It took me a long time to realize that doctors won’t offer me services or tests unless I ask for them.
I’ve been dealing with a strange array of symptoms since moving to Berlin, so I went to my OB/GYN to ask for a hormone profile blood test to rule out low thyroid, polycystic ovary syndrome (PCOS), endometriosis, etc.
At first, she said no.
I’ve gotten quite used to this in Germany. The healthcare system is readily available to most citizens and residents (thanks to public insurance), but, as a result, the level of care seems slightly compromised compared to the U.S.—where if you have insurance, you’re gravy. If you don’t, you’re screwed.
The healthcare systems in the U.S. and Germany are some of the best and most privileged in the world, but moving from one to the other has given me a new perspective on their many systemic flaws.
In Germany it’s difficult to book an appointment with any kind of specialist (especially an endocrinologist — still no luck), and once you do get an appointment, it seems like the doctor is racing the clock to get you out in record time.
They do their best to avoid testing for preventive measures.
And this is frustrating. It’s frustrating because healthcare is moving away from solely reactive care that treats symptoms and towards a more holistic, preventive care that empowers the patient to take control of underlying problems.
We’re stuck in the middle of a technological growth spurt, and with that, come the growing pains.
Even the best healthcare systems in the world are far behind the current technologies and possibilities in personalized treatment. And although many people might not want to track their health, analyze their data and spot patterns, more and more people will be taking their health into their own hands, even before the antiquated institutions catch up.
Doctors are losing their authority over your long-term health. Sure, if you have appendicitis, or take a nasty fall, by all means, go to the doctor. But if you’ve been in pain — or feel a little off — and don’t know why, your doctor might not have the time or tools to play detective.
This is why you need to be your own health advocate. Taking control of your health does not mean dissolving your relationship with your doctor, but it will help them do a better job and help you find answers to personal health questions. Goodbye, Dr. Google and WebMD.
So, back to the story… The OB/GYN said “no” to my request to get a hormone test, and tried to convince me it was unnecessary. She even said “I’m sure you’re fine” without knowing a thing about my medical history.
I pleaded with her, almost to the point of tears. I listed all my symptoms: fatigue, low BBT (since I can remember my BBT is around 96–97°F, or ~35°C), heavy and irregular periods off the pill, mood swings, foggy brain, dry skin… the list goes on. I told her everything.
She said that insurance wouldn’t cover the hormone test for these symptoms, but that they would if I said I was growing hair in odd places, since abnormal hair growth is a common sign of PCOS.
Okay, this kind of makes sense, but to provoke some conversation I asked her why insurance companies didn’t offer the test for problems like declining mental health, but did for superficial symptoms like random hair growth (no offense to chest hair). She didn’t have a good answer, but we moved on and agreed to forge it. She scribbled that I’m growing hair on my chest, looked at me and said, “if anyone asks, you need to say this is why you’re getting the test.”
Sometimes you have to negotiate with your doctor. And sure, doctors have plenty of reasons to push back. The current medical system would crumble if every single patient wanted an allergy test, hormone profile, vitamin/nutrient check. Someday, we’ll be doing all of these tests at home or on the go, and I can’t wait for that day.
After my doctor agreed to the hormone profile, I asked for an ultrasound. I never had one and wanted to know if I had any (fairly common) abnormalities that could be easily spotted like cysts, etc.
She shook her head and said, “Oh no. That’s not necessary. It’s too much — it costs 30 euros.”
In my head I was thinking: DAMNIT, DOC. But I said, “That’s fine. I’d like to know.”
When it comes to reproductive disorders, many go undiagnosed. It takes people with endometriosis an average of 8 doctors and 10 years to be diagnosed.
You need to be direct in the doctor’s office if your gut tells you something is off. This doesn’t come naturally to everyone — it definitely didn’t for me, and it takes a lot of effort to be taken seriously if you’re not visibly ill or itching to get pregnant.
If you’ve been noticing weird patterns in your cycle or haven’t been feeling 100% lately, I highly recommend going to your OB/GYN and requesting the following tests:
- Hormonal profile
- Pap smear*
- STD tests
*Between ages 21–29, every three years
Process of elimination may be the only way to target the root of your problem, and ultimately, find relief. The results from these tests will help you determine what is (or isn’t) going on in your body, and hopefully pave the way for a better, healthier life.