How to Get the Most from Your Care:
A Guide for Being a Proactive Patient

A Guide for Being a Proactive Patient

Everyone wants the best medical care possible. This involves more than scheduling a doctor’s appointment. A proactive patient is an informed one who finds a good doctor and medical facility, does independent research using reliable sources, and asks detailed, relevant questions. Each of us is ultimately in charge of our own health. The following are some tips for becoming a more proactive patient.

Click here for the Proactive Patient Checklist.

• This is a printable guide you can use as a reference and a questions checklist to bring with you to your doctor’s appointment(s).

Find a good doctor and medical facility

As in every profession, there are doctors who excel in their specialty, doctors who perform average work, and doctors whose skills are less than desirable. Finding the best takes some effort on the part of the patient.

• Get a recommendation from a friend, family member, healthcare professional, or neighbor. Many times, patients need to see physicians who participate in their health insurance’s "network" of doctors. In this case, asking a co-worker who carries the same insurance can be a good approach. However, asking your general practitioner or another doctor or healthcare professional is often the best way to find experts in a particular field. Healthcare professionals network at medical conferences and other events and almost always know who "the top performers" are.

• Do a background check. Once a doctor has been identified, visit the American Medical Association’s (AMA) Web site and perform a search. The AMA is the largest medical society in the United States. Its Web site provides useful information on 650,000 member and nonmember doctors of medicine (MD) and doctors of osteopathy or osteopathic medicine (DO). Note that it does not include other licensed healthcare professionals such as dentists, optometrists, chiropractors, nurses, or allied health personnel. Use the website to learn or verify a doctor’s credentials, including specialty, where and when he/she attended medical or professional school, and whether the doctor is board-certified. Medical specialty boards determine whether candidates have received sufficient preparation in accordance with established educational standards, provide comprehensive examinations designed to assess knowledge, skills, and experience requisite to the provision of high quality patient care in that specialty, and certify those candidates who have satisfied the requirements. Many boards require recertification at periodic intervals.

All doctors must be licensed. Licensure requires medical school plus a minimum of one year of internship. Board certification comes from a specialty board usually after a minimum of three years post graduate residency training. Many doctors are NOT board certified. Board certification is a minimum standard, and patients seeking the best care should always see a board certified physician whenever possible. Fellowship training is a level beyond basic residency training and usually implies expertise in a particular subspecialty field within a more general specialty.

• Ask questions. Call the doctor’s office and ask about the doctor’s patient load, how long it generally takes to get an appointment, the average wait time at the office, etc. If health insurance is a concern, always verify that the doctor accepts a particular insurance prior to scheduling an appointment.

• Consider the medical facility. If treatment requires time in a hospital or medical facility, it’s important to research the facility as well. A doctor may be affiliated with or located in a hospital or other type of treatment facility. Some doctors treat patients in multiple hospitals. Ask the doctor for a recommendation of the best facility in the area for the specialty. The Joint Commission on Accreditation of Healthcare Organizations advises choosing a facility that performs a large number of the procedure(s) the patients will need. According to the American Cancer Society, hospitals with at least 500 beds typically offer more services. The best hospitals offer pathology labs, diagnostic labs, and blood banks; round-the-clock physician staffing; social work services; advanced diagnostic and therapeutic equipment; and an intensive care unit. Teaching hospitals are often affiliated with reputable medical facilities. Before leaving a hospital or treatment facility, it is important to ask about follow-up care.

Be prepared and ask questions

• Research, research, research. Research the health concern using reliable print or online sources prior to the doctor’s appointment whenever possible. Contact non-profit organizations or governmental agencies for information or advice on credible resources. (Imaginis provides a list of resources for breast cancer and women’s health issues at http://www.imaginis.com/breasthealth/menu-resources.asp). Don’t rely on memory on the day of the appointment. Jot down questions and bring reference materials. If unsure of the diagnosis prior to the appointment, try searching by symptoms to get an idea of possible diagnoses. Read about various diagnostic tests and treatments for the condition. An informed patient asks more relevant information and often gets more detailed answers to her questions. After the appointment, performed more detailed research using the information the doctor has provided.

• Try to bring past medical records to a new doctor whenever possible. If diagnostic tests (such as CAT scans, MRIs, mammograms, etc.) were performed, bring a copy of the films.

• Ask questions, questions, and more questions. Being a proactive patient means asking a lot of questions. As described earlier, researching before and after appointments can help patients determine what questions to ask. Here are some suggestions:

• If a medicine is prescribed, try to ask detailed questions about the medicine. For example, ask the name of the medicine, how it works, when and how long to take it, what foods and drinks to avoid, what side effects are possible and if there are ways to deal with those side effects, how to know when the medicine is working or not working, and whether interactions are possible with other prescription or non-prescription drugs.

• If a medical test or procedure is needed, get a full explanation of what will happen. Ask the doctor to explain the procedure from start to finish. Ask why the doctor believes the procedure should be performed, whether it will require a hospital stay (and if so, for how long), what side effects are possible, the estimated length of recovery, what it will feel like after the procedure, whether follow-up care is necessary, when test results will be available, etc. Don’t forget to ask about the doctor’s experience. Ask how many how many of the particular procedure the doctor has performed. The more the better. Ask about the alternatives and pros and cons of any recommended procedure/treatment.

• Always get the test results. Never assume no news is good news. Ask for the results of all medical tests and for an explanation of what the results mean. Before the test, ask when to expect the results. Follow up with the doctor’s office or medical facility if results don’t come when expected.

• Get a second opinion for any major procedure, such as surgery. Patients diagnosed with serious conditions (such as breast cancer) should not hesitate to get a second opinion before beginning treatment. The purpose of a second opinion is to obtain a comprehensive, independent review of the diagnosis and the planned course of treatment. It is essential that patients have confidence in their doctors and treatment teams before proceeding with treatment.

• Follow the doctor’s instructions. According to the Food and Drug Administration (FDA) and the National Council on Patient Information and Education, 14% to 21% of patients never even fill their original prescriptions. Many others fail to schedule follow-up appointments in a timely manner or conform to other doctor’s instructions. Patients should never blindly follow advice that makes them uncomfortable. They should ask questions if a doctor’s advice sounds out of the ordinary. If the answers aren’t satisfactory, get a second opinion. However, patients satisfied with their doctor’s answers should adhere to their advice to ensure the best medical care possible.

Additional Resources and References

• Imaginis.com, The Women’s Health Resource: http://www.imaginis.com
• The U.S. Food and Drug Administration: http://www.fda.gov
• The U.S. National Cancer Institute: http://www.cancer.gov
• The American Cancer Society: http://www.cancer.org
• The National Council on Patient Information and Education (NCPIE): http://www.talkaboutrx.org/
• American Hospital Association: http://www.hospitalconnect.com/DesktopServlet
• American Medical Association: http://www.ama-assn.org/
• Joint Commission on Accredited Healthcare Organizations (JCAHO): http://www.jcaho.org/

Updated: December 30, 2008