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You did the thing. You saw your doctor, asked your questions, and maybe got some answers. But as you walk out to your car, that familiar cloud of confusion and anxiety starts to set in. What did they say the next step was? Was I supposed to get a blood test or an X-ray first? Did I actually get the answer I needed?
Even a good visit requires follow-up action, and a bad visit often requires a total strategy reset. In this episode, Dr. Charlsie Celestine, a board-certified OB-GYN and host of the For Vaginas Only podcast, acts as our post-game coach. She walks us through how to utilize the “After-Visit Summary,” the crucial difference between a Patient Navigator and an RN, and exactly what to do—and say—if you realize you’ve just been medically gaslit.
Charlsie Celestine (00:03)
I know a lot about that after-visit anxiety. It should not be like that. After a visit, you should feel calm. You should feel like you understood things, and that anxiety should get lower. And if it’s not, then reach out again.
Priya Bathija (00:19)
Okay, so you did the thing. You saw your doctor. You asked your questions. Maybe you got some answers. Or maybe you’re on the way towards the answer you need. But then why does it still feel so confusing? Even if you had a good visit with your doctor, there’s still action that needs to be taken. And often, anxiety that needs to be soothed. Do you need a follow-up? An x-ray? A blood test?
What did your doctor say? Shoot, you were supposed to be taking notes. What if you still have questions you forgot to ask? Or maybe the appointment didn’t go well. You’re angry. You feel like calling your mom and crying about it. That does usually help, by the way.
What if you aren’t feeling heard or didn’t get the information you needed? That can be really frustrating. Maybe you need to find a new doctor and you’re disappointed that you feel like you’re starting from scratch again. Or possibly you have no choice but to make it work with the doctor you’ve got. So what do do now?
Hi, I’m Priya Bathija and this is the Women’s Health Playbook. Together we’re gonna make healthcare just a little bit easier because right now, navigating the US healthcare system, especially as a woman, is like playing a game, except you don’t know the rules. The instructions are written in a language you don’t speak and the stakes are your life. We’re here to change the game by arming you with the right plays. Today’s play,
What do you need to do after your doctor’s appointment to stay on top of your follow-up? And make sure you know what comes next. Our coach for today is Dr. Charlsie Celestine.
Charlsie Celestine (02:12)
am a board certified obstetrician and gynecologist. I’ve been practicing for over 10 years now.
Priya Bathija (02:19)
Charlsie. is also the host of the podcast, For Vaginas Only.
Charlsie Celestine (02:24)
There I kind of debunked a lot of the things that women were getting told in not just from their doctors, but from their friends and misinformation from the internet ⁓ and just explaining things in more detail that can happen during a GYN visit and some diagnoses you may have that are confusing and actually breaking it down for you in a way that you can clearly understand without all the medical jargon and all of that.
Priya Bathija (02:51)
Charlsie says her mission is to provide accessible information about the female body. On her podcast, she covers topics like endometriosis, her recommended vitamins and supplements for vaginal health, and what to do if you find a lump or a bump.
Charlsie Celestine (03:07)
So that’s my platform of For Vaginas Only the podcast and on the internet, social media and all of that.
Priya Bathija (03:15)
We’ll put a link to Charlsie’’s podcast and community in the show notes.
This is a conversation with a clinician that gets us to what comes next. Charlsie walks us through what to do if the appointment with your doctor went well and how to cope if it didn’t, plus getting the most from your healthcare teams and electronic medical record after the fact.
Charlsie, thank you so much for joining us for the fifth episode where we’re gonna talk about what comes next after the doctor’s appointment.
Charlsie Celestine (03:51)
Yeah, thank you so much for having me, Priya.
Priya Bathija (03:54)
Let’s jump in. Yeah. At this point, we have a woman who has gone to her doctor’s appointment and it went well and she left that appointment with a list of action items. What might some of those action items be?
Charlsie Celestine (04:13)
So action items after a woman sees a doctor, matter what kind of doctor, what kind of specialist it is, can be a whole range of things. It can be anything from picking up and starting a new medication, whether it’s a trial dose to see if it’s working well for you or not. It could be getting an imaging study done, like a chest x-ray or a pelvic ultrasound in my world. It could be doing some lab work that you need to complete before your follow-up visit.
so the doctor can review some things or add a little bit more pieces to the puzzle to figure out what’s going on. So it could be a whole host of things. It could be even as simple as documenting, which is not really always so simple, but documenting your symptoms. So I tell a lot of patients about keeping a diary over the next few weeks to a few months, depending on what we’re looking at. So those are some of the action items you can be taking home from a doctor’s visit.
Priya Bathija (05:06)
So it can be a wide range of things. How can you plan or organize for these follow-up actions or any follow-up care that you need to have? I know it’s a big question because it be a range of things, but any tips that you would give our listeners?
Charlsie Celestine (05:25)
Yeah, I am probably old school. So I’m always about writing something down, whether it’s something digital that you’ve created that’s written down on your phone, whether it’s an actual list like I would do with pen and paper. In my practice, we also print out for the patient the end of visit summary, which has in it my notes, a future appointment if we set that with the date and the time and my action items listed in it so that the person can have it right in front of them.
Priya Bathija (05:58)
That’s really helpful. Is that something that a lot of doctors do? Because I’ve never been given something like that.
