The Art of Not Accepting No For An Answer
As I talked about previously, my mom was just hospitalized for several days due to a bad combination of asthma and the flu. Because my father recently passed away, she had had to change insurance companies from the plan she was on through my dad’s work to one offered by her own employer. Also because of this, she had to find a new primary care physician.
Luckily, she met one in the hospital that is in her plan’s network and she felt comfortable with. She made sure that he was accepting new patients, and then put him down as her new primary care physician. The hospital told her to follow up with him in 1 to 2 weeks to check on how her new medications were working, and she went home from the hospital. She then called the new doctor’s office, only to be told that they couldn’t see her until May. She tried to convince them it was important she be seen sooner, and she had nowhere else to go instead, but they were inflexible. My mom is not the most assertive of people, so she said okay and then talked to me, in tears over her predicament.
Luckily, I have enough assertiveness for the both of us, so I called the doctor’s office back, and after talking to several different people, got her an appointment for next Thursday. Why was I successful when my mom wasn’t? Because I go into things like this with the mindset that no is not going to be the final answer. It takes some assertiveness (which I promise, you can fake if you try hard enough) and a willingness to spend some time on the problem, but in many cases, it can be done.
1. Know if no really means “not for you”. Calling a doctor’s office, I just basically assume that they really do have appointments available before May, they just aren’t willing to give them to a new patient. If there is a possibility there, I’m going to do my best to convince them they need to let me have that possibility. Which leads to…
2. Have reasons why you are the exception that makes the rule. Know why they should make an exception for you when they didn’t for the 100 other people. In this case, I used the events of the past few months, my mom’s fragile emotional state, and other health factors to make my case. Whatever the situation, be prepared with a list of factors that push you to the front of the list.
3. Be reasonable in your expectations and approach. I wasn’t asking to be seen today, or even tomorrow. I was willing to accept any appointment they offered within a reasonable time frame. My expectation was that they could fit my mom in within the timeline the hospital wanted her seen at, which I felt was medically appropriate. Don’t go into a negotiation expecting no compromises on your side. Know what’s important to stand firm on and what can be adjusted.
4. Get them on your side. Empathy will get you a lot farther than hostility. I never told them they were unreasonable. I put them in my shoes and asked them to look at things from my perspective, and used that to bolster my position.
5. Ask for the next person up the chain. Sometimes whoever you start speaking with can’t really help you, because they lack the authority. Move up the chain. Ask for a supervisor.
6. Expect that the final answer has to be yes. I went into things expecting to succeed. If you expect to fail, you will. Every new person I spoke with, my first sentence was I am making an appointment for my mother for a followup from her recent hospitalization, and the followup needs to be in the next two weeks. Eventually I was transferred to a person who simply scheduled my request. I’m not sure the person I talked to before that one knew that was going to happen. 
Now, does this always work? No, of course not. There have been times I truly went into things expecting to succeed in my endeavor and after a long frustrating time, didn’t achieve the desired outcome. But for every time that has happened, there has been a time where I’ve changed no to yes by being reasonable, persuasive, and persistent.
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March 11th, 2009 at 11:13 am
Your Mom has a wonderful daughter!
March 11th, 2009 at 11:42 am
Wow, Good for you!
March 11th, 2009 at 11:46 am
Well done! I’m sure your mom was grateful.
And if all else fails, let loose the waterworks. I’m ashamed to admit it, but it’s worked for me a few times. It was never intentional, but suddenly doors flew open where there weren’t any before.
March 11th, 2009 at 12:18 pm
Great post and good job fighting for your mom when she didn’t have the fight in herself…
March 11th, 2009 at 12:22 pm
Very well said!
I learned a lot about being a squeaky wheel when my disabled daughter was in the public school system: the guiding principle on their part was “do as little as possible”, which I, of course, absolutely disagreed with. I wanted a level playing field. I used your well articulated techniques and was pretty successful, though I lost my cool on more than one occasion! It is a sad state of affairs that in our society the “squeaky wheel” gets the attention, but so be it. I hated every minute of it, but since it wasn’t for me, it was simply what had to be done.
A key phrase I learned long ago which, depending on the circumstances, you can either say out loud or to yourself is “this is NOT acceptable.”
I’m busy now teaching my kids how to be assertive and tactful at the same time. They’ve seen me in action, and now I articulate the process each time it happens. Makes for a lot of eye rolling, but –whatever
Glad you stood up for your Mom. Make sure to do it for yourself, too!
March 11th, 2009 at 2:12 pm
This is excellent advice. I enjoy your blog very much and I thank you for sharing your experiences. I wish the best for you and your family. How wonderful that you were able to help your Mom. She must be very proud!
March 11th, 2009 at 2:35 pm
This is a really good article Paidtwice and good for you for sticking up for your mom. I hope she’ll feel better soon.
