By Erika Schwartz, M.D.

When Sandy B., 47, was in a fender bender, she was rushed to the local hospital with pain in her neck. In the ER, she was given CT scans of her head, neck, chest and abdomen. The doctors found nothing broken, but the incidental finding was a suspicious nodule in her lungs. The finding prompted a biopsy. The procedure went wrong and while the nodule was benign, Sandy landed in the hospital with a collapsed lung and was on a respirator for three weeks. She almost died.

Melanie R’s physician found a small nodule in her thyroid at her annual physical. The doctor sent the 24-year-old for an ultrasound. The results showed a cyst. She was referred to an expert in thyroid disease who performed a biopsy and hit a blood vessel in the process. Her neck blew up and obstructed her breathing. A breathing tube had to be placed in her trachea and she was given massive doses of steroids. It took days to shrink the swelling. She, too, almost died.

Harold N., 57, took his daily baby aspirin religiously. While playing an intensive game of squash, he fell and hit his head. He saw his doctor the next day to make sure the headache that kept him up all night wasn’t anything serious. The doctor reassured him he was fine. He never asked about the aspirin, which thins the blood and increases the risk of bleeding. Two days later, after suffering a subdural hematoma – which involves bleeding on and around the brain, most often resulting from a serious head injury – he died.

Everyone Has A Story To Tell

All you have to do is ask. Everyone has a personal medical horror story or knows one who does. There is consensus among health care consumers and providers that our health care system is plain broken. And while we all agree we must fix it, trying to figure out how leads to murky, confusing, overwhelming, unsolvable messes. When did health care, which should be about taking care of people and excellent customer services, turn into “health scare” – where the patient is treated like a second-class citizen, intimidated and bullied, and possibly left fearing for his or her own life, while accepting mediocre care at best?

In my 40 years of practicing medicine, I have witnessed the disintegration of individualized care and the demise of the doctor-patient relationship as subspecialties and advanced technologies have changed the landscape and priorities in health care. We’ve made many remarkable advances in medicine, such as those involving genomics, immunotherapy, organ transplants, immunizations and stem cells. But we’ve lost the humanistic side of medicine. Common sense medicine and the compassionate doctor who is grateful to care for a patient have been replaced with standardized, disease-centered protocols and never-ending tests and procedures with little or no patient touch. That may define progress, but the price of never making eye contact or knowing important details of a patient’s life have led to more problems than solutions.

Insurance companies, drug companies, cover-ups for deadly mistakes and just protecting the bottom line have all taken a heavy toll on a most inspiring and caring profession. But patients aren’t powerless, and can take steps to not only protect themselves from bad outcomes, but to ensure they receive optimal care. We can make the system work and integrate modern progress with the wisdom of experience.

Improving the Health System and the Patient Experience

Simple changes in your personal perspective will improve the entire health system – and your experience as a patient – in short order. It all starts with you and building your self-confidence as a health care consumer. You alone live in your body, so listening or taking advice blindly from a person with a white coat and an MD after his or her name doesn’t guarantee success or health or a long happy life. You may think “the doctor knows best,” but that isn’t always the case. The doctor doesn’t know better than you do. To take control of your health and never be a victim again, follow these seven tenets:

1. Find a doctor who makes eye contact and asks personal questions. There’s no excuse for arrogance. If the doctor is staring at the medical record and doesn’t look at you, she won’t see you as a human being. You’re better off with no care at all than the shoddy care this doctor is about to give you. Just walk away – there’s always a better fit that might save your life.

2. Give up on trying to be the perfect patient. People don’t tell the truth to their doctors because they believe that will make them a good patient. People don’t ask questions because they are embarrassed and don’t want to upset the doctor. I say bollocks! The more you are your own advocate, the more likely you are to get good care. If the doctor doesn’t respect you or won’t answer your questions politely and patiently, walk. This doctor will do you more harm than good. Say goodbye to trying to be the perfect patient and hello to being a smart, self-protective patient.

3. Tell it like it is. Don’t lie. If the doctor asks a question, give a straight answer. The doctor’s office is the wrong place to be coy or a poor communicator. It’s your life, so treat it with respect and honesty. If the doctor doesn’t listen or is disinterested, leave. I promise there is a doctor who will care about you. Find that doctor.

4. Don’t let fear dictate your decisions. God bless the Internet. We now all have access to a glut of information. Unfortunately, most of it doesn’t apply to you. So while I do encourage you to surf the net, please don’t use the information to scare yourself into a panic. Most medical situations don’t require immediate decisions. Spend your time with the doctor expanding your information base. Ask about the risk-benefit ratio of any recommendation. If you’re not scared, you will easily find second opinions and perspectives that will truly help make your life better.

5. When in doubt, just say no. Don’t get pressured into a particular treatment just because the doctor is sure you need it. A 38-year-old patient of mine with a history abnormal Pap smears was told to have a hysterectomy to play it safe. The gynecologist told her she was getting too old to have children and her insurance would cover the procedure. Fortunately, she wasn’t a perfect patient and refused. Two years later she had a baby, and she's doing great six years later. Moral of the story: You’re the only one who knows what’s right for you, and saying no may save your life and your reproductive organs. Not to mention that once you take it out you can never put it back in. Don’t forget that one please!

6. Don’t do it just because your insurance covers it. Patients with comprehensive insurance coverage often find themselves undergoing a slew of tests and procedures. Maybe that’s because insurance pays, or maybe it’s that the doctor wants protection from malpractice. Regardless of why, every test and procedure has risks, and there are no guarantees that doing more will lead to better outcomes. Ask your doctor: How will the results of this test or procedure affect the course of my treatment?

7. Take responsibility for fixing yourself. Great health rarely comes from pills, procedures and tests. Remember the saying: You are what you eat. It’s the absolute truth. Improve your diet, get some serious sleep, move off the couch, deal with your stressors and stop running to the doctors.