Charlsie Celestine (06:03)
Yeah, I think for most of the electronic health records these days, it’s a thing that is able to be printed out, whether the office has that set up properly or not, or whether they have bought into that part of the EHR, which is a thing too. There’s different pieces of an electronic health record you could buy, but most will have that capability this day and age.
Priya Bathija (06:24)
So it’s definitely something people should ask for if they’re interested.
Charlsie Celestine (06:27)
Yeah, an after visit summary.
Priya Bathija (06:30)
After visit summary, that’s great to know. So how can you connect with a doctor or care team once you’ve done all your follow-up care? Like how does that work if you’ve gone to get the diagnostic test or you’ve picked up the prescription and you feel like it’s working? What’s the best way to keep the communication going with your provider?
Charlsie Celestine (06:52)
It depends on the person and your best way of communicating, as well as in combination with what your doctor’s office has set up. But there’s a few different ways. So a lot of offices have a way to contact the provider through the electronic health record, whether that’s emailing them that actually goes to their electronic health record or going into the EHR on the website, logging in with your username and password. And you can write to the office or write to the staff that
Sometimes I will say it doesn’t always get directly to the doctor, which is not always a bad thing. There are nurses that work in offices. There are other staff that work in offices that can answer a lot of the questions that we get regularly. And then it has to be upgraded to the doctor directly, or if you write in there that you want to speak to the doctor directly, that’s something you can do as well. And then it will get to your provider that way. I will say some doctor’s offices also have direct emails. You can email them. You can call the office. But for me, I love a visit.
even if it’s just a simple question, whether these days we have telehealth visits, so you can schedule a visit, you know, do it right from your couch and be face to face with your doctor for a quick question, or you can come back in person. So, but I always think also when you leave your doctor’s visit, it’s part of that after visit summary to have your follow-up visit scheduled so that you know there’s a time period where you’re going back to see that doctor to follow up on the things that you were supposed to get done.
Priya Bathija (08:18)
Yeah, so I have a primary care physician now who I love and the thing she always does is when she orders blood results from me, she says, they’re going to come in, I’m going to look at them and if they look a little off, schedule a telehealth visit and we’ll talk through them. Right. And I like that she makes that plan before I even leave the office because it’s so helpful to know and it’s helpful to know that she’s open to further conversation, not sending me a message.
Charlsie Celestine (08:51)
Right, so that’s what I personally do a lot. Of course, every type of doctor’s visit, the amount of patients that you see is different. you know, not everything is gonna be exactly as I do or, you know, I’m saying there’s different ways to do it. But I think for me that that’s kind of the best route. And for me, when I see a doctor, I like to know that I’m able to schedule that telehealth visit or that follow-up visit in person if I wanted to. And it’s not like eight months from now, you know?
Priya Bathija (09:16)
It’s not after you’ve sort of forgotten that you did a reiteration to what happened. Yeah, no, that’s great. And we talked in the last episode about the actual patient visit and we talked about how that can be an opportunity to build a relationship with your clinician because it’s important that you have that two-way connection and conversation back and forth. How do you use this period after a visit to help
Charlsie Celestine (09:19)
Right.
Priya Bathija (09:45)
Continue that relationship building.
Charlsie Celestine (09:48)
So I think, yes, you need a relationship with your doctor. That’s the primary relationship, especially when you’re talking healthcare, right? But in reality, it’s a healthcare team. So there are other members of the staff that are very well versed in what the doctor is looking for or wants. So whether, like I was talking about before, if you have a registered nurse on staff that can communicate with the patient.
There’s also a position, like in my office, for example, it’s called a patient navigator. And they specifically will contact the patients, do follow-ups if you miss your appointment, find out why, schedule your next appointment, find your labs if they didn’t happen to end up in the doctor’s inbox and things like that. I think, yes, forming that relationship with your doctor is important, but having that RN’s number, having that patient navigator’s number, as a direct line or their emails so that you can speak to them directly as well if the doctor happens to not be able to be reached. Like for me, example, my first thought in my head is sometimes I have a whole day in the operating room. So if it happens to be on a Tuesday, I might not be able to get back to you, but my patient navigator or my nurse could.
Priya Bathija (11:00)
Yeah, that’s really helpful to know and it’s important that you build that relationship with the entire care team. Sometimes we forget that. just think about the doctor.
Charlsie Celestine (11:10)
And have a direct line, not just the office number, the general one, or, you know, unless that office number gives you a hit too for the RN, you know? Not just like a general contact number, but direct lines and direct emails for the staff that is actually part of your care team.
Priya Bathija (11:30)
Hey, it’s Priya. I just wanted to pop in here and encourage you to send this episode to a friend. The information we’re sharing here is so valuable, and it’s how we help each other get the best care possible as women in America. So hit the share button on whatever app you’re listening on. Send it to your daughter, sister, aunt, mother, a coworker, or honestly, send it to every girl dad you know. Because the more we all know, the better healthcare will be for everyone. Okay.
to the play. So this has been really helpful and sort of explains the path that you would take if your doctor’s appointment went well. Let’s sort of flip the script and talk about if your doctor’s appointment didn’t go well. Can you talk about some of the things that may go wrong in a doctor’s visit?
Charlsie Celestine (12:22)
Two things that come to mind is that the first one being just that you and the doctor just don’t gel. You know, like you go and you just feel like the doctor’s not really listening to you, they don’t really understand what you’re trying to say, you’ve spent the 15 minutes, 20 minutes trying to get your point across and you just don’t feel like you’re being heard. Now I will say everybody has an off day, okay, even doctors. So I don’t like to say if it’s the first time that’s ever happened to write them off.
