If you feel nervous about an upcoming doctor’s appointment, you’re not alone. While it’s estimated that only about three percent of the population experiences iatrophobia — an extreme fear of doctors — surveys suggest that at least one in three of us keeps putting off that medical appointment, even if we suspect we need medical care. And according to the Cleveland Clinic, it’s pretty likely these rates increased during the COVID-19 pandemic.
The consequences of healthcare hesitation are substantial. Research published in BMC Medicine found that missed medical appointments are a major risk factor for premature death. And the pandemic has brought this issue into focus: The past few years have presented plenty of barriers to things like routine screenings, and doctors are already starting to witness the poor health outcomes of this medical hiatus. Scientific American reports that screenings for some cancers fell by 90 percent, for example — and as a result, the National Cancer Institute estimates there will be at least 10,000 excess deaths from breast and colon cancer alone in the decade ahead.
In this post, mental health experts weigh in on what contributes to this medical anxiety — and how to overcome it.
You don’t need to have a full-blown phobia to feel stressed at the doctor’s, either. Roughly one in five people experiences what’s called white coat hypertension: this means that their blood pressure typically stays in a healthy range — and then suddenly spikes in the presence of a medical professional. This condition comes with a 36 percent higher risk of developing heart disease, according to researchers.
So with the stakes so high, why are many of us so reluctant to schedule that checkup? Whether you’ve had that dull ache in your back for a while now, keep brushing off that weird mole as no big deal, or just postponed your routine Pap smear yet again, these are some of the reasons we get so stressed about medical appointments.
“It’s common to be afraid of being judged or shamed by a doctor about lifestyle factors such as alcohol and drug consumption or sex, eating, and exercise habits,” says Sarah Kaufman, LMSW, a psychotherapist at Cobb Psychotherapy in New York City. Another common worry? Concern that your doctor will comment on your body shape, size, or weight.
(Afraid of giving your doctor the whole truth about your lifestyle? Read “Most of Us Lie to Our Doctors — Here’s Why We Need to Stop.”)
“Others fear that an unhealthy habit or neglect may have culminated in a catastrophic situation they will finally have to face,” says Dr. Monica Vermani, a trauma, stress, and mood disorder specialist and author of A Deeper Wellness.
If these fears sound familiar, keep in mind that healthcare professionals are never there to judge — having a complete picture of your health helps your doctor ensure that they are giving you the best care possible. If it seems like they’re asking a lot of questions, the reason is simply that they are trying to understand your situation. A good primary care provider creates a judgment-free space where you both can focus on your health.
Our brains work all day to make connections — so over time, it’s easy to build an association between sickness or injury and the doctor’s office. In a sense, we’ve learned to feel stressed and anxious in the presence of a medical professional, even when we’re physically just fine.
For some people, medical appointments feel unsatisfying and unhelpful, Dr. Vermani explains. “Since typical doctor visits are short, people often leave feeling rushed and unheard.” This also can prevent people from sharing critical information with doctors — which can lead to needless medical tests to explore physical concerns that are really rooted in psychological issues, she adds.
But if you’re feeling unheard, it may be time to switch primary care providers. An ongoing relationship with a trusted, compassionate primary care provider is a key element of maintaining good health — just as important as eating well and staying physically active. And an ongoing relationship means routine checkups, which allow you to collaborate with an expert team as you make strides toward your health goals.
“Racial and gender discrimination are pervasive within the medical system and can lead to medical harm and mistreatment,” Kaufman says. “This can leave people of color and transgender and gender nonconforming folks feeling extremely distrustful of the medical care they receive.”
Medical exams may trigger memories of past physical, emotional, or sexual abuse in trauma survivors.
“Simple instructions such as being asked to disrobe, lying on an exam table, or being physically touched while being examined in sensitive areas such as the breasts, buttocks, or genitals can lead to a panic attack or a traumatic flashback in a survivor of sexual assault,” says Romeo Vitelli, PhD, a psychologist and consultant for Mom Loves Best.
He adds that even seemingly innocuous aspects of being in an exam room can trigger anxiety in people with past traumas — for instance: being told to “relax,” as an assailant or abuser might have done in the past; being asked invasive-feeling or personal questions about sensitive topics; and sensing a loss of control.
Classic anxiety-busting tricks can be extremely helpful in a medical setting. Kaufman suggests utilizing grounding and mindfulness techniques, for example, like focusing on your breath or naming items you see in the waiting room.
Here are some other expert tips that can help take the stressful sting out of doctor’s visits:
If it’s feasible, Kaufman recommends that you bring a friend or loved one along with you to your appointment. Leaning on social supports is critical to our overall well-being, she says, and that includes managing anxiety around doctor’s visits.
It can help alleviate some of your anticipatory anxiety, too, adds Dr. Vermani. “And having someone there can help you capture any information or details that you might otherwise miss or forget.”
Whether or not you can have someone come with you, prepping for your appointment can ease the stress of being there and ensure that you don’t forget crucial information in the moment.
“If you think you will be too emotional to speak effectively, you can prepare a list and hand it to your doctor,” Dr. Vermani says. Include anything that’s happening in your life that could be contributing to your symptoms, from current stressors to supplements you might be taking.
(Get more tips on getting ready for a visit to the doctor, in “Taking Charge of Your Health: How to Prepare for a Routine Checkup.”)
“We often do not share enough information with our doctors,” Dr. Vermani says. She says that if you’re anxious, tell them. If you need a moment to collect yourself during an appointment, ask for it. If you have questions, address them. “Try not to discredit your own concerns.”
After all, any doctor who would dismiss your stress or anxiety doesn’t have your best interests in mind, Dr. Vitelli adds.
Researchers from the University of Michigan Medical School and School of Public Health found that at least one in five people has felt discriminated against in a healthcare setting. It’s an unfortunate reality, and the experts say that leaning on resources to find a healthcare provider you trust can go a long way in easing your anxiety.
“Lean on your trusted network,” Kaufman says. “Survey friends and family for their recommendations — and if you have other medical professionals you trust, ask them for referrals.”
She also recommends checking out the Health at Every Size (HAES) directory, which includes a list of providers who have signed a pledge to celebrate body diversity and positivity.
If you’ve experienced trauma or are struggling with any type of psychological issue, primary care physicians can be a valuable gateway for referrals to effective treatments, Dr. Vermani says.
“It’s important to realize that doctors aren’t mind readers and that you have the right — and a responsibility to yourself — to tell your doctor what you are dealing with in your life,” she explains.
“If attending an appointment in person is too stressful, arrange for virtual appointments, if possible,” she adds.
Primary care providers who listen, who follow up after your appointments, and who bring compassion to their work every day — that’s the Carbon Health difference. Find a provider near you, via carbonhealth.com or the Carbon Health app, and start making strides toward your health goals!