Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered podcast. I'm Dr Neha Pathak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine. Before we open today's episode, I want to let you know that we'll be discussing sensitive topics, including trauma and sexual trauma, so it may not be suitable for all listeners.

For millions of people, walking into a doctor's office is a challenge. If you've experienced physical abuse, sexual assault, or medical trauma, the exam room can feel like one of the most vulnerable, triggering places in the world.

The fear of being harmed, dismissed, misunderstood, or not believed can be powerful enough to keep you from showing up at all. But the cost of staying away is real. Missed screenings, undiagnosed conditions, and health consequences can compound quietly over time. Today's conversation is for every survivor who's ever put off an appointment, frozen in the exam room, or left a visit feeling like something was done to you rather than with you. Our guest is here to change that.

She's gonna give us practical, empowering language that we can bring into every appointment so that you walk in informed and prepared, knowing that you have every right to be a partner in your own care, not just a patient on a table.

So first, let me introduce my guest, Dr Bayo Curry-Winchell. Dr Bayo is a nationally recognized health advocate who's board-certified in family medicine. She's the founder of Clinicians Who Care and serves as a medical director at St. Mary's Health Network and the Washoe County Sexual Assault Response Team in Reno, Nevada.

Welcome to the WebMD Health Discovered podcast, Dr Bayo.

Bayo Curry-Winchell, MD, MS: Thank you for having me. I'm excited to be here.

Pathak: Well, I am so thankful to you for the discussion that we're about to have. I'd love to ask about your own health discovery. What led you to the work that you're doing currently?

Curry-Winchell: My work started with my father, who passed away just a few years ago at the age of ninety-nine. He was a Triple War veteran, World War II, Korean, and Vietnam. And as a child, I would watch him go to doctor's appointments. I would be right there by his side, and I would watch his symptoms that he would share—knee pain, different things—get dismissed and looked over.

Or he would actually be told, like, "Oh, it's not that bad. You served three wars. You, you've got this." And when I would see the defeat in his eyes as he was sharing what was happening and the dismissal, that is where my story started because I knew I wanted to be a doctor that didn't provide that type of care, and I wanted to be able to advocate for people.

When they share something's wrong, that should be honored. And so all credit goes to my father, William Curry, for this journey into what I do every single day.

Pathak: That is so beautiful. Thank you so much for sharing his story and how that connects with the work that you're doing today. And that sort of brings us into our topic, which is helping someone navigate their health journey, the health system, when they've experienced sexual assault or medical trauma.

How do you help people navigate the health system when they've experienced those types of traumas?

Curry-Winchell: The first thing I do is I remind myself, and I remind the students I work with, to imagine yourself in the place of your patient. You're walking into an office that you may have never been to before. You have people touching you, getting your vital signs, checking your blood pressure, but they're touching you, and you, you really don't know what to expect next.

You're then in an exam room. It's often very sterile and cold. You're asked to undress, have a gown that may be open in one area, and it can feel extremely intimidating and anxiety-provoking. And so that's what I start with first, imagining putting yourself in your patient's situation.

And now, for anybody, that is a vulnerable situation. Now, imagine that you're coming into this with trauma and that you have been sexually assaulted or had something happen to you that you had no control over. So all of those things trigger the nervous system just in general. And when you are coming into that exam room with additional worries and anxiety because of your past experiences, your nervous system is gonna kick in, and that's gonna mean your heart is racing.

You might have difficulty concentrating, all while trying to share with someone who you probably have never met your most intimate issues of what is of concern. And so I think that is the important piece to start with.

Pathak: I think that is so well said in terms of what's happening emotionally, physically, and how to really sort of get into the mind and the heart of the patient and the potential injury that they may have suffered or that they're silently managing while you're going through the steps of caring for them.

So this also explains why many survivors delay or avoid preventive care because of these fears, because of these feelings. What are some of the long-term health consequences of putting off routine exams? And what do you want patients who may be listening, or who know someone who may be suffering in this way and putting off care, what do you want them to know?

Curry-Winchell: That delay shows up in not getting your Pap smear, maybe not getting a full exam, getting your heart checked out, blood work. And it reminds me of a patient I had a few years back, a woman in her mid-30s who had not gone to a doctor for maybe since she was a child, and it was because of a history of sexual assault.