But if you’ve gone there two times, you know, three times and it’s still the same, then maybe it’s time to find a different provider that actually is somebody that gels with you, you know? And your best friend might love that doctor, but it just might not work for you. The other thing is if you feel like they don’t know who you are. That’s one of the things that I hear a lot. You come in, it’s your follow-up visit, and the doctor just doesn’t remember what happened last time or you have to explain everything again from the last visit. You just feel like you’re reiterating yourself. You’re not getting any answers. That’s another thing that I hear a lot from patients, families, friends that can go wrong as well.
Priya Bathija (13:30)
Yeah, and I want to dive deeper into medical gas lighting, but before we get to that, what if you leave without a list of action items, you leave without getting an answer to a question that you have? How do you recommend a patient seek out what they need at that point?
Charlsie Celestine (13:50)
I would try to talk to the doctor or your care team one last time, whether it is by sending a message on the patient portal, whether it’s an email, whether it’s a phone call or that follow-up telehealth visit. Because a lot of times when you’re in the room, a couple of things are happening. Sometimes you’re getting just a lot of information thrown at you and it’s very hard to digest it all in one sitting. And then when you get home, you’re like, wait, I forgot this or…
I didn’t even get my real question answered and I didn’t even realize. So I think those are ways to kind of circle back and be like, well, I have one more thing, two more things to go over. I think that’s a good way to do it. Not just sit at home and be anxious and just feel like the person didn’t listen to you or didn’t hear you, but actually try one more time to advocate for yourself and get your question asked.
Priya Bathija (14:42)
Yeah, I think that’s important. Like personally me, I’d just be like, don’t remember, deal with it next time, right? And that is not the best, like no one should be doing what I do when it comes to my life. That is a really great approach to do that follow up, continue building on the relationship and get the information.
Charlsie Celestine (14:59)
Like get your questions answered. I know a lot about that after visit anxiety. I’ve had patients come to me, they’re like, it’s been a year that somebody told me this thing and now you’re telling me that it’s fine. I don’t understand. I thought I was, you know, gonna die. And I’m like, no, no, no, no. Like, first of why did it take you a year to come and ask the questions? Please don’t do that. You know, the anxiety after a visit, that should not be like that. After a visit, you should feel calm. You should feel like you understood things and that anxiety should get lower. And if it’s not, then reach out again.
Priya Bathija (15:28)
Very good point. So you mentioned that an appointment could go wrong if a doctor’s not listening to you or you feel like every time you show up, you’re repeating the same thing and not getting anywhere further. ⁓ Sometimes that term is referred to as medical gaslighting. Can you tell us a little bit more about what it looks like and what can be done in response?
Charlsie Celestine (15:55)
So the biggest way that it looks is when you come in and you’ve been dealing with something for a while. It’s a major issue in your day to day life. And then you see that doctor and they tell you that everything is fine. Everything is fine. Everything is normal. There’s nothing wrong. You have no problems. Bye. Go back into your life and good luck. You’re too stressed, which stress though can cause problems. I will say that.
Yeah, they just minimize it to something that to you feels like it’s being minimized and overlooked. And they’re not actually even ordering a test. They’re not looking into anything. You know, that is definitely medical gaslighting for sure. That’s the biggest way that I see it pop up.
Priya Bathija (16:41)
So what can a person do if they feel that that’s happening? We talked a little bit about it in the last episode of what you can do in your appointment. But what if you don’t fully understand what’s happened until you have some time to process it and now you’re home and you realized you haven’t been listened to, you want someone who will listen to you. What do you do?
Charlsie Celestine (17:06)
Unfortunately, you have to, which for some people it’s easy, some people it’s hard, but you really have to put your foot down, step up and advocate for yourself. I know it’s like a broken record. I feel like people say that all the time and they make it sound so easy. It’s not easy. Not everybody has that type of personality. Not everybody wants to seem confrontational, but it’s your health, it’s your body, it’s stressing you out. You can’t think about anything else. You have to put your foot down. And if that doctor or provider of whatever sort is not listening to you, find another one.
Priya Bathija (17:39)
That’s great advice. you know, we’ve been talking a lot through this season and this play about building a relationship. And I just want to drop in something that you said earlier, like everyone has a bad day and physicians can have a bad day too. So just caution everyone before they jump ship and try to find another doctor that they sort of take your other advice from earlier. And
Give the doctor a second chance. Follow up, try to get some information and see how it goes before you write them off for another provider.
Charlsie Celestine (18:15)
Exactly and say like I don’t really feel like you were listening or you know this problem is still a big deal to me and I you know getting extra rest or trying to be less stressed like you had mentioned is not helping. It’s still there like do you think perhaps a whatever imaging study might help or can we check XYZ blood work that I’m interested in? Ask. People ask me all the time and sometimes if I honestly if I don’t feel like that’s what it is I’ll tell them but I’ll say like let’s check.
You know, let’s check. If it’s really bothering you, if this is the thing you want to check, let’s check this. But let’s also check these other things that I think it might be. ⁓ Because sometimes you just want the answer that you’re looking for the thing that you think it could be and it won’t settle your mind until you find that out. Plus you’re getting the input from your doctor on what they think it could be, the differential diagnosis as we call it. You can ask your doctor, okay, maybe you…
think that nothing’s wrong, but let’s pretend or let’s think for a minute and say that something could be wrong. What are the possibilities of what it could be? Like, what do you think? Ask your doctor that and then go down that path.
