Don’t be a distraction



Don’t interrupt the nurse when he’s preparing your medications. One study found that the more times you distract him, the greater the likelihood of error. [Each interruption was linked to a 12 percent increase in errors.]” —Sally Rafie, a hospital pharmacist with the UC San Diego Health System. Check out these other 34 secrets your pharmacist won’t tell you.

Ask what your doctor will be doing
The surgeon who performed the best in our complication rate analysis said he and his partner drape their patients, do the whole operation, and close the incision themselves. He said, ‘I just know nobody is going to do it as carefully as I’m going to.’ Check whether your doctor will be doing your entire procedure and whether she will do your follow-up care.” —Marshall Allen, a reporter who covers patient safety for ProPublica, a nonprofit news outlet

Nurses are overwhelmed





“Hospitals often force nurses to handle more patients than they should—even though studies show if your nurse is responsible for fewer patients, they have better outcomes. California is the only state with hospital-wide minimum nurse-patient staffing ratios. Researcher Linda Aiken at the University of Pennsylvania found that each extra patient a nurse has above an established nurse-patient ratio made it 7 percent more likely that one of those patients would die.” —Deborah Burger, RN, copresident of National Nurses United. Here are 50 more secrets nurses want you to know.

Administrators make big bucks




“Top administrators at U.S. hospitals are paid extremely well. CEOs make $400,000 to $500,000 a year, not including benefits like stock options. Administrative expenses eat up as much as 25 percent of total hospital expenses we pay for—much higher than in other countries.” —Cathy Schoen, executive director of the Council of Economic Advisors at the Commonwealth Fund, a foundation that focuses on health care

Doctors are incentivized to overtreat





“I hear from surgeons all the time whose bosses are basically beating on them to do more operations. While some hospital systems have moved to flat salaries, most still provide bonuses for more volume. Doctors have an incentive for over-treatment.” —Marty Makary, MD, MPH, a surgeon and the author of Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care. Be extra careful when it comes to these 14 risky medical treatments that don’t always work.

You may unknowingly pay for out-of-network care



Even if you’re careful to choose a hospital and a surgeon that are in network, there’s no guarantee that everyone involved in your care at the hospital is also in network. The radiologist, anesthesiologist, pathologist, and even the assistant surgeon could be out of network, and—surprise!—you’ ll be billed at a much higher rate. [Some states, including New York and California, now have laws to prevent this from happening.]” —Cathy Schoen

Ask if you’ll be admitted

“You can stay overnight in the hospital but never officially be ‘admitted.’ Instead, the hospital can say you are there ‘under observation.’ That can be tricky for seniors because if they’re then sent to a nursing home for rehab, Medicare won’t pay for it unless they were actually admitted. Always ask whether you’re admitted.” —Deborah Burger, RN. Plus, watch for these 10 signs a hospital wants to discharge you too early.

Hospitals side with doctors


“The hospital is incentivized to keep doctors happy. Surgeons bring in patients, who bring in dollars. If a patient has a complaint about a doctor or if a doctor has a high complication rate, the hospital’s financial incentive is to protect the doctor.” —Marshall Allen. Find out why your pharmacist probably knows more than your doctor.

Specialists quietly pad your bill



“Less-well-trained physicians will call in an abundance of consults to help them take care of the patient. If those specialists check on you every day, your bill is being padded and padded. Ask whether those daily visits are necessary.” —Evan Levine, MD. Don’t miss these other 18 secrets health insurance companies don’t want you to know.

Ask how to recover faster



“Since each day in the hospital costs $4,293 on average, one of the best ways to cut costs is to get out sooner. Find out what criteria you need to meet to be discharged, and then get motivated, whether it’s moving from the bed to a chair or walking two laps around the hospital floor.” —James Pinckney, MD.

Bring your own meds


It’s a lot cheaper—and usually OK—to bring your own medicines from home, but the hospital pharmacy will have to check them to verify they are what the bottle says. Just ask your doctor to write the order.” —Michele Curtis, MD, an ob-gyn in Houston, Texas. Don’t miss these 10 signs you’re taking too many prescriptions.

