In my post, Diamox Pointers, I refer to using the ‘Assertive Method’ to help you get the treatment you want to try but didn’t give much information at all about it – just a vague, unhelpful reference. I have seen this method mentioned in a conversation on Inspire (the EDNF message board) and, unfortunately, still cannot find the original post I saw it in. But, now, a couple years after I wrote the post about Diamox, I have decided to try and clarify what I was referring to. I have received several emails recently from folks who are desperately trying to find a doctor who will let them try Diamox, so I feel this is a timely post – if more than 2 years late!
The Assertive Method is effective in many situations but is well suited for use by chronic illness patients when interacting with doctors. It gives the patient a way to get what is wanted or needed without resorting to methods that may be overly emotional or combative and which would be viewed negatively. Certainly, it is not a foolproof method- there are some situations that there are no easy answers. But, it can be very effective in the kinds of situations patients find themselves in and empowering for a person struggling to be heard.
The Assertive Method
This method consists of four statements, delivered in one concise sentence each:
- This is the situation
- This is how I feel about it
- This is what I want you to do
- What do you think?
Once you have made your 4 statements, you say nothing until the other person finishes speaking.
Possible Outcomes and Your Responses:
- If you get what you asked for, wonderful. Be polite and express your genuine appreciation.
- If you get an acceptable alternative, show your willingness to cooperate and say “That seems reasonable, I’m willing to try it.”
- If the result is unclear or you feel avoids your request, ask for further explanation and/or repeat steps 3 and 4.
- If you don’t get your original request or an acceptable alternative say, “I understand, but [this is what I want you to do].” Do not argue, just restate steps 3 and 4 until you get the result you are asking for.
- If you are offered an option that you must refuse, briefly say no and why: “No, I can’t/won’t do that because it will (hurt me, conflicts with other treatments/advice, etc.)”. If pressed, repeat your statement again, “I understand, but I can’t/won’t do that because it will (hurt me, conflicts with other treatments/advice, etc.)” And then restate steps 3 and 4 again.
Things to Consider
- If it seems that the other person is unclear on steps 1 or 2, go ahead and restate them at any point you feel it necessary.
- Sometimes silence is golden. If there is a pregnant pause or silence while the other person thinks, let it work for you and don’t be tempted to fill the void too soon. If there is a pregnant pause after YOU finish speaking, stand your ground and let it stretch out. Your objective is not to argue, but to make your 4 statements until you get a response. Your statements simply place the ball in the other person’s court, so to speak
- If you feel you need to check that the other person understands your requests, ask something like, “Am I explaining myself?” or “Am I being clear about the situation?”. I like to ask ‘Does that make sense?” in a genuine tone. These kinds of statements are not as in-your-face as asking “Do you understand?” or “Are you listening?”.
- You can practice this ahead of time if you need to. You can role play with a friend or loved one until you feel comfortable – it could be helpful if they can throw out possible responses or even crazy ones, just to give you practice staying on script. Or you can just rehearse mentally until you are confident you know the steps and can follow your script.
- You can and should adapt this to the situation and your own personality. You can soften the script, to be less confrontational, as long as you remember that you are there to get results. You can be very straight shooting, to be more pointed, as long as you remember that you are not there to fight. Make it your own and be willing to shift to a question asking or discussion phase when appropriate.
- Remember, what you ask for is key. If you want a doctor to consider letting you try Diamox, per the Driscoll Theory, you might make step 3 something like: “I want you to read the Driscoll Theory (best if you have copies of articles or something to hand him) and consider prescribing Diamox, because I believe it could help me.” You don’t have to (nor would it be wise) to say, “I want you to prescribe Diamox.” What you really want is for the doctor to get on board and consider your research, so phrase it accordingly.
- This is not the only method or even the best method to use in all situations. Sometimes, you will want a sincere back and forth with your physician or, another time, you may need his specific advice on treatment. You do not need or want to always go in with an agenda. BUT, for situations like asking for a specific medication or treatment from a doctor who is reluctant or where you need to assess his willingness to listen to you, this can be an effective method.
Continue the 4 steps until you achieve a satisfactory outcome or until you see no point in continuing the conversation. The point is to a) be very specific in communicating your needs b) to communicate in such a way that does not burn bridges or cause offense and c) give you a script to use in difficult situations.
We all have found ourselves in situations that cause us to get so flustered or intimidated that we are at a loss for words. Considering how long we often have to wait to see a specialist and how important a visit to the doctor can be, this method may be a way for you to politely get your point across in a composed and assertive way, avoiding displays of emotion that undermine your goals or blanking completely, wasting the visit and going home dissatisfied.
If you use this, let me know how it goes – for good or ill!