact can help to show sincerity and that you’re listening. However, we know that ‘holding the gaze’ isn’t always easy, especially for those who are neurodivergent, or simply introverted or shy, but you can practise using a mirror or with people to whom you are close and feel more confident.

5. Be honest about the challenges you face

Say up-front that you find certain things about communicating or engaging in appointments difficult, demonstrating you are both self-aware and honest about your own challenges – this in itself can help to open up dialogue.

6. Rehearse and use confident phrasing

Use phrases such as:

‘I’m concerned about…’

‘This is affecting my daily life’

‘I’d like to explore the options’

‘Could you explain the reasoning’

‘What are the next steps’

‘Why?’

Phrases like these signal your wish to collaborate with your doctor in decisions about your health and care.

The last one is especially important if you’re advised that you’re not eligible for a particular course of action, such as a referral. You can also ask for your request to be documented in your medical notes.

7. Hold the silence

Don’t feel the need to fill any silences that take place. Allow both the other person and yourself time to ponder what’s been said.

8. Fogging

This is a technique that involves calmly letting the other person know that you have heard what they have to say and accept this as their opinion without feeling like you have to justify your own, different, viewpoint.

For example, your doctor might say, ‘Lots of patients report mood swings when using this treatment’.

With ‘fogging’, you might respond with, ‘I appreciate that being the case. However, I’m experiencing depression that is difficult for me and my family to cope with, so I’d like to talk through some other options’.

Instead of getting flustered or angry, take a few moments to compose yourself by acknowledging the other person’s comments before moving on to your own perspective.

In healthcare settings, this type of conversation can help move both you and your doctor towards a solution, sometimes called a ‘shared decision’.

Fogging can help to avoid confrontation; it shows that you’re respectful of the healthcare professional’s expertise, but it also maintains a focus on your experience and preferences.

9. The Broken Record technique

This is a technique that can be helpful in situations where you need to assert your position without losing your temper, or losing track of your goals because you are too upset to think clearly.

Clearly state your key point, priority, or goal. Calmly repeat it without over-explaining. Make sure to keep breathing so you remain calm, and stay focused on your point to avoid being distracted.

As with the fogging technique, you can acknowledge the other person’s perspective to show you value their input, without it detracting from your own viewpoint.

For example, you might say, ‘I understand what you mean about mood swings being typical for this treatment and that it’s considered a good choice for my condition, but I’d still like to try a different approach’.

By using the broken record technique, you can maintain your assertiveness and ensure that your needs are heard and understood.

10. The Sandwich technique

This technique is also known as the ‘feedback sandwich’, because it frames constructive criticism, your request, or goal, between two layers of positive remarks.

For example, you might say, ‘I really welcome your perspectives on this. However, I am concerned about the impact this current medication is having on my mood and need to discuss another way forward. Thank you for helping me go through the options’.

The approach is designed to make your feedback or difference of opinion easier for the other person – in this case, the healthcare professional – to accept. It can be helpful in making the interaction more positive and constructive.

11. Be your authentic self

Whether this is needing to cry or use your own words for things, such as slang, don’t let it worry you.

Sometimes, trying to hold back from crying or trying to use language that isn’t familiar to you can take so much effort that you can’t concentrate on what you need out of the appointment.

Remember, it’s OK to cry. Sometimes, the anticipation of an appointment, or talking about the impact symptoms are having on your life can make you feel tearful. It can often be better to let those feelings out and have a cry than try so hard to keep your emotions bottled-up that you can’t focus on what’s being said.

Doctors say that they won’t be surprised if you do cry and that you shouldn’t worry about doing so. Many appreciate that crying can be a release of tension and have a therapeutic effect.

You might also need to use your own language or terminology to describe symptoms or body parts – and that’s OK too. Your doctor should ask you to explain a bit more if they’re puzzled, including if you’ve mispronounced things. It doesn’t matter – what matters is that you both eventually get to a shared understanding and can take things forward together.

12. Ask questions

It’s important for you to understand what’s going on with your body, including whether there have been any investigations or tests from which you need to know the results.

Don’t be afraid to ask for results and next steps to be explained to you and for answers to be written down, or a leaflet to be given to you so you can read back at your own time.

13. Reflect back

Check your understanding by repeating back to the doctor the core of what you’ve heard so that they can clarify anything you might have misheard or misunderstood.

If there’s something you don’t understand, don’t be afraid to politely interrupt and ask. You are the one in charge; the appointment is about you! And if you haven’t managed to cover everything, ask to make another appointment.

This page is part 5 of 5 of FTWW’s My Voice Counts Self-Advocacy Toolkit.

Next up:

Our My Voice Counts animations and scenarios will show you how to apply the tips and techniques you’ve learned.