Working With Your Doctor

What I’ve learned about asking, from both sides

How you communicate with your care team shapes what you get out of each visit. This is what has worked for me, the research behind it and an honest look at the written questions I sent before my first birth.

Why the relationship matters

Every practice says it’s focused on the patient. My experience with my OB-GYNs, and especially with the high-risk specialist who managed my first pregnancy, is that you still have to manage the relationship. There’s ego in medicine. You hear it all the time: they’re the sweetest patient, they’re the sweetest nurse. Once someone has been identified as likable or nice, people are nicer to them, and they like that person more in return. In my experience, patients who are liked get treated better. It’s human nature.

Research also examines how attitudes toward a patient can affect care:

Clinicians aren’t exempt. In a 1993 study of 17 internists and 530 of their patients, physicians liked healthier and more satisfied patients more. In a classic study of hospital wards, nurse researcher Felicity Stockwell found that the quality of care nurses gave was influenced by how popular a patient was.
Words in a chart travel. In a study using a hypothetical patient case, medical students and residents who read a note written with stigmatizing language viewed the patient more negatively and chose less aggressive pain treatment than those who read a neutral note about the same case.

I opened with thanks, chose my words carefully and tried to handle conflict deliberately. Some of that helped me get answers. It did not fix a relationship in which I no longer felt cared for. Below is what I tried, what it got me and where it stopped working.

1. What I tried with my first specialist

I opened with thanks. I sent recaps. I asked for calls. Before my first birth, I also sent a written document with 32 numbered questions. Many held more than one question. At the top, I wrote: “If you cannot answer or aren’t responsible for these questions please direct me to who is.” I grouped them the way I’d prepare for any important interview: the doctor’s approach, communication style, data, managing risk, my birth plan and the long term. My doctor answered every one in writing.

2. What my questions got me

When I went back through the answers, they fell into four groups.

Hospital and practice logistics, specific enough to plan around: 11 of the numbered questions. Example: “Inductions are started by residents and general OBGYNs covering in the hospital.”
The doctor’s clinical approach, specific: 7 of the numbered questions. Example: “If closed, I start with a balloon and misoprostol, then rupture of membranes when the balloon comes out.”
General statements about values or philosophy: 10 of the numbered questions. Example: To how they create an inclusive environment: “All our staff is highly trained and dedicated to all patients.”
Pointed elsewhere or left open: 4 of the numbered questions. Example: To how consent would be handled on the day of birth: “See #8.”

The logistics answers were the most usable. Support-person limits, when inductions started, length of stay. Most of these are hospital policies that a hospital tour or website could have answered; my doctor even linked the visitor policy page. (“Getting Ready for the Hospital” lists them.)

Questions about values got general answers. “How do you promote relaxation and comfort during labor?” got: “We tailor that to each patient. And your nurses are very dedicated to this.” I asked about common complications for Black women and what would be done to avoid them or bias. The answer was that patients in the practice usually come with preexisting risks such as hypertension, that “You are on aspirin for prophylaxis for this,” and that the institution had “done many training of staff to avoid bias.” I developed preeclampsia anyway. Aspirin lowers the risk; it doesn’t erase it.

The most important answer came from a follow-up about my own situation. Under the question about informed consent, I added that we’d discussed a possible induction but I wasn’t aware of the risks. The written answer laid out why induction was being recommended for me, what could go wrong and why delivery shouldn’t go past 41 weeks. It also said: “I apologize if this was not clear that those were what I was discussing at the previous visits including at the [earlier] visit.” We had talked about the risks in the room. I hadn’t taken them in until I had them in writing.

3. What they didn’t get me

The answers didn’t change the relationship. My visit notes described my questions as too extensive for the time we had, and in my second pregnancy, the practice cancelled my care without a physician ever explaining why. It is possible to communicate thoughtfully and still be dismissed. I struggle with advice that leaves the patient carrying the entire explanation for why an encounter went badly.

As for the questions themselves, some were preparation: who would start my induction, how many people could be with me, what would lead to a cesarean. Some were compensation. I was asking in writing for what I wasn’t getting in the room: time, explanations of my own care and confidence that someone was tracking the details. Looking back, sending that many questions reflected how much I still needed explained, and how little I trusted the relationship with my provider.

4. Where preparation worked

With a gynecologist who started out rushed, written notes changed what came out of the visit. About nine months after my first birth, I had a painful lump under my cesarean scar. The gynecologist looked at it and said it should go away. I went through my notes: how the pain had started and spread, my keloids (thick, raised scars), my cesarean after a failed induction and my questions about another pregnancy. By the end, imaging was ordered, referrals were made and my surgical team was asked to call me. That evening, I sent a written summary of everything we’d agreed. Afterward, the gynecologist kept saying, “I’m assigning you a lot of homework, homework, homework.” In my follow-up, I wrote: “I’m trying to keep the situation positive, so I want to send a follow-up note just to make sure my concerns don’t get misconstrued.” My preparation changed that appointment. It didn’t secure the follow-through: getting the referral placed and my records sent took months more of asking. (“Nine Months Later, I Was Still Asking What Happened in My Surgery”)

With the OB who got it right in my second pregnancy, I barely needed preparation. I came armed the way I always do, and my OB was already ahead of me. Tests and referrals arrived as notifications, not as replies to my requests.