Priya Bathija (19:27)
that’s such a creative way to do it. never thought that I would have just been like, no, no, I really I would have gone to Google or AI and said, the test I need. Thank you very much.
Charlsie Celestine (19:37)
No, I was just looking at Google AI at the bottom the other day and it said like, it can be wrong. So please check. Exactly. It can be wrong. So please check the proper sources like your doctor or, you know, even like I was talking about my podcast and for vaginas only like proper resources, not just chat GPT or Google AI.
Priya Bathija (19:58)
Great warning, great warning. Okay, so if you feel overwhelmed, you feel like you need additional support, how can you build the right team around you of advocates, friends, and family?
Charlsie Celestine (20:12)
There is so much that goes into that. mean, friends and family, think are a big one because to be honest, that’s who we’re talking to most of the time, right? You’re not talking to your doctor all the time or their care team. You have to have friends that you trust with your medical problems or whatever issue is going on at the time. I also am a big advocate for mental health services. So whether it’s a therapist or some sort of behavioral health specialist to talk through it as a
unbiased party. It doesn’t have to be somebody that is going to prescribe you medications or anything, but just somebody to talk about what’s going on can ease a lot of anxiety around medical problems, big and small. I think also, like we talked about earlier, finding the right doctor for whatever’s going on. I also think everybody needs a host of doctors. Like I know when I was younger and I was, you know, 19, 20, I barely even saw the doctor. Still, I’m not the best patient as a doctor. That’s like a thing.
But you should, especially as a woman, should have a gynecologist and you should have a primary care provider as they are not the same. You know, if you’re 45 now, you should be seeing the GI for your colonoscopy. Like you just need to make sure you have these routine things set up and following guidelines for even if nothing is actively wrong that you’re aware of. So those are some important factors.
Priya Bathija (21:32)
Yeah, no, that’s great. And preventative screening is so important. You mentioned the GI for a colonoscopy. Last year was the first year I fully got through my list of preventative screenings for the first time in my life at the age of 46. I think the last time it happened was when my mom was taking care of all my health care. it’s so important. And there are so many women that are not getting the screenings that they need. And so thank you for raising that.
What other tips or tools or actions can women take after their doctor’s appointment that we haven’t covered already?
Charlsie Celestine (22:09)
So I would recommend right after your doctor’s appointment, make sure you, which I kind of touched on before, have all the contact information that you need for any type of follow-up or follow-up questions. So don’t leave without that patient navigator’s business card. Don’t leave without the nurse phone number, just in case you need something when you get home or if you like remember something when you get home. ⁓ I would also, something we didn’t touch on is…
Make sure you, which is kind of in the visit and after, which I’m not sure if you touched on before, but have somebody come to your visit with you, especially if you feel like it’s an overwhelming type of visit, or might be, or if you’re somebody that just knows you can’t remember things that are medical all the time. And then debrief with that person after the visit about what they heard, what they remember, so that you can make sure that you have all the pieces of your visit solidified. So that’s a big thing as well.
Priya Bathija (23:12)
Yeah, no, that’s really great. And in the last episode about the exam visit, we did talk about bringing a patient advocate or a friend or a family member that can be sort of your eyes and ears in the appointment. They can advocate for you. They can raise issues that you forget to raise when you’re talking to your clinician and how they can really be a support structure. But
Our speaker talked about how it’s really important to have a conversation before your appointment with that person so that you can be clear what roles you want them to play. And so I love that what you’re offering builds on that, right? Debrief with that person and figure out who’s taking on the next steps and how engaged they will be as you move forward.
Charlsie Celestine (24:01)
Exactly, and I actually had that recently. My patient brought her daughter in. I’ve had people bring friends in. But that debrief after is important. Sit down in a quiet place, write things down, whether it’s on paper and pen like me or your phone, and go over what happened in the visit so everybody can be clear about that.
Priya Bathija (24:17)
Great. Well, Charlsie, thank you so much for joining us for this episode of the playbook. And that’s a wrap on episode five.
Charlsie Celestine (24:26)
Yeah, thank you for having me.
Priya Bathija (24:36)
Thank you for listening to the Women’s Health Playbook. We hope this breakdown helps you receive better care as a woman in the United States. If you want to dive deeper into the tactics and resources we discussed today, you can find those in the show notes for this episode. The Women’s Health Playbook is brought to you by New Health. That’s my company. We help people and organizations reimagine how they prioritize and deliver care for women. For more information on the work we do, visit newhealth.com. That’s N-y-o-o health.com. And for more plays you can use to take control of your health and healthcare journey, visit us at womenshealthplaybook.com. I’m Priya Bathija. Catch the next episode of the Women’s Health Playbook right now in your favorite podcasting app. And we hope you’ll share this episode with a friend because the more we all know, the better healthcare will be for everyone.
I know a lot about that after-visit anxiety. It should not be like that. After a visit, you should feel calm. You should feel like you understood things, and that anxiety should get lower. And if it’s not, then reach out again.
Priya Bathija (00:19)
Okay, so you did the thing. You saw your doctor. You asked your questions. Maybe you got some answers. Or maybe you’re on the way towards the answer you need. But then why does it still feel so confusing? Even if you had a good visit with your doctor, there’s still action that needs to be taken. And often, anxiety that needs to be soothed. Do you need a follow-up? An x-ray? A blood test?
