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50+: Live Better, Longer

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Be Your Own Health Advocate

Change from passive patient to an active advocate for your own health care.

A: Ask Questions continued...

Gruman founded the Center for the Advancement of Health, a nonprofit policy institute in Washington, D.C., and serves as its president. Her experience has taught her to ask, "What does that mean?" when something a doctor says goes over her head. "If I didn't say that, they'd just assume that I knew," she tells WebMD.

"The onus is on the patient to indicate when they don't understand something," she says.

Ideally, doctors should always communicate at a level that matches a patient's knowledge, but that's not a realistic expectation. Gruman doesn't fault doctors for occasional and unintentional lapses in communication.

"They're under incredible time pressure and they know a lot," she says. "If you don't understand, they will stop and explain it to you."

Gruman also asks doctors to consider hypotheses she has formed about her health based on her own observations. "It allows my doctors to say either, 'I hadn't really thought of it that way, maybe that's true,' or it allows them to say, 'that bone isn't connected to that bone, so probably not.'"

B: Be Prepared

The average patient has three issues he or she wants to address during a visit with a doctor. Because time with the doctor is limited, it helps to make a list of the most important issues to cover and take it with you.

"If you have something that's really scaring you, it's best to get that on the table early on," Haidet says.

Avoid "doorknob complaints." Those are things you suddenly remember, or pluck up the courage to mention as you're walking out the door: "Oh, and by the way, I'm having chest pain." At that point the doctor can't do anything but tell you to make another appointment, or to go to the emergency room, as the case may be.

C: Communicate Concerns and Desires

Communication means asserting yourself if you have a problem with the care you're getting, or if there's an issue you want your doctor to consider.

Your out-of-pocket costs, for example, may be a concern. Nearly 46 million Americans lack health insurance, and even those who are insured end up paying about one-third of what they spend on health care out-of-pocket. Nevertheless, many are shy about bringing up financial concerns with a doctor.

"There are many barriers that prevent patients from raising concerns," says G. Caleb Alexander, MD, an assistant professor of medicine at the University of Chicago. Some are embarrassed, he says, while others don't bring it up because they think there's nothing doctors can do, or that they don't have enough time to talk about it. What's more, some people fear they will get substandard care if they mention money is an object.

"The fact of the matter is that in almost all cases physicians have good options available to assist patients who are burdened by their out-of-pocket costs," Alexander says.

For example: the doctor may know about financial assistance programs or other resources to help you pay your bill. Or the doctor may be able to help by discounting the fee for the office visit, or by sending you home with free prescription drug samples. You might also find out that a less expensive treatment option could potentially work just as well as a newer and pricier option.

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