How to Speak Doctor When You’re Tired of Being Dismissed

In the modern medical machine, treatment isn’t so much tailored as it is templated — dispensed not according to the patient in front of the doctor, but by the sacred scrolls of Treatment Dogma™, a rigid catechism of “best practices” based largely on what’s easiest to justify, bill, or defend in court. You will not be treated as a unique biological entity with a history, comorbidities, and inconveniently strong opinions. No, you will be processed through The Algorithm — and heaven help you if you don’t fit. Watch closely for the holy words of this doctrine: “guidelines,” “standard of care,” “typical case,” and the ever-damning “we don’t usually...” These are not just words — they are incantations, used to ward off clinical nuance and summon the specter of one-size-fits-all medicine. When you hear them, understand: the physician is not speaking to you, but to an imaginary composite patient, age 67, with no cardiac history, no prior treatment, no questions, and ideally, no pulse.

You’ve been diagnosed. You’ve done your homework. You’ve survived the surreal blend of vague reassurances, euphemistic side effects, and upbeat pamphlets written by pharmaceutical copywriters on Prozac. You are, in other words, dangerously informed , and this makes you an immediate threat to the smooth flow of the 11-minute clinical visit.

To survive this brave new world, you’ll need to master a second language: Doctor. Not medical jargon — that’s child’s play. No, we’re talking about the dialect doctors use to dismiss, deflect, and politely tell you that your suffering is inconvenient to the treatment algorithm.

Here’s your crash course in translation, subversion, and selective diplomacy.

🩺 Phrase #1:
Doctor says:

“Your symptoms aren’t typical.”

What it means:
"I don’t have a tidy diagnosis for this, and frankly, I don’t want one.”

How to respond in fluent Doctor:

“That’s interesting. I’d love to see the literature that defines ‘typical’ in hormonally suppressed men over 70 with a Gleason 9 tumor. Can you forward it?”

(They won’t. But now they know you’re armed.)

🩺 Phrase #2:
Doctor says:

“Let’s just monitor for now.”

What it means:
“I don’t want to deal with this until it becomes a catastrophe.”

Fluent counter:

“What’s the clinical threshold that would trigger intervention, and can we document that in the chart today?”

(Translation: “If I die waiting, someone’s getting subpoenaed.”)

🩺 Phrase #3:
Doctor says:

“I’m not sure that’s related.”

What it means:
“I have no idea what’s causing it, and I’d rather not look.”

How to respond:

“Fair enough. Could we run the differential anyway, just to rule out treatable causes? I’d hate to chalk it up to age and miss something fixable.”

(Said with a smile. A very cold, patient smile.)

🩺 Phrase #4:
Doctor says:

“Well, the guidelines don’t recommend it.”

What it means:
“This is above my pay grade and if it’s not in a flowchart, it doesn’t exist.”

How to respond:

“Guidelines are helpful, but given my unique tumor biology and cardiac history, shouldn’t we tailor care to the patient in front of you — not the median man in a Phase III trial from 2011?”

(This will either shut them up or send them to UpToDate in a panic.)

🩺 Phrase #5:
Doctor says:

“This may just be anxiety.”

What it means:
“I’ve run out of interest, and you’re still talking.”

Your fluent reply:

“I agree there’s a psychological toll here, but correlation doesn’t imply causation. I’d prefer we explore physiological explanations first before prescribing meditation.”

(Also acceptable: “I wasn’t anxious until this appointment.”)

🩺 Phrase #6:
Doctor says:

“Let’s give it some time.”

What it means:
“If you’re lucky, it’ll resolve on its own and I won’t have to work.”

Response:

“Time is not on my side. What would the proactive version of this approach look like?”

Bonus follow-up:

“Could we document that we’ve chosen not to investigate further at this time?”

(Watch how quickly they do decide to investigate.)

🩺 Phrase #7:
Doctor says:

“You’re doing really well, all things considered.”

What it means:
“You’re still breathing. Let’s call that a win and move on.”

Translation tactic:

“I appreciate that. Just to clarify, are we measuring ‘well’ by objective markers or just survivability?”

Add extra points for using phrases like “symptom burden,” “functional baseline,” and “risk-benefit calculus.”

🩺 Bonus Survival Phrases to Memorize
“What’s the mechanism of action behind that?”
(They’ll either answer, or realize you’re not a bystander.)

“Is this supported by clinical evidence or anecdotal experience?”
(Translation: “Are we winging this, or do we have data?”)

“If you were in my position, would you want more clarity before waiting?”
(Guilt. Subtle and timeless.)

Final Note: The Tone Matters
Fluent Doctor is not about confrontation. It’s about strategic interrogation with plausible deniability. You’re not arguing — you’re “seeking clarification.” You’re not challenging — you’re “collaborating in care.” You’re not doubting — you’re just terribly curious.

And if all else fails?

Say nothing. Just stare at them for a full five seconds after they speak.

The silence of a well-informed patient is the most terrifying sound in medicine.