Tell the truth.
We know you bend the truth a little when telling us the good and bad you do to yourself. That's why we at least double, up or down, the most fudged claims. For example: I exercise about twice a week nearly always means I rarely exercise. If you tell us you seldom eat cheeseburgers, to us that means most other days you're eating cheeseburgers. And "I'll follow up with you—I won't forget," translates to, "I'll stop back when the kids are grown."
Bring your spouse or partner.
When you're giving your health history or describing a problem, there are a lot of questions that only a partner can answer (such as how many times an hour you stop breathing while asleep). When you tell us that you rarely eat chips after 8 p.m. or that you've been taking your cholesterol-lowering drugs with the discipline of a Marine, your spouse will shoot you (or us) a look that says, "Are you kidding me?" We never miss it. And hey, sometimes your spouse wants to blow your cover. It's called love.
Beware the doc's sixth sense.
But if you try to snow us, we might try to trip you up. For example, we'll ask if you're fit enough to climb three flights of stairs. You'll say yes, unless you're over 85 or bed-bound. Then we'll ask, 'When was the last time you climbed three flights?' You'll say 'Maybe a month... ' and your spouse will send a look that says, 'You haven't climbed three flights of stairs since we voted for Ike.'
Learn the shorthand.
When your doctor hands you a script (that's doctorspeak for "prescription"), she knows you can't understand the arcane Latin-y squiggles and abbreviations. Doctors typically write the name of the medicine first, then the form (say, capsule or tablet), dosage, amount (say, 30 tablets), directions for taking it, and finally the number of refills.
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Ask when the results will be in.
When you're anxious for test results, don't think, No news is good news. It's no news. Too many patients wait for the doctor to call them with results, or they figure that silence means everything's fine. Smart patients always ask when the results will likely be in, and they call the office that day. And the next day, and so on. It's an extra reminder for us to call the lab if it's running behind. A postcard from the lab may have been lost. And in a bustling office, records can sit for a day or two without us knowing. So be a nudge.
Your pharmacist is the least expensive and most accessible health resource you have.
While it might seem easier to forge a personal relationship with one pharmacist at a small mom-and-pop pill dispensary, smart patients can and do establish great relationships with superstore pharmacists too. You can see her anytime you want, without an appointment—all consultations free. In medicine, that's extraordinary. Your pharmacist has an amazing wealth of knowledge at her fingertips, which means at your fingertips. Many also have access to new technology that can answer questions (such as, Is it safe to take this brand-new medication with this even newer medication?) in a blink. What's more, they get a soldier's-eye view of patients with similar conditions using different medications every single day. They see who improves, and who complains about side effects. And they know which side effects could mean serious trouble. Why do so few people take advantage of this golden resource? It baffles us.
If a doctor doesn't accept your insurance, but he is really your top choice, don't give up.
Call the insurance company and ask if it would consider adding this doctor to the list. If it won't, ask why. Sometimes, if even just a few patients ask the insurer to add a doctor, and the physician approves, the company will agree. Likewise, ask your doctor if you could persuade him to begin accepting your insurer. And every year when you renew your health insurance, call your doctor's office and make sure it intends to keep accepting this insurance plan. When we're deciding which insurance carriers we'll work with, we can be swayed by just a few small factors—and if dropping a plan will create big problems for two or three regular (and well-liked) patients, that can carry weight.
Ask the nurse. Nurses know everything.
If you need to find a great doctor, grill the head ER or ICU nurse at the largest local hospital, preferably a teaching hospital. These nurses get a battlefield view of doctors at their best and worst. If all hell isn't breaking loose and the nurses have a few relatively quiet minutes, you'll have a chance to politely approach one. A nurse may say, "Well, to be honest, Dr. Addison is a complete jerk and everybody hates him, but if you're in serious trouble, there's nobody better."
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Need surgery? Hunt for the specialist's specialist.
You don't just want a doctor who is comfortable with performing a particular surgery as part of a wide repertoire; you want the surgeon who is obsessively focused on the exact technique you need done. Today, one surgeon can gain so much experience with one very specific surgery that her patients have fewer complications than the national average. Aside from asking your regular doctor to point you to the maestro of your surgery, doing Internet research can help you locate such a hyper-specialized surgeon. Hopefully, one works at your hospital (and takes your insurance plan). Also, make sure your hospital is Joint Commission accredited for quality and safety. Go to qualitycheck.org to find the best hospital for you.
Learn from the past.
Consider having an autopsy performed on your parents when they pass away. Few are done today compared with decades ago, as it's rarely thought necessary when a cause of death is clear. Although it can be expensive, there's much value in knowing if your 82-year-old father has undiagnosed prostate cancer that had been advancing since his 50s, or heart disease even though it was a stroke that did him in. This is especially useful if the death was due to an accident. Reassure your living parent this doesn't mean that foul play is suspected, there can't be an open casket, or the body will be shipped to a CSI sound stage.
Customize your living will.
There's no one-size-fits-all living will. If things should take a particularly unhappy course and you can't speak up for yourself, you can tell hospital staffers ahead of time which measures you do or do not want to receive, such as artificial breathing, artificial feeding, or cardiopulmonary resuscitation (CPR)—you know, the organized theatrics you've seen in TV shows and movies, when a hospital team tries to revive you after your heart stops beating or you stop breathing unless you request a do-not-resuscitate order (DNR). Unlike on television, however, there is not a 99.9% chance that you will be revived successfully and to full consciousness within five seconds by a tanned actor, but we'll try our best.
'YOU: THE SMART PATIENT,' COPYRIGHT © 2006 BY MICHAEL F. ROIZEN, M.D., AND OZ WORKS LLC, F/S/O MEHMET C. OZ, M.D., AND JOINT COMMISSION RESOURCES, IS PUBLISHED IN PAPERBACK AT $14.95 BY FREE PRESS, 1240 AVE. OF THE AMERICAS, NEW YORK, NEW YORK 10020