5. A communication problem, or a relationship problem?

The difference I’ve learned to look for: when I’m clear and specific, does the answer come? With the gynecologist, it did; my notes changed the visit. With my first specialist, clear and specific questions got written answers, but not the time, explanations or follow-through I needed. That isn’t something better wording fixes.

Even so, I stayed with my first specialist for an entire pregnancy because I was afraid that leaving meant giving up safety and continuity. In my second pregnancy, the care I found out of state showed me I could feel safer with a different provider.

I don’t have a clean rule for when to go. What I have is a pattern I’ve learned to watch for in myself: longer messages, dozens of unanswered questions and fear that raising a concern will annoy someone. When my preparation starts to look like it did then, I take it as a sign that I’m compensating for the relationship, not just preparing for the visit.

Key points

In a 2023 CDC survey, 44.7% of respondents held back questions or concerns during maternity care. Of those, 28.8% thought what they were feeling was normal and 20.7% worried their provider would think they were being difficult. Write your questions down and ask the most urgent one first.
An estimated 40% to 80% of medical information is forgotten immediately, and almost half of what patients remember is incorrect. After any visit that matters, send a written recap: “To confirm, we agreed…”
Language labeling a patient as difficult appeared in the labor and birth notes of nearly 3 in 10 patients in one 2025 study. Read your visit notes in your portal. Under HIPAA, the federal health privacy law, you can ask the practice to amend information you believe is inaccurate.

Putting it to use

Get an answer

One list, most urgent first. Separate messages get answered one at a time, and the pattern gets missed.
Open with thanks if it feels natural. Gratitude shouldn’t be a condition of being heard.
Frame it as shared risk, not an audit. “Given my history of preeclampsia, what should we both be watching for, and what would make you want to see me sooner?”
Put the discrepancy in front of them. A heart rate that didn’t match the screen, a label that didn’t match the instructions, two blood pressure thresholds from the same hospital. Put the two facts side by side and ask which one to follow.
Ask for the reasoning. “What do you think is going on, and what would make you think differently?” If you need it at home: “Can you put the reasoning in writing so I can follow it?”
Spend the doctor’s time on your own risks and decisions. Send hospital logistics, such as visitors, room policy and length of stay, to labor and delivery. On questions about values, ask for what will be done, not what is believed: instead of “How do you avoid bias?”, ask “What will you check, and how often, to catch preeclampsia early in someone with my history?”
Ask for a second opinion plainly. “I want a second opinion. Can you help me arrange that and explain how we’ll coordinate the recommendations?”
Instead of “Why didn’t you order that?”, try: “Is that something worth considering for me? What would make it useful or not?”
Instead of “I read online that…”, try: “I came across this and wanted to ask whether it applies to me.”
Instead of “You’re not listening.”, try: “My question about [the symptom] is still unanswered. Can we go through it before we move on?”
Instead of “That’s wrong.”, try: “I’m seeing two different instructions. Which one should I follow?”

Make the plan usable

Send the recap. “Thanks for today. To confirm, we agreed…” It catches misunderstandings while they’re small.
Who does what, by when. When something has to happen, write it once and repeat it: “This test has to happen by this date. Can you help me get it scheduled?”
Resolve conflicting instructions at the source. Ask the prescribing clinician or pharmacist to settle the specific discrepancy, and write down the answer.
Use the practice’s channel. Ask how it wants questions sent and how fast it answers portal messages. Ask for a dedicated visit when your questions won’t fit a routine one.
Get the final birth plan scanned into your chart.
Be kind to everyone who moves your care. Coordinators, schedulers and the front desk handle your appointments, referrals and records. Learn their names, and thank the nurses.

Recognize the limit

Respectful isn’t the same as backing down. After days of scheduling messages in my second pregnancy, still without a high-risk specialist (maternal-fetal medicine, or MFM), I wrote: “I still do not currently have an established MFM overseeing my pregnancy.” Polite, specific and not softened.
Name your plan if you can’t be seen. When the lump under my scar was getting bigger, I wrote: “I would like to be seen in person by an OBGYN today but if I’m unable to I will go to the emergency department.” It was a plan, and it told them how serious it was.
Escalate in order: the practice, then the hospital’s patient relations office, then your insurer’s nurse case manager. Keep it about the care: what you need, by when and who is responsible.
Watch for the pattern. If clear, specific questions keep going unresolved, that’s the relationship, not your wording. Ask someone in your life to help you find another practice.

Take this back

To discuss with your care team:

What’s the best way to bring you questions between visits?
Which of my questions should go to you, and which to the hospital, anesthesia or nursing?
Given my history, what would lead you to recommend an induction or a cesarean?
When we disagree, how would you like me to raise it?

To discuss with the people in your life: Will you read my message and tell me whether it clearly says what happened, what I need and when I need an answer? If I keep having to fight for basic care, will you help me find someone new?

Next in the series: “Urinary and Vaginal Infections in Pregnancy”