Top 5 things to do when you hear NO in healthcare

Hearing NO in the middle of a conversation can be off-putting, daunting, and often unpleasant.  Hearing NO when you are trying to get an urgent doctors appointment or schedule a crucial imaging test can be frustrating, debilitating, and sometimes even scary.

Life has shown us that the more emotional stake we have in something, the greater the impact its lack will have on us. 

What do I mean by that? 

If I go to my local hamburger joint and order a large burger with fried onions and a portabello mushroom on top, I will be disappointed when they tell me they don’t have any mushrooms left, but I will not feel devastated. 

Ok, truth be told, if I were nine months pregnant at the time, I might cry a little, but you get the point. 

However, if I’ve just been told by the doctor that my daughter may need surgery, and I wait 20 minutes on the phone for the scheduling secretary to tell me, oh so matter of fact, that there are no appointments, and she has no idea when there will be more appointments, that NO could cause a great deal of tension.

So I’ve put together a list of the 5 most important things you should do when you hear that no.

#5 Don’t freak out.

 I know this seems like a no brainer, but as I said before, the higher the stakes…? 

Let’s be real.  When you are calling to schedule an MRI appointment, in your head, you are hearing the doctor say, “Well it good be a headache, could be a brain tumor.  Let’s see.”  When the person on the other end of the line says, “sorry, can’t help you”, we hear them saying, “F%##* you! I don’t really care if you die.” 

Which is not actually what they are saying. Hence the rule, ‘keep calm’. Remember, in Israel, NO is just the beginning of the conversation, and in general, the bored sounding clerk does not mean you ill will. They are really just doing their job. Keep your sanity for the ongoing process.

#4 Reframe your question.

Often, repeating your question using different words and with a different emphasis, can actually do the trick. 

Example: You are calling to make an appointment with a specialist.  You ask the clerk, “Does Dr. Peter have appointments this week?”  Because your doctor told you that you must see this specialist, Dr. Peter, ASAP. 

Answer?: a brief laugh followed by, “Dr. Peter is a very busy man.  Of course he doesn’t have appointments this week.”

Reframing: “I saw my doctor yesterday, and he was very concerned and said I needed to speak with Dr. Peter urgently, hopefully, this week, or at the latest the beginning of next week.  Is there any possibility?”

To which the clerk answers, “Well, Dr. Peters keeps late hours on Thursday’s for urgent cases. I’ll put you on the list.

This actually works.

#3 Speak in your native tongue.

My husband, a native Israeli, actually gave me this advice when we were first married and I’ve used it ever since.  I was having trouble dealing with some government officials about my rights, and I was getting frustrated, angry, and when that happens to me, it often goes right to teary-eyed, which has rarely helped my case. 

I related the events to my husband and he said next time you go in, and you start to feel frustrated, switch to English. It doesn’t matter if they don’t understand you.  Then the weight of comprehension will be on them. Besides, you always sound more confident in your native tongue, and an empowered you can express herself much more clearly and succinctly in any language.

When you are calling to schedule an MRI appointment, in your head, you are hearing the doctor say, “Well it good be a headache, could be a brain tumor.  Let’s see.”  When the person on the other end of the line says, “sorry, can’t help you”, we hear them saying, “F%##* you! I don’t really care if you die.” 

#2 Choose your battles.

You will hear many NOs in your healthcare journey, as well as many yeses.  Some will be brick walls, others like canvas tents, and some will actually turn into windows.  But you need to save your energy and your bonus points for when it really counts.

Example: The secretary tells me that the pediatrician is available only on Tuesday, and not on Thursday when it would be really convenient for me since I will be in that neighborhood on Thursday with my son. But on Tuesday, I will have to make a special trip. 

I could argue for ten minutes trying to convince the secretary to schedule me in, or complain about how it’s not fair that I can’t come on Thursday, blah blah.

First, I am violating Rule #5.  Second, if I wear her down and she finally acquiesces and gives me an appointment on Thursday, I will have lost my bonus points. 

What does that mean?   In a month from now, when I really need the doctor to give me a prescription without me having to come in (technically a no-no, but can be arranged if everyone’s in the mood), I will ask and the secretary will say, “Absolutely not” and she will not back down.

#1 Always elicit one additional piece of information after the NO.

After you’ve reframed (Rule #4) but the status remains unchanged, try to leave the conversation with one additional piece of information that you didn’t have at the start of the conversation.

Examples: 

• So, Dr. Levy won’t be in ‘til 2025, but is there another doctor we could see?
• I understand that you have no one who performs that procedure, but could you ask someone in your office if, maybe, they know?
• So what centers do work with your clinic to conduct that test?
• Can I download that form online, instead of coming in?

You will be surprised at how much new information you can receive if you ask specific questions.

As it is so often said in Israel, NO is just the beginning of the conversation.