Well, when she was in my clinic and she was sharing with me that she was feeling tired and having headaches, and I said, "Oh, you know, how long has this been going on?" And she said, "For a couple of years, but you know, I'm stressed. I just have a lot going on."

And I said, "What prevented you from coming in sooner?"

And she said, "Well, I was also just afraid that it wasn't gonna be anything. I didn't wanna waste anybody's time. And I also have a real fear of seeing doctors."

And I asked then an open-ended question, "Tell me a little bit more about that."

And that was a beautiful moment because, in that moment, I provided space that I didn't even know I was gonna provide.

And she shared with me that she had a history of sexual assault, and coming to the doctor was very triggering. And that's why, although she had had this fatigue and headache, she decided not to come in. And so it's really important that we remember that the symptoms your patient comes in with—there might be other things that are a part of it that could prevent them.

And so, fast-forward, she ended up having a blood pressure of 170 over 110. And so she has essential hypertension. We were able to address it, but she had been walking around with elevated blood pressure for who knows how long. But because of what had happened to her in the past, she had decided not to show up.

And so it, it has real consequences. We all know that elevated blood pressure can stress the kidneys. It stresses the heart. It can increase your risk for a heart attack or a stroke. And so that is how it shows up in people delaying their care and can ultimately impact their longevity.

It can lead to someone not living as long as they were hoping to or not being able to do the activities that they love.

Pathak: For someone who's listening today, can you help us, number one, understand what they can do to take an active role in scheduling that next appointment? And what are some of the words they can come into the clinic with to have that conversation without waiting for the provider to pick up on cues?

Curry-Winchell: The first thing I recommend is writing down all of your fears, whether you wanna write them in your phone, write them in a journal, say them out loud, or record yourself, because then those fears, that anxiety, live somewhere. And when they live somewhere, you're then able to address, "Okay, I am extremely anxious that this doctor may dismiss me," or, "This doctor may not take my symptoms seriously," or, "I'm just nervous to be in front of this doctor."

And when you do that, you're able to decide how you would like to respond to what may happen in that doctor's visit. So doing that "what if," which a lot of people have just in general, but when you have anxiety or you have a history of sexual assault, there's even more. And so writing it down and then deciding how you would like to respond.

The other thing I would recommend when it comes to your appointment, I would do three things. First, write down the most pressing things to you. You can jot them down on your phone. The second thing is, what would I like my doctor to address from these three things? And the third thing, what is my goal when I leave that doctor's office?

And that gives you a real sense of control over what you would like. And just by doing that, I, I like to talk about how, when you see your doctor and you are coming in with a history of sexual assault or medical trauma, it can feel so overwhelming that, when you're in that exam room, things are being done to you.

Well, I like to help empower my patients so that by having what you want out of that appointment, what you're expecting, it helps you become a part of that appointment. So instead of things happening to you, you are a part of the care because you have decided, "This is what I want out of it."

Pathak: And do you recommend people coming into the office prepared to share that they've had a sexual trauma or an incident within the healthcare system that makes them more anxious? How do you think about navigating that piece?

Curry-Winchell: Well, first, I wanna be very mindful and protective of that person who has experienced sexual assault. Although we have wonderful clinicians out there that wanna help everyone, not everyone is trauma-informed as far as being educated on how to do it. And so it's important to be protective, of course, with your history and your story because, if you provide that to the clinician, you don't want to have another level of trauma.

So what I would recommend to this person is, first, if you're able to, explore and see if this doctor or clinician that you're seeing has a history or education of providing trauma-informed care. And that can be hard. There's not a lot of clinicians out there. The second thing that you can do is, before you go into the appointment, decide: Do you want to share your story?

A lot of people don't, so this is what I would recommend. You can say this phrase when you're in front of your doctor: "I'm curious, do you have any history of providing medical trauma-informed care?" That way, you're not necessarily having to share your story, but it gives you some information about this clinician's background, and then you can decide if you feel comfortable.

The other thing you can say, if you feel comfortable, is, "I have a history of medical trauma, and it's really important to me that I'm a part of every step of my care, from the time you touch me, whether it's listening to my heart, listening to my lungs, or what we're going to order next." I think those types of questions or phrases that you can say to that clinician help empower you but also let your clinician know where you're coming from and can also be protective if you're not sure whether you want to, you know, share your entire story.

Pathak: I love that. Those are really, really practical tips. I'd love for you to help us be really concrete, specifically around the exam phase of the appointment. So a lot of patients don't realize that they have choices, that they can be a part of the decision of how the exam is conducted, how a healthcare professional approaches them, or when they might need a break and to ask for that and advocate for that.

