Flip the Clinic: Managing Your Own Health

Patients with multi-system disorders of regulation, such as dysautonomias, must advocate for themselves and take responsibility for managing their own health. The concept of "flip the clinic" addresses this need. It is where patients and health care practitioners improve medical care together.

Advances in technology and medicine, changes in health insurance and the way medical practices are run, and access to information that wasn’t available to patients in the past have changed the traditional clinical experience. This new way is often referred to as flipping the clinic. Flip the Clinic is a conversation started by the Robert Wood Johnson Foundation. * Its aim is to improve the patient-clinician experience through collaboration.

Flipping the clinic isn’t unique to treating dysautonomia patients, it’s relevant to anyone who wants to engage with their doctor and take charge of their own health. However, it’s especially important for managing the chronic and often multiple health issues faced by dysautonomia patients.

Flipping the clinic is an attempt to achieve two goals.

  • The first goal is to empower patients, family, and caregivers to be more informed and engaged in their own health and healthcare.  
  • The second goal is to enable healthcare providers to improve the ways they communicate with patients and support them better during and between office visits.    


This new mindset requires two essentials:

  • A patient who is willing to learn about their dysautonomia and monitor their own symptoms.
  • A health care provider and patient who are willing to work together in managing the treatment plan.

Here’s the traditional clinical experience as described by Dr. David S. Goldstein in the book, The Dysautonomia Project:

“For many decades the standard medical practice model in the United States has been about the same. A person feels something wrong and goes to the doctor for a routine checkup. The doctor has the person fill out forms and questionnaires, asks questions, does a physical examination, orders tests, carries out procedures, refers to consultants, makes a diagnosis, prescribes treatments (especially medications), bills for the time and procedures, and has the person return for follow-up. My guess is that you are so used to this model you’re thinking, “Well of course. What the point? What’s the alternative? And even if there were an alternative, how would it be an improvement.” 

An alternative clinical experience:

Flipping the clinic is a two-way street, but it often starts with you, the patient.

Patient: You recognize that you have a limited time with your provider, so you arrive prepared to make the most of the time you have. You come to the appointment having tracked your symptoms (severity, frequency, and how they respond to treatment). You’ve taken time to identify what makes the symptoms worse and what makes it better. You’ve thought through and listed any questions you want to ask. You organize and share this information along with other medical records from specialists with the provider who appreciates this data because they’re looking for facts to use as a basis for helping the patient improve their health.  

Provider: The healthcare provider (and the staff) engages in two-way conversations, works with you to build a treatment plan, helps you maintain your own set of medical records, and listens to your concerns and ideas (even if they may disagree). They welcome your involvement and empower you by coaching you, suggesting tools that may help with tracking symptoms and recommending resources including internet-based learning and online patient support groups

What if my provider doesn’t want their clinic flipped?

Ultimately, you can only control what happens on your end of this clinical experience, and that may require finding a different provider. Finding one who is willing to learn about dysautonomia is critical, unless you are fortunate enough to have a doctor who is also an autonomic specialist.  If you bring a copy of The Dysautonomia Project to your provider, and they’re unwilling to even consider looking at it, or if they suggest it’s all in your head, that’s a good sign that it’s time to move on.

A good primary care provider oversees the continuity of your care while working with you and other experts in the field. Ask yourself, “Are they working with me in taking care of my health?” If yes, then it’s important to build that relationship.

At The Dysautonomia Project we recommend patients work with their health care providers in a collaborative way and learn as much as they can about autonomic disorders because education is the number one form of treatment.

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