What did your doctor say? Shoot, you were supposed to be taking notes. What if you still have questions you forgot to ask? Or maybe the appointment didn’t go well. You’re angry. You feel like calling your mom and crying about it. That does usually help, by the way.
What if you aren’t feeling heard or didn’t get the information you needed? That can be really frustrating. Maybe you need to find a new doctor and you’re disappointed that you feel like you’re starting from scratch again. Or possibly you have no choice but to make it work with the doctor you’ve got. So what do do now?
Hi, I’m Priya Bathija and this is the Women’s Health Playbook. Together we’re gonna make healthcare just a little bit easier because right now, navigating the US healthcare system, especially as a woman, is like playing a game, except you don’t know the rules. The instructions are written in a language you don’t speak and the stakes are your life. We’re here to change the game by arming you with the right plays. Today’s play,
What do you need to do after your doctor’s appointment to stay on top of your follow-up? And make sure you know what comes next. Our coach for today is Dr. Charlsie Celestine.
Charlsie Celestine (02:12)
am a board certified obstetrician and gynecologist. I’ve been practicing for over 10 years now.
Priya Bathija (02:19)
Charlsie. is also the host of the podcast, For Vaginas Only.
Charlsie Celestine (02:24)
There I kind of debunked a lot of the things that women were getting told in not just from their doctors, but from their friends and misinformation from the internet ⁓ and just explaining things in more detail that can happen during a GYN visit and some diagnoses you may have that are confusing and actually breaking it down for you in a way that you can clearly understand without all the medical jargon and all of that.
Priya Bathija (02:51)
Charlsie says her mission is to provide accessible information about the female body. On her podcast, she covers topics like endometriosis, her recommended vitamins and supplements for vaginal health, and what to do if you find a lump or a bump.
Charlsie Celestine (03:07)
So that’s my platform of For Vaginas Only the podcast and on the internet, social media and all of that.
Priya Bathija (03:15)
We’ll put a link to Charlsie’’s podcast and community in the show notes.
This is a conversation with a clinician that gets us to what comes next. Charlsie walks us through what to do if the appointment with your doctor went well and how to cope if it didn’t, plus getting the most from your healthcare teams and electronic medical record after the fact.
Charlsie, thank you so much for joining us for the fifth episode where we’re gonna talk about what comes next after the doctor’s appointment.
Charlsie Celestine (03:51)
Yeah, thank you so much for having me, Priya.
Priya Bathija (03:54)
Let’s jump in. Yeah. At this point, we have a woman who has gone to her doctor’s appointment and it went well and she left that appointment with a list of action items. What might some of those action items be?
Charlsie Celestine (04:13)
So action items after a woman sees a doctor, matter what kind of doctor, what kind of specialist it is, can be a whole range of things. It can be anything from picking up and starting a new medication, whether it’s a trial dose to see if it’s working well for you or not. It could be getting an imaging study done, like a chest x-ray or a pelvic ultrasound in my world. It could be doing some lab work that you need to complete before your follow-up visit.
so the doctor can review some things or add a little bit more pieces to the puzzle to figure out what’s going on. So it could be a whole host of things. It could be even as simple as documenting, which is not really always so simple, but documenting your symptoms. So I tell a lot of patients about keeping a diary over the next few weeks to a few months, depending on what we’re looking at. So those are some of the action items you can be taking home from a doctor’s visit.
Priya Bathija (05:06)
So it can be a wide range of things. How can you plan or organize for these follow-up actions or any follow-up care that you need to have? I know it’s a big question because it be a range of things, but any tips that you would give our listeners?
Charlsie Celestine (05:25)
Yeah, I am probably old school. So I’m always about writing something down, whether it’s something digital that you’ve created that’s written down on your phone, whether it’s an actual list like I would do with pen and paper. In my practice, we also print out for the patient the end of visit summary, which has in it my notes, a future appointment if we set that with the date and the time and my action items listed in it so that the person can have it right in front of them.
Priya Bathija (05:58)
That’s really helpful. Is that something that a lot of doctors do? Because I’ve never been given something like that.
Charlsie Celestine (06:03)
Yeah, I think for most of the electronic health records these days, it’s a thing that is able to be printed out, whether the office has that set up properly or not, or whether they have bought into that part of the EHR, which is a thing too. There’s different pieces of an electronic health record you could buy, but most will have that capability this day and age.
Priya Bathija (06:24)
So it’s definitely something people should ask for if they’re interested.
Charlsie Celestine (06:27)
Yeah, an after visit summary.
Priya Bathija (06:30)
After visit summary, that’s great to know. So how can you connect with a doctor or care team once you’ve done all your follow-up care? Like how does that work if you’ve gone to get the diagnostic test or you’ve picked up the prescription and you feel like it’s working? What’s the best way to keep the communication going with your provider?