What do you want patients to know before they go into that exam so they know exactly how to have that conversation so that they can be a part of the exam as well?

Curry-Winchell: I love this question. So, for me personally, when I see every patient, I try to be as intentional as possible. I sit down. I try to be eye level because just that in itself can make someone feel comfortable, where you're not standing over them. The other thing I do is I ask, "Is there anything that I could do to make your exam more comfortable?"

And that's a wonderful thing because that opens up the opportunity for the patient to say, "Yeah, I would love for you to let me know what's going to happen before you touch me, before you perform any exams."

And I personally—I'll just walk you through what I do. I go in, I sit down, get at eye level. I ask very open-ended questions, curious about, you know, your care, curious about what your thoughts are.

And before I touch my patient, I always say, "Is it okay if I start listening to your lungs? Is it okay if I listen to your heart?" And a lot of us as clinicians, we were trained to—you go in the room, you introduce yourself, and then you just start listening to their heart, listening to their lungs. But there needs to be a conversation.

This is a relationship. I am touching you. I am performing an exam. And in order to do that, I need your consent. And that starts with sharing and asking those questions first. So that's what I do. Before I even lift up my patient's shirt—and I even do this with little ones, with my pediatric patients—I say, "Is it okay if I listen to your heart? Is it okay if I lift up your shirt?" All of those things are really important.

And so I think those are really things that not only a clinician but also a patient can say: "I would love for you to walk me through how this exam is going to happen," meaning, what are you going to do before it happens?

The other thing that I love for patients to share is, "I would like to let you know that I would feel more comfortable if, when I need to say I'd like to take a break, I can pause during this exam." Now, and I know during certain procedures, I always share this, that can't always happen. But a lot of things in an exam room, that is possible.

And so I think those are real ways that both the patient and the clinician can do that. And that's what I do in my exam room. I share all the options, and I share everything because, in the end, it's about them. And I'm here just to be a part of their care. And I am so grateful that I get to.

Pathak: Can you talk about exams—you've already started to—or procedures that may be especially triggering? Pelvic exams, Pap smears, prostate exams, I think, may fall into the same category if we're talking about our male patients.

So how do you want patients to approach recognizing that this exam is probably going to be potentially more triggering, more invasive? What can patients do to make sure that these experiences feel safer and more manageable for them?

Curry-Winchell: The first thing is to ask, "Is this a procedure that you feel I need? And if you do, why?"

There is something to be said about if you have the information of why you have to have, or why a procedure is being recommended. I think that part is important. It can all of a sudden help sometimes reduce that anxiety because the patient is thinking originally, if you don't explain to them, "Well, I just have to have this done. They're telling me I have to have this done," versus, "I really wanna make sure that my prostate is, you know, that there aren't any abnormalities."

And all of a sudden, the patient is a part of their own care because they're like, "Yes, I do wanna know. I wanna know that there isn't anything abnormal." And so I think that part is an important piece when it comes to invasive exams.

The more you know—we hear that term all the time—but let's put it into more context. The more you know, the more comfortable you might feel with having a procedure.

The other thing is asking. There's a lot of history, let's say, when it comes to IUDs, different procedures that are done on women, and not getting adequate pain control.

And those stories live with one person telling another person that, "It was a terrible experience. I was in so much pain." And recognizing that and making sure that you share with your clinician, "I've heard that this procedure is really painful. I've heard that this can be very uncomfortable. What options are available for me to have pain management?"

And just by having that information, because we do know for IUD placements, you should have pain management options. You should no longer have to be screaming on a table to get this procedure done. So I think those are real ways that patients can feel informed and also advocate for themselves when they see their clinician.

Pathak: This conversation has been really important, I think, to set the stage for what someone should expect in the exam under ideal circumstances. If they're not seeing those ideal circumstances, you've provided scripts or suggested ways that a patient could bring this up in the exam room so that they can feel more safe.

What's your recommendation if you feel like, as a patient, I am now setting the stage. I have tried some of the suggested language, and it still doesn't feel like I'm being heard, I'm being respected. I don't feel safe. I've brought up the fact that I'm concerned about pain management. Those feelings are not being honored.

What are some of the signs that someone might look out for, and what are some of the ways to then stop the exam if you don't feel safe and then reach out for a second opinion? How do you guide people toward that?

