A Dose of Michelle
By Michelle McCaster, CRNA
Guest Column
Have you ever left a medical appointment thinking, “I didn’t get to say what mattered?” Maybe you still have questions about a test result, a prescription or whether the clinician understood your pain. You deserve clear answers and a plan you understand.
Speaking up is not arguing. It is taking part in your care. Your clinician brings medical expertise; you bring essential knowledge of your symptoms, history, daily life, and goals. Good decisions need both.
Why this conversation matters
Patients’ concerns deserve a respectful response, and the responsibility to listen belongs to healthcare professionals and systems too. A national study of emergency department visits from 1999 to 2020 found that White patients with pain-related visits were more likely than Black patients to receive an opioid prescription (40% versus 32%), even after adjustment for measured factors including pain severity. Another study found that about half of the White medical students and residents surveyed endorsed at least one false belief about biological differences between Black and White people; those who did rated a Black patient’s pain lower in simulated cases. [1, 2]
A 2025 study of 28 Black patients at one Midwestern academic institution described dismissiveness, lack of empathy, and missing information. Its findings reflect a small group in one setting, not every patient or clinician. Together, these studies reinforce why pain should be assessed individually and concerns taken seriously. They do not explain any one patient’s care, and an opioid is not the right treatment for everyone. [3]
Speak up with these five steps
1. Prepare for the visit. Write down your main concerns and put the most important first. Note when symptoms began, what changes them, and how they affect daily life. Bring a current list of medicines, supplements, and allergies. [4]
2. Ask until the plan makes sense. Try: “What do you think is causing this?” “What are my options, including the benefits and risks?” “What could happen if I wait?” If medical language is confusing, ask for a plain-language explanation.
3. Understand your medicines. Ask what each medicine is for, how and when to take it, what benefit to expect, and what side effects or interactions to watch for. Ask what to do if you miss a dose. Your pharmacist can help too. Do not stop a prescribed medicine suddenly without medical guidance; some need to be reduced gradually. [5, 6]
4. Bring support or seek another opinion. A trusted person can listen and take notes; you can also ask to speak with the clinician privately. A second opinion may help with major surgery, an uncertain diagnosis, a high-risk treatment, or symptoms without a clear explanation. Ask how to get your records and whether your insurance requires a referral.
5. Leave with a follow-up plan. Repeat the plan in your own words. Confirm who will share test results, when to follow up, and which symptoms need urgent attention. If promised results or calls do not arrive, follow up; no news does not always mean good news.
Words you can use when you feel dismissed
“I’m still concerned because this is affecting my daily life. What possibilities have we considered, and what is our next step?” You can also ask, “Could you document my concern and the plan we agreed on?” If you still do not feel heard, consider another provider or a second opinion.
Your questions matter. Speak honestly, ask for explanations, bring support when helpful, and follow up. You should not have to prove you are stoic to deserve careful attention.
About the author
Michelle McCaster, CRNA, has more than 30 years of clinical experience and has practiced nurse anesthesia since 2010. She is Anti-Basileus of the Xi Eta Eta Chapter of Chi Eta Phi Sorority, Inc. Her professional affiliations also include AANA, OSANA, Diversity in Nurse Anesthesia, and Delta Sigma Theta Sorority, Inc.
Sources
[1] Thompson T, et al. “Trends in Racial Inequalities in the Administration of Opioid and Non-opioid Pain Medication in US Emergency Departments Across 1999–2020.” Journal of General Internal Medicine. 2024;39(2):214–221. doi:10.1007/s11606-023-08401-2.
[2] Hoffman KM, et al. “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs About Biological Differences Between Blacks and Whites.” PNAS. 2016;113(16):4296–4301. doi:10.1073/pnas.1516047113.
[3] Gantt B, et al. “‘I Wasn’t Heard at All’: Black Patients’ Perspectives on Communication in Surgery.” The American Journal of Surgery. 2026;254:116686. doi:10.1016/j.amjsurg.2025.116686.
[4] Agency for Healthcare Research and Quality. The 10 Questions You Should Know. ahrq.gov/questions/10questions.html.
[5] MedlinePlus. Talking With Your Doctor. National Library of Medicine. medlineplus.gov/talkingwithyourdoctor.html.
[6] U.S. Food and Drug Administration. Stop–Learn–Go: Tips for Talking with Your Pharmacist to Learn How to Use Medicines Safely. fda.gov/drugs/information-consumers-and-patients-drugs/stop-learn-go-tips-talking-your-pharmacist-learn-how-use-medicines-safely.
This article provides general education and is not a substitute for advice from your own licensed healthcare professional.