March 11th, 2009 at 3:51 pm
PaidTwice,
You’re magnificent. I really admire the way you’re dealing with all the stuff life is throwing at you.
March 11th, 2009 at 7:56 pm
Very well said, Erin. PaidTwice and her Mum both needed this tiny victory right now.
March 11th, 2009 at 9:29 pm
I’ve talked a few times about how important it is to be stubborn (but polite) when faced with a “no.” It’s amazing how a little persistence pays off, isn’t it?
March 11th, 2009 at 10:02 pm
If your mom does not like this physician and wants to change all she has to do is call the insurance company and change her primary care physician to another Doctor. As for finding one… Once things settle down, It helps if you set up meetings with the potential physicians. I always explain that I am new to the area and I am looking for a new doctor and I would like to meet with them before I choose to have them be the PCP. Most will meet with you without charging you. And you only see a doctor for 5 minutes. You see the staff much longer. She should like the staff too.
March 12th, 2009 at 9:09 am
What a well written and excellent post. Your step by step guide will help anyone who needs to take the next step. You should be be proud of yourself, if I was your Mon I would want you fighting my corner, Margaret
March 12th, 2009 at 4:14 pm
Good stuff! I had a similar experience with my insurance company a year ago. I had called 3 different times in advance to make certain my procedure would be covered and I would only have to pay my copay. The bill came later and they were trying to charge me $2,600 more than my $25 copay. The first time I called I was tired and was trying to fit the call in real quick so I just got off the phone when I wasn’t getting anywhere. The second time, I made sure I was going into this without paying one dime more than I had previously been told several times. It took an hour and a half and I finally got through to the representative when I said, “This is NOT ACCEPTABLE.” I think it may have been the first time she had heard that in her life. Anyway, she eventually determined I was correct and remitted payment before the end of business that same day. What would have happened if I hadn’t called back? You have to be your own advocate and not feel badly about it.
March 12th, 2009 at 11:00 pm
Thanks so much for this posting.
It’s really tough to lose a parent and try to adjust to life without him or her.
I really loved the part in your post that states we should expect a yes. For so long now I have realized that you get what you expect…and it’s true. Love your site,I’ll be back…
March 13th, 2009 at 5:09 am
Good for you!! I live in an area where doctor’s are in short supply and it’s always hard to get an appointment. If you get sick, you have to either sit in the doctor’s office for hours or go to the emergency room. You are right about getting them on your side. I have had them call me back when a cancellation came in. It pays to be persistent AND pleasant.
March 19th, 2009 at 9:10 pm
Have you ever thought of renting out your assertiveness?
Seriously: I personally would hire someone like you to run interference with me in predicaments like this. I just hate that kind of thing and don’t do well at it.
March 22nd, 2009 at 2:52 pm
I seriously need to learn how to do this.
My mom can do it so easily, and wins almost all of the time.
I on the other hand, ehh sorta stuck with this one.
I’ll learn in time!
March 22nd, 2009 at 2:57 pm
I had to be all over my insurance company like a dog with a bone, to get them to pay my cancer treatment bills…now at about 3/4 mill retail billed, total.
I developed a system of tracking claims on a spreadsheet, noting the pending or denied claims, pulling those EOB statements, and camping out on the phone.
When the CSR would answer, they’d inevitably ask the standard polite, “How are you today?” I used that as an opportunity to actually answer the question, what I was going through as a cancer patient, with a good attitude and a fighting spirit, to elicit their sympathy. I wouldn’t let them cop a bureaucratic attitude with me.
I kept careful notes on each EOB statement on what the problem was and what needed to be done to fix it, and when I should expect results and check the situation online/call back. I marked my Yahoo calendar and set the reminders so I wouldn’t forget.
It was really frustrating at first, but they finally figured out that they had the contract loaded wrong (my employer switched to them the day before I started this whole bout of cancer). Then things got a lot easier, and there’s some denials but it’s usually laziness about connecting the physician referral to the submitted claim. It’s a lot easier to break the logjam.
I assumed good will, but could play hardball if I had to. I mastered “stacking the deck”–I’d call from the hospital while receiving treatment. The nurses knew I was doing this and why. I’d have the CSR on the line at the time the nurse would shove the needle into my Mediport and I’d let out a yelp of pain. Which I didn’t normally do but that’s what’s needed on a phone call. Then I’d explain, Oh sorry, that was the nurse shoving the needle into the Mediport in my chest to start the IV of chemo drugs. LOL!!!!
I’d tell them things like it was mean to kick a cancer patient when she’s down. I didn’t have any family nearby to monitor my bills and insurance statements and had to do it all myself…while chemobrained and ill. I’d lay it on thick.
My docs love me because I have a good attitude about treatment and always would come in with a joke, and I treated the nurses and receptionists well, too. Honestly, I think they’d do anything for me.