Curry-Winchell: Some of the red flags that you want to look for are if your clinician is dismissive of your concerns, if your clinician shares that there's only one option and isn't able to explore other options. Now, that being said, sometimes there may only be one treatment, but having a conversation and sharing, "This is the only treatment that I'm aware of, but I would love for you to be able to go and explore, get a second opinion," I think that is important because a good clinician will support you in getting a second opinion. And so if you find yourself in a situation where the clinician is dismissive, if you do not feel safe, it is so important to stop the exam. You do not have to go through an exam that you do not feel safe or continue to see a doctor that doesn't listen, care, or believe you.

And I want to go into a couple of things that you can do before this situation might happen. Having someone by your side is a powerful way to advocate for yourself. By having a second set of eyes during your exam, someone to hold your hand, someone to be a witness to what is happening is a great way to advocate for yourself.

The other thing is to honor the feelings that you feel and not dismiss them. I've seen multiple patients where they've shared that they saw a clinician, and they knew in their heart that this clinician was not a safe space for them.

And so when that happens, make sure that you leave or get a second opinion. And the other thing I would say is, if you feel comfortable sharing with that clinician, "I do not feel heard. I do not feel seen, and this does not feel safe to me."

Now, not everybody's going to feel comfortable doing that because something we didn't get into that is important to mention: there is a power dynamic that happens between a clinician and a patient every single visit.

For example, you can be the most educated, the most well-traveled, but all of a sudden, when you see a doctor, all of that can evaporate. It's happened to me. I'm sure it's happened to anyone that's listening right now. And the reason why is you're in this room, you don't feel well, you are hoping that your doctor will help you.

And that can put you at a disadvantage where all of a sudden, all the things that you wanted to say may not come out. Or if you feel unsafe, you may not feel comfortable saying it because that clinician is the one that decides if you get a test done, if you get a medication, if you get a referral.

And so when those power dynamics happen, having someone by your side, honoring the feelings you have, getting a second opinion if those phrases don't work, finding a new doctor or, like I said, sharing, "I don't feel that you are hearing me right now. I don't feel that you are honoring what I'm experiencing."

Pathak: Another thing I often tell people, and if your doctor doesn't tell you or suggest it, you might want to suggest it, is having a chaperone.

If you weren't able to bring someone with you, you can always ask, "Is there other support staff in the office that can be here with me, that can hold my hand?" If that's how you want to ask for it, just so that there is another person from the office in the room with you if you're feeling uncomfortable.

Curry-Winchell: Absolutely. That part is key, asking for someone from the office with you. And this may be an unpopular opinion, but I think it's important that, as clinicians, we start to honor this. Even if you have someone on the phone, if that patient needs someone on the phone just to be a part, to feel like they have someone with them, I think that's huge.

I mean, I see patients who live sometimes in rural areas, and maybe that one family member could not come with them, and so they're there by themselves. And I've offered, you know, a chaperone, and they'll say yes, and they'll say, "Well, can I call my loved one too, just so I can feel more comfortable?" This part is huge.

Some of my patients will say, "I'm a little nervous that I might forget some of the things that I wanted to say to you, Dr Bayo, and so can I have my loved one on speakerphone or during a procedure?" And I think that that's a real way to also help people and for patients to ask, you know, "Is that a possibility?"

Pathak: I love that. I think that that is such good advice, and most clinicians would want you to have that additional support to be a part of the appointment. So I, I love that. That's really helpful.

Curry-Winchell: And that's a red flag if they say no. I want to add that. If that clinician says, "No, you can't have any support," that's a red flag.

Pathak: Right. Right.

You know, throughout this conversation, you've provided us with so much practical information, empowering scripts, empowering ways to raise questions, to alert your clinician if you have questions, if you're concerned, if you're not feeling heard.

I'd love to end our time together by giving you the floor and just sharing one message that you hope that every survivor remembers before their next medical appointment, something they can carry with them into the exam room that would help them feel safer and feel empowered. What would that message be?

Curry-Winchell: First thing is, you have the right to get the best care possible, and any clinician that you choose to be a part of your care needs to honor that and needs to cherish it. And if you find yourself, if you are comfortable, in front of that clinician using this phrase of, "I would like to know your thoughts on providing medical trauma care," sometimes that can help.

