• Ava Hoffman

you can fire them

CW // medical gaslighting

I will never forget the moment that my mother told a doctor off.

It. Was. Glorious.

We were sitting in his office, candidly describing what life looked like, and begging him to change my medication and put me on a steroid.

He refused. He kept insisting that increasing my dosage would be a better option.

My mama reminded him that we’d done that already. Twice. I was sicker than ever.

He continued to refuse our requests, sympathetically nodding, asserting that he understood the severity of my symptoms, my difficulty in finishing school, and the limited life I was leading.

My splendidly fierce mother and advocate looked this doctor in the eye, straight faced, and said, “Go buy a bottle of Miralax, drink the whole thing, shit yourself 12 times, and go into work wearing an adult diaper. Then you can tell my daughter you understand.”

I didn’t know whether to gasp, laugh, or cry, and I’m pretty sure I did all three.

I never saw that doctor again.


Once upon a time, healthcare practitioners were inherently trusted. They were known to care for people, and we saw them as trained specialists with our best interests in mind. The patient was the expert of their health and body, and the provider was there to assist and offer in-depth clinical opinions.

Over the years, the profession and our society has shifted. Instead of being able to trust our providers, we’ve been conditioned to follow their advice, no questions asked. We’ve been trained to view those with lengthy credentials as the sole experts and authorities of our health and bodies.

We’ve all seen the growing mistrust towards the healthcare industry. Personally, I think it’s warranted. That doctor I told y’all about? He was receiving kickbacks from the company who made the medication that I wasn’t responding to. No wonder he kept upping the dosage and refusing to prescribe me something else!

More and more of us feel the traditional medical system and its staff are failing us. Our bodies aren’t well and the prescribed treatments don’t seem to get us where we want to be. Finding a provider who listens and see the whole picture feels impossible.

I’ve found so many of us long for better yet remain unsure how to walk forward. We know we are not okay with how our health looks presently, and we aren’t comfortable with our current care. But how do we get to a better place?

I think there’s a simple truth that can kickstart this shift!

Your healthcare providers work for you.

They work. For. YOU.

If your accountant messed up your taxes, you wouldn’t go back. If your contractor fell behind on the renovation, you’d fire him and replace him. If your grass people weren’t doing the landscaping how you wanted, you’d address the problem.

Same thing with our doctors and providers.

Chiropractor not listening? Go somewhere else. Doctor ignoring your symptoms? Find a different doctor. Dentist you just feel uncomfortable around? Get a different dentist!

It isn’t always this easy, though, is it?

For some reason, we are unsure what the red flags are. We don’t know how to fire a provider, and we certainly don’t know how to go about the transition.

That’s okay.

I’ve been in the healthcare system for 14 years. I’ve had over a dozen regular providers. I’ve fired three doctors. I’ve transitioned care three times. I’ve been there.

It's still hard for me!

So here are five red flags, five steps to take, and five things to keep in mind for the transition when you need to fire a provider!



1. Believes in Education over Experience

I am extraordinarily grateful for the time, effort, money, and debt our doctors put into their medical education. It makes them qualified to diagnosis and offer lifesaving, quality-of-life-improving treatments. HOWEVER, medical education will NEVER trump a patient’s experience. Regardless of how many years a provider has spent studying, at the end of the day, it is YOUR body. YOU have the symptoms. YOU know what feels off. YOU know what kind of life you’re trying to live. And take it from your friendly neighborhood geneticist, you WILL respond uniquely to viruses, autoimmune incidents, and drugs. Medicine has NEVER been one-size fits all. Personally, the best thing a provider can say to me is, “You probably know more than I do!” It means my years of living with the disease and my own education are seen, respected, and considered. A provider that tells me what I’m experiencing isn’t possible or unimportant isn’t long for my health care team.

2. Refuses to Cooperate

3. Rude and Condescending

4. Reluctant Learner

5. Offers No Explanation


1. Decide What You'll Tolerate

We all have our limits. What are you willing to tolerate? Can your provider accuse you of lying about your sexual activity? Can your provider insinuate that you are making up your symptoms? Is it okay for your provider to make a joke about school shootings? Is it okay for your provider to treat you like you’re an ignorant incompetent idiot? Will you pay a provider to share their political propaganda with you? Will you pay a provider who shows up 40 minutes late and never addresses your questions? There are a million more questions you can ask yourself, but the bottom line is this: How do you want to be treated, and what do you want your appointments to look like? Boundaries are healthy, friend, and knowing what is comfortable for you is vital, in this space and in other areas of life, too!

2. Choose Your Exit

3. Know Your Non-Negotiables

4. Research Other Providers

5. Be a Self-Advocate


1. Request Your File

If you are switching practices or offices, you will want to request your file at your final appointment. If you’re not comfortable doing this in person, you can always call the office and request it, too. They are legally obligated to provide it to you – it is your information!

Your new provider may be able to request your file, too, if they have your ex-practitioner’s information. So grab a business card at your last appointment that you can provide to your new office!

If you are staying within the same practice or system, you won’t need to do this because your new provider has access to the same system already.

2. Update Your Prescriptions

3. Wait

4. Trust Yourself

5. Prepare Your Questions


There are a myriad of reasons you might be seeking a change in your care, friend - personality mismatch, feeling rushed at appointments, walking out confused, a general uncomfortability, opposing views on care. And each and every one of your reasons is valid.

This is YOUR health and YOUR care team. You get to choose who cares for you, friend. That is a fact that will never change, regardless of what the world says.

The beauty of our system is the endless possibilities and choices of providers. Don't settle for care that is less than, friend. Choose what is best for you - presently and for your future well-being, too!

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