Charlsie Celestine (06:52)
It depends on the person and your best way of communicating, as well as in combination with what your doctor’s office has set up. But there’s a few different ways. So a lot of offices have a way to contact the provider through the electronic health record, whether that’s emailing them that actually goes to their electronic health record or going into the EHR on the website, logging in with your username and password. And you can write to the office or write to the staff that
Sometimes I will say it doesn’t always get directly to the doctor, which is not always a bad thing. There are nurses that work in offices. There are other staff that work in offices that can answer a lot of the questions that we get regularly. And then it has to be upgraded to the doctor directly, or if you write in there that you want to speak to the doctor directly, that’s something you can do as well. And then it will get to your provider that way. I will say some doctor’s offices also have direct emails. You can email them. You can call the office. But for me, I love a visit.
even if it’s just a simple question, whether these days we have telehealth visits, so you can schedule a visit, you know, do it right from your couch and be face to face with your doctor for a quick question, or you can come back in person. So, but I always think also when you leave your doctor’s visit, it’s part of that after visit summary to have your follow-up visit scheduled so that you know there’s a time period where you’re going back to see that doctor to follow up on the things that you were supposed to get done.
Priya Bathija (08:18)
Yeah, so I have a primary care physician now who I love and the thing she always does is when she orders blood results from me, she says, they’re going to come in, I’m going to look at them and if they look a little off, schedule a telehealth visit and we’ll talk through them. Right. And I like that she makes that plan before I even leave the office because it’s so helpful to know and it’s helpful to know that she’s open to further conversation, not sending me a message.
Charlsie Celestine (08:51)
Right, so that’s what I personally do a lot. Of course, every type of doctor’s visit, the amount of patients that you see is different. you know, not everything is gonna be exactly as I do or, you know, I’m saying there’s different ways to do it. But I think for me that that’s kind of the best route. And for me, when I see a doctor, I like to know that I’m able to schedule that telehealth visit or that follow-up visit in person if I wanted to. And it’s not like eight months from now, you know?
Priya Bathija (09:16)
It’s not after you’ve sort of forgotten that you did a reiteration to what happened. Yeah, no, that’s great. And we talked in the last episode about the actual patient visit and we talked about how that can be an opportunity to build a relationship with your clinician because it’s important that you have that two-way connection and conversation back and forth. How do you use this period after a visit to help
Charlsie Celestine (09:19)
Right.
Priya Bathija (09:45)
Continue that relationship building.
Charlsie Celestine (09:48)
So I think, yes, you need a relationship with your doctor. That’s the primary relationship, especially when you’re talking healthcare, right? But in reality, it’s a healthcare team. So there are other members of the staff that are very well versed in what the doctor is looking for or wants. So whether, like I was talking about before, if you have a registered nurse on staff that can communicate with the patient.
There’s also a position, like in my office, for example, it’s called a patient navigator. And they specifically will contact the patients, do follow-ups if you miss your appointment, find out why, schedule your next appointment, find your labs if they didn’t happen to end up in the doctor’s inbox and things like that. I think, yes, forming that relationship with your doctor is important, but having that RN’s number, having that patient navigator’s number, as a direct line or their emails so that you can speak to them directly as well if the doctor happens to not be able to be reached. Like for me, example, my first thought in my head is sometimes I have a whole day in the operating room. So if it happens to be on a Tuesday, I might not be able to get back to you, but my patient navigator or my nurse could.
Priya Bathija (11:00)
Yeah, that’s really helpful to know and it’s important that you build that relationship with the entire care team. Sometimes we forget that. just think about the doctor.
Charlsie Celestine (11:10)
And have a direct line, not just the office number, the general one, or, you know, unless that office number gives you a hit too for the RN, you know? Not just like a general contact number, but direct lines and direct emails for the staff that is actually part of your care team.
Priya Bathija (11:30)
Hey, it’s Priya. I just wanted to pop in here and encourage you to send this episode to a friend. The information we’re sharing here is so valuable, and it’s how we help each other get the best care possible as women in America. So hit the share button on whatever app you’re listening on. Send it to your daughter, sister, aunt, mother, a coworker, or honestly, send it to every girl dad you know. Because the more we all know, the better healthcare will be for everyone. Okay.
to the play. So this has been really helpful and sort of explains the path that you would take if your doctor’s appointment went well. Let’s sort of flip the script and talk about if your doctor’s appointment didn’t go well. Can you talk about some of the things that may go wrong in a doctor’s visit?
Charlsie Celestine (12:22)
Two things that come to mind is that the first one being just that you and the doctor just don’t gel. You know, like you go and you just feel like the doctor’s not really listening to you, they don’t really understand what you’re trying to say, you’ve spent the 15 minutes, 20 minutes trying to get your point across and you just don’t feel like you’re being heard. Now I will say everybody has an off day, okay, even doctors. So I don’t like to say if it’s the first time that’s ever happened to write them off.
But if you’ve gone there two times, you know, three times and it’s still the same, then maybe it’s time to find a different provider that actually is somebody that gels with you, you know? And your best friend might love that doctor, but it just might not work for you. The other thing is if you feel like they don’t know who you are. That’s one of the things that I hear a lot. You come in, it’s your follow-up visit, and the doctor just doesn’t remember what happened last time or you have to explain everything again from the last visit. You just feel like you’re reiterating yourself. You’re not getting any answers. That’s another thing that I hear a lot from patients, families, friends that can go wrong as well.
Priya Bathija (13:30)
Yeah, and I want to dive deeper into medical gas lighting, but before we get to that, what if you leave without a list of action items, you leave without getting an answer to a question that you have? How do you recommend a patient seek out what they need at that point?