If you just happen to be with someone who is medically trauma-educated or someone who is mindful of what you're saying, that can sometimes help change the entire exam because those words may help your clinician adjust how they're going to speak to you, how they're going to perform that exam, or even take a second to change that conversation.

So the first thing is to find someone who will honor and cherish your care, and the second thing, to know that you have the right to have the care that you are a part of, not care that is being done to you. And I just, I honor that, and as someone who is a sexual assault survivor, I see you, I feel you, and I know how hard it is to show up and have someone and not know what's going to happen. And that's the biggest thing.

Pathak: Thank you for sharing that. Thank you for sharing your own story. And I think in what you're saying, what so powerfully stands out to me is that what you've gone through, your life experiences are your own to share or not share with your clinician or your medical team, but still letting them know, giving them this opportunity to understand that there is something that needs to be understood about this person.

So I love how you said just really raising the idea that by just saying something like, "I'm just curious about your experience or your training in trauma-informed care," should be a signal to your provider that, okay, I don't need to ask what the story is unless they're comfortable sharing, but I need to change my approach, or I need to modify, or I need to be even more thoughtful in my approach with this patient.

So I want to thank you so much for your powerful messages today and for sharing your story and your father's story with us.

Curry-Winchell: Thank you so much for having me. This has been delightful, and thank you for being a fantastic host. I just want to say it was a wonderful conversation. I'd love to add, if someone is looking for a clinician, please check out the free resource, clinicianwhocare.com.

It was inspired by my own story of medical dismissal, and it is a community of people helping other people find a doctor who provides compassionate care. It has over 5,000 names worldwide. We are in China, we are in Europe, we are in Canada, and all 50 states. And it's a very simple process where if you are looking for a clinician, you go on the list, and you're going to find every type of clinician: MD, DO, therapist, midwives, pharmacists, and every specialty of medicine, cardiology, family medicine, ER.

And then you'll read the stories of what people have shared about how this clinician made a difference in their care. There's only positive comments, and it's like if a friend ever called you and said, "Do you know the name of a clinician that I should see?" This list serves as that trusted recommendation.

And if you know the name of a clinician who has provided amazing care, please consider adding their name because every single name added could be a lifeline for someone who's looking for that same care. So please check it out. It's free, it's growing every day, and it is a beautiful community of people helping other people find compassionate care.

Pathak: So beautiful, and what an important resource. Thank you so, so much for your time today, Dr Bayo.

Curry-Winchell: Thank you for having me.

Pathak: I'd like to close this episode with my three key takeaways.

First, you are always allowed to ask questions before anyone touches you, and even if you're in the middle of the exam, you can stop it at any time. One of the most empowering things you can do before any exam is simply to ask your provider to walk you through exactly what they're going to do before they do it.

And you don't need to share your full history or explain why. You can simply say, "I'd like you to let me know what's gonna happen before each step of the exam," or, "Is there anything you can do to make me more comfortable?" And if you wanna know whether your provider has experience with trauma-informed care, you're allowed to ask that too, directly and without needing to provide an explanation.

A good clinician will not only welcome that question, it'll change how they show up for you.

Second, you always have the option to stop the exam, leave your appointment, and get a second opinion. That's something that does not get said enough. You do not have to complete an exam that does not feel safe.

You're allowed to pause, ask for a break, ask for a chaperone, or ask to have a support person in the room or even on the phone. And if your provider dismisses your concerns or insists there's only one option without any explanation or makes you feel like your comfort doesn't matter, those are red flags.

A good clinician should support you in seeking a second opinion if you want one. If yours doesn't, that's information worth having. You are not being difficult. You're advocating for yourself, and that's exactly what you deserve to do and what you should do.

And finally, you are not alone. There are resources available to you. Before your next appointment, take a few minutes to write down your top concerns, what you want your provider to address, and what you wanna walk away with.

That simple act shifts the dynamic from care being done to you to care you're actively part of.

And if you're looking for a provider who leads with compassion and has been recommended by real patients for the quality of their care, check out the free resource clinicianswhocare.com. It's a growing community of over 5,000 clinicians worldwide, searchable by specialty and location, built on one simple idea: that every person deserves a doctor who truly listens.

To find out more information about Dr Bayo and her work, make sure to check out our show notes.

Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform.

If you'd like to send me an email about topics you are interested in or questions for future guests, please send me a note at [email protected].

This is Dr Neha Pathak for the WebMD Health Discovered Podcast.