Appointments Improv-ed.  Lessons from Improv to Improve Your Appointment

Have you ever been to a doctor’s appointment and felt like you were being punished? Every question you asked or suggestion you made was immediately met with a “No,” “Don’t,” or “No, but”?  Don’t do this, don’t eat that, you can’t do this now. You are not alone. For many of us, navigating chronic conditions or health challenges, we often seem to be met with a constant barrage of “NO”. It’s demoralizing, depressing, and doesn’t help with mental status or recovery.

I remember 10 years ago, when I was first diagnosed, I felt like at every turn, someone was yelling ‘no’ at me. Even lying in an ICU bed, a nurse told me, “Well, you won’t be able to do this now, or you can’t do that.” Ouch. It felt like punishment — like life as I knew it was over. 

Months later, after a cross-country move, I caught up with a childhood friend, The Plate Coach, Tara Mardigan, who happened to be a registered dietician (RD) in Boston at the time. I made an appointment and handed her a list of what I normally eat, expecting the usual red pen and “no.” Instead, she said, “I want you to enjoy food,” and we worked together to optimize the things I loved to eat for my health. That small pivot — from forbidding to partnering — changed everything.

THE YES AND

This interaction—and many that followed—took me back to my improv lessons years ago with Shawn Westfall in Washington, DC. He taught us the classic improv game “Yes, and…”: one person offers an idea, and the next responds with “yes, and…” and builds on it. The story keeps moving forward, the players supporting, not rejecting each other’s contributions, all adding to the scene. Shawn taught me how to work with my fellow improvers, support them, and build on each other’s ideas, which resulted in some great laughs and lasting relationships, our ultimate goal.

It was no surprise that Shawn took his skills and applied them to business and leadership, founding Westfall Partners. I love the tagline – ‘Business Improv’ed.’ I selfishly stole it and used it for my title here. Shawn now applies the same improv techniques and principles he taught us in class, bringing them to the company stage to foster creativity and collaboration, ultimately helping companies meet their short and long-term goals.   

You’ve probably been on this company stage before — you are in a group, trying to solve a problem, you or someone else suggests an idea, and the idea immediately gets hit with a chorus of “No, but…” or “but the problem is”, followed by a hundred reasons why it won’t work.  

Using the “yes and” technique in this situation can steer this meeting from negative to positive – acknowledging and building upon others’ ideas, rather than immediately dismissing them. “Yes, and” can help keep open minds and empower the team, ultimately leading to a faster solution.

The same negative dynamic often shows up in healthcare. As patients, we bring questions or ideas into the exam room and are met with a wall of “no’s”. Anything we bring up as a possibility is met with immediate dismissal. It’s deflating. However, just as in improv or the workplace, shifting to a “Yes, and…” approach keeps the conversation open and collaborative, ultimately leading to better outcomes—or, more accurately, achieving our personal health’s short- and long-term goals.  

So how does this work?

Let’s cue the scene — the leadership gown is on, and the dialogue begins.

THE SCENE

I recently had a specialist appointment for a shoulder injury. After the usual questions, I was told, “We normally prescribe anti-inflammatories, but since you can’t take those, you’ll have to just rely on ice and heat to manage the discomfort.” True, I can’t take anti-inflammatories because of my condition—but that was it? Especially with pain that was a sleep-disrupting 8 out of 10?

Frustrated, I took a breath and asked, “I understand the risk with anti-inflammatories, AND I could check with my cardiologist if I can take them short-term. He agreed. I then added. AND in addition to ice and heat, I would like to know if there are other strategies we can consider? Do you have other patients with my condition?” I reminded him that he probably had some older patients who also had compromised cardiovascular issues. He paused and replied, “Well…steroidal shots and surgery, but I don’t think we are there yet.”

I said, “I understand that surgery can be higher risk for someone like me and should be considered later. Are there any other non-surgical options?” After a moment, he said, “We can try steroid treatment—yes, let’s do that.” Finally—something actionable!

WHAT I LEARNED

This recent experience was just one of many I’ve suffered through.  What I did differently here was take a moment to acknowledge the “negative” and add the AND, asking for more options. Acknowledging isn’t agreement – it’s just recognizing you understood what was said. I continued to do this until we found a suitable strategy. I know I won’t always have providers like my friend Tara, who approach their care collaboratively—thinking, ‘Let’s work together to find a solution.’ I also recognize that most providers will likely never learn from Shawn on how to use the “yes, and” in their professional work to help those of us with conditions manage our health short and long-term goals.

What I can change is the conversation on my care stage and foster a collaborative environment. I can apply Shawn’s lessons and encourage collaboration, building on the negative suggestions to foster a partnership. Doing this can lead to an outcome similar to what I experienced with Tara years ago—both positive and additive, where every participant contributes to the solution, creating a better scene and outcome.

So how can you flip the script and use “Yes, And” at Appointments? The next time you find yourself getting a barrage of no’s.  

1.  First, take a breath. All too often, the frustration causes people to shut down and accept the negative.  

2. Acknowledge the negative feedback: “Yes, I understand you are saying this…”

3. Add that “AND” →  “Yes, I understand what you are saying AND 

Then you can add your own – here are some examples:

I know I’m not a candidate for this therapy, and are there other options?

Yes, I should limit running for now.  What other activities could I try to stay active? Is walking an option? And what about swimming?

Yes, I understand this medication is standard and important for this ailment. And what lifestyle choices provide benefits?

Last but not least: take your after-care summaries and rewrite them using the ‘Yes And’ language. This way, you will see the opportunities instead of just the roadblocks.

Some examples:

Don’t run until further notice →

Rewrite: Refrain from running AND try swimming or walking.

Reduce salt in meals →

Rewrite: Limit salt, AND try adding spices to enhance the flavor.

Your appointments provide an opportunity for you to co-direct your care. So next time you’re in that crinkly gown, staring down another list of “don’ts,” try adding a little improv. Say: “Yes, I hear what you are saying AND what’s possible for me now?” It’s essential to remember that advocating for your health and seeking more options is not just a right, but a responsibility we all share in our healthcare journey.

You may leave with a script that feels less like a limitation and more like a possibility. After all, your health journey isn’t improv comedy—but the same rules can apply: the scene works best when no one gets shut down at “no” and you work together to accomplish both your short and long-term health goals.