Charlsie Celestine (13:50)
I would try to talk to the doctor or your care team one last time, whether it is by sending a message on the patient portal, whether it’s an email, whether it’s a phone call or that follow-up telehealth visit. Because a lot of times when you’re in the room, a couple of things are happening. Sometimes you’re getting just a lot of information thrown at you and it’s very hard to digest it all in one sitting. And then when you get home, you’re like, wait, I forgot this or…
I didn’t even get my real question answered and I didn’t even realize. So I think those are ways to kind of circle back and be like, well, I have one more thing, two more things to go over. I think that’s a good way to do it. Not just sit at home and be anxious and just feel like the person didn’t listen to you or didn’t hear you, but actually try one more time to advocate for yourself and get your question asked.
Priya Bathija (14:42)
Yeah, I think that’s important. Like personally me, I’d just be like, don’t remember, deal with it next time, right? And that is not the best, like no one should be doing what I do when it comes to my life. That is a really great approach to do that follow up, continue building on the relationship and get the information.
Charlsie Celestine (14:59)
Like get your questions answered. I know a lot about that after visit anxiety. I’ve had patients come to me, they’re like, it’s been a year that somebody told me this thing and now you’re telling me that it’s fine. I don’t understand. I thought I was, you know, gonna die. And I’m like, no, no, no, no. Like, first of why did it take you a year to come and ask the questions? Please don’t do that. You know, the anxiety after a visit, that should not be like that. After a visit, you should feel calm. You should feel like you understood things and that anxiety should get lower. And if it’s not, then reach out again.
Priya Bathija (15:28)
Very good point. So you mentioned that an appointment could go wrong if a doctor’s not listening to you or you feel like every time you show up, you’re repeating the same thing and not getting anywhere further. ⁓ Sometimes that term is referred to as medical gaslighting. Can you tell us a little bit more about what it looks like and what can be done in response?
Charlsie Celestine (15:55)
So the biggest way that it looks is when you come in and you’ve been dealing with something for a while. It’s a major issue in your day to day life. And then you see that doctor and they tell you that everything is fine. Everything is fine. Everything is normal. There’s nothing wrong. You have no problems. Bye. Go back into your life and good luck. You’re too stressed, which stress though can cause problems. I will say that.
Yeah, they just minimize it to something that to you feels like it’s being minimized and overlooked. And they’re not actually even ordering a test. They’re not looking into anything. You know, that is definitely medical gaslighting for sure. That’s the biggest way that I see it pop up.
Priya Bathija (16:41)
So what can a person do if they feel that that’s happening? We talked a little bit about it in the last episode of what you can do in your appointment. But what if you don’t fully understand what’s happened until you have some time to process it and now you’re home and you realized you haven’t been listened to, you want someone who will listen to you. What do you do?
Charlsie Celestine (17:06)
Unfortunately, you have to, which for some people it’s easy, some people it’s hard, but you really have to put your foot down, step up and advocate for yourself. I know it’s like a broken record. I feel like people say that all the time and they make it sound so easy. It’s not easy. Not everybody has that type of personality. Not everybody wants to seem confrontational, but it’s your health, it’s your body, it’s stressing you out. You can’t think about anything else. You have to put your foot down. And if that doctor or provider of whatever sort is not listening to you, find another one.
Priya Bathija (17:39)
That’s great advice. you know, we’ve been talking a lot through this season and this play about building a relationship. And I just want to drop in something that you said earlier, like everyone has a bad day and physicians can have a bad day too. So just caution everyone before they jump ship and try to find another doctor that they sort of take your other advice from earlier. And
Give the doctor a second chance. Follow up, try to get some information and see how it goes before you write them off for another provider.
Charlsie Celestine (18:15)
Exactly and say like I don’t really feel like you were listening or you know this problem is still a big deal to me and I you know getting extra rest or trying to be less stressed like you had mentioned is not helping. It’s still there like do you think perhaps a whatever imaging study might help or can we check XYZ blood work that I’m interested in? Ask. People ask me all the time and sometimes if I honestly if I don’t feel like that’s what it is I’ll tell them but I’ll say like let’s check.
You know, let’s check. If it’s really bothering you, if this is the thing you want to check, let’s check this. But let’s also check these other things that I think it might be. ⁓ Because sometimes you just want the answer that you’re looking for the thing that you think it could be and it won’t settle your mind until you find that out. Plus you’re getting the input from your doctor on what they think it could be, the differential diagnosis as we call it. You can ask your doctor, okay, maybe you…
think that nothing’s wrong, but let’s pretend or let’s think for a minute and say that something could be wrong. What are the possibilities of what it could be? Like, what do you think? Ask your doctor that and then go down that path.
Priya Bathija (19:27)
that’s such a creative way to do it. never thought that I would have just been like, no, no, I really I would have gone to Google or AI and said, the test I need. Thank you very much.
Charlsie Celestine (19:37)
No, I was just looking at Google AI at the bottom the other day and it said like, it can be wrong. So please check. Exactly. It can be wrong. So please check the proper sources like your doctor or, you know, even like I was talking about my podcast and for vaginas only like proper resources, not just chat GPT or Google AI.
Priya Bathija (19:58)
Great warning, great warning. Okay, so if you feel overwhelmed, you feel like you need additional support, how can you build the right team around you of advocates, friends, and family?
Charlsie Celestine (20:12)
There is so much that goes into that. mean, friends and family, think are a big one because to be honest, that’s who we’re talking to most of the time, right? You’re not talking to your doctor all the time or their care team. You have to have friends that you trust with your medical problems or whatever issue is going on at the time. I also am a big advocate for mental health services. So whether it’s a therapist or some sort of behavioral health specialist to talk through it as a
unbiased party. It doesn’t have to be somebody that is going to prescribe you medications or anything, but just somebody to talk about what’s going on can ease a lot of anxiety around medical problems, big and small. I think also, like we talked about earlier, finding the right doctor for whatever’s going on. I also think everybody needs a host of doctors. Like I know when I was younger and I was, you know, 19, 20, I barely even saw the doctor. Still, I’m not the best patient as a doctor. That’s like a thing.
But you should, especially as a woman, should have a gynecologist and you should have a primary care provider as they are not the same. You know, if you’re 45 now, you should be seeing the GI for your colonoscopy. Like you just need to make sure you have these routine things set up and following guidelines for even if nothing is actively wrong that you’re aware of. So those are some important factors.
Priya Bathija (21:32)
Yeah, no, that’s great. And preventative screening is so important. You mentioned the GI for a colonoscopy. Last year was the first year I fully got through my list of preventative screenings for the first time in my life at the age of 46. I think the last time it happened was when my mom was taking care of all my health care. it’s so important. And there are so many women that are not getting the screenings that they need. And so thank you for raising that.
What other tips or tools or actions can women take after their doctor’s appointment that we haven’t covered already?
Charlsie Celestine (22:09)
So I would recommend right after your doctor’s appointment, make sure you, which I kind of touched on before, have all the contact information that you need for any type of follow-up or follow-up questions. So don’t leave without that patient navigator’s business card. Don’t leave without the nurse phone number, just in case you need something when you get home or if you like remember something when you get home. ⁓ I would also, something we didn’t touch on is…
Make sure you, which is kind of in the visit and after, which I’m not sure if you touched on before, but have somebody come to your visit with you, especially if you feel like it’s an overwhelming type of visit, or might be, or if you’re somebody that just knows you can’t remember things that are medical all the time. And then debrief with that person after the visit about what they heard, what they remember, so that you can make sure that you have all the pieces of your visit solidified. So that’s a big thing as well.
Priya Bathija (23:12)
Yeah, no, that’s really great. And in the last episode about the exam visit, we did talk about bringing a patient advocate or a friend or a family member that can be sort of your eyes and ears in the appointment. They can advocate for you. They can raise issues that you forget to raise when you’re talking to your clinician and how they can really be a support structure. But
Our speaker talked about how it’s really important to have a conversation before your appointment with that person so that you can be clear what roles you want them to play. And so I love that what you’re offering builds on that, right? Debrief with that person and figure out who’s taking on the next steps and how engaged they will be as you move forward.
Charlsie Celestine (24:01)
Exactly, and I actually had that recently. My patient brought her daughter in. I’ve had people bring friends in. But that debrief after is important. Sit down in a quiet place, write things down, whether it’s on paper and pen like me or your phone, and go over what happened in the visit so everybody can be clear about that.
Priya Bathija (24:17)
Great. Well, Charlsie, thank you so much for joining us for this episode of the playbook. And that’s a wrap on episode five.
Charlsie Celestine (24:26)
Yeah, thank you for having me.
Priya Bathija (24:36)
Thank you for listening to the Women’s Health Playbook. We hope this breakdown helps you receive better care as a woman in the United States. If you want to dive deeper into the tactics and resources we discussed today, you can find those in the show notes for this episode. The Women’s Health Playbook is brought to you by New Health. That’s my company. We help people and organizations reimagine how they prioritize and deliver care for women. For more information on the work we do, visit newhealth.com. That’s N-y-o-o health.com. And for more plays you can use to take control of your health and healthcare journey, visit us at womenshealthplaybook.com. I’m Priya Bathija. Catch the next episode of the Women’s Health Playbook right now in your favorite podcasting app. And we hope you’ll share this episode with a friend because the more we all know, the better healthcare will be for everyone.
In this episode, we walk you through these key topics:
- The “After-Visit Summary” (AVS): What it is, why it’s crucial for reducing anxiety, and how to get one if your doctor doesn’t offer it.
- Your Follow-Up “To-Do” List: Common action items, including medication trials, imaging studies, lab work, and symptom diaries.
- Relationship Building Beyond the Doctor: Understanding the vital roles of Registered Nurses (RNs) and Patient Navigators on your care team.
- When the Vibe is Off: How to determine if a doctor just had a bad day or if it’s time to find a new provider.
- The Medical Gaslighting Response: Recognizing minimization and a creative “what if” tactic to force a dismissive doctor to take your symptoms seriously.
- The Power of the Post-Visit Debrief: Why you should always sit down and review the appointment details with your support person immediately afterward.
The Playbook: “Behind the Clipboard” Checklist
Dr. Celestine suggests these specific actions following your appointment:
- Before you leave the building: Ask the front desk for a printed or digital After-Visit Summary (AVS).
- Identify your non-doctor contacts: Secure direct lines or portal access to the Registered Nurse (RN) and/or Patient Navigator for faster responses on non-emergency questions.
- Debrief immediately: Sit in a quiet place (like your car) with your support person and write down everything you both heard and remembered while it’s fresh.
- The “What If” Advocacy Tactic: If a doctor minimizes your symptoms as “nothing,” re-advocate by asking: “I understand you think everything is normal, but let’s think for a minute and say that something could be wrong. What are the possibilities in that case?”
- The 24-Hour Rule: If your after-visit anxiety hasn’t decreased within 24 hours because you still have unanswered questions, reach out via the portal or schedule a quick telehealth follow-up immediately. Don’t wait a year.