Check, check, check your bill

“Eight out of ten hospital bills we see contain an error, so check your bill carefully. You may identify a drug you didn’t take. Or you know that you discontinued a treatment on Tuesday, but you were charged for Wednesday. The number on the bill is only a starting point. Try to negotiate for 35 to 50 percent off the charges.” —Pat Palmer, CEO of Medical Billing Advocates of America. Find out how much you pay for healthcare compared to other states

Second-guess tests

Fifteen to 30 percent of everything we do—tests, medications, and procedures—is unnecessary, our research has shown. It’s partly because of patient demand; it’s partly to prevent malpractice. When your doctor orders a test, ask why, what he expects to learn, and how your care will change if you don’t have it.” —Marty Makary, MD.

Hospitals are becoming more like hotels

Hospitals worry about losing revenue to retail clinics, urgent-care centers, and private surgery centers. To attract patients, they try to appear like hotels. They have waterfalls, pianos, and big windows. Instead of hiring people with backgrounds in health care, they’re bringing in people with experience in retail and five-star hotels.” —Bill Balderaz, a health-care IT consultant

We’re not prepped for EBOLA


Hospitals say, ‘Don’t worry. We’re prepared for a serious disease like Ebola.’ But nurses on the front lines treating these patients are scratching their heads and thinking, We are not prepared at all. We are fighting to get the right equipment and training to take on these infectious diseases.” —

Hospitals are getting violent


“There is more violence than ever before. Nurses have been attacked, bitten, spit on, and choked. It’s partly because hospitals are no longer prescribing pain meds to addicts, and addicts can get very aggressive. It’s also because our mental health system is broken, so some of those people are coming into the hospital and acting out.” —John M. White, a hospital security consultant. Thankfully, science has figured out how to treat pain without addictive pain meds

We’ve seen it ALL


We see crazy things. I had a patient run buck naked into the ER waiting room. A patient asked me out while I was holding a basin, catching his vomit. We pull bugs out of people’s ears regularly.” —An ER nurse in Dallas, Texas.

Hospitals cut chaplains to save money

Spiritual care is not a profitable area for hospitals, so it gets cut. The vast majority don’t have enough chaplains, and some U.S. hospitals today don’t have chaplains at all.” —Rev. Eric J. Hall, CEO of the HealthCare Chaplaincy Network, a New York–based nonprofit.

We bet on (or against) you

Hospital staffers have placed bets on patients. Guess the Blood Alcohol is a common game, where money (or drinks) changes hands. Others try to guess the injuries of a patient arriving via ambulance. Surgeons have been observed placing bets on outcomes of risky procedures.”

VIP patients can affect your care

“In many hospitals, VIP patients get special treatment. They may stay in special areas or have a VIP notation on their chart, which means that whenever their bell goes off, we are expected to make that patient’s request a priority, whether it’s ‘I need some water’ or ‘Can you get me some stamps?’ Hospitals don’t add more nurses; they just take away from the care everybody else gets.”

Surgeons multitask major operations


“Your surgeon may be doing someone else’s surgery at the same time as yours. We’re talking about complex, long, highly skilled operations that are scheduled completely concurrently, so your surgeon is not present for half of yours or more. Many of us have been concerned about this for decades. Ask about it beforehand

Electronic paperwork annoys us

Most of us hate electronic medical records systems. We don’t like that we have to click off boxes instead of focusing on the patient. The choices they give us to click on don’t give the doctors a real understanding of what we’re doing. A lot of things get missed.” —Karen Higgins, RN. When doctors are filling out by hand,

Our priorities have changed



“Because Medicare has put more emphasis on the results of patient satisfaction surveys, hospitals are pushing us to emphasize customer service. It makes me worry we will do what we can to make people happy in place of what we should. To say that you need to focus on getting this person’s dinner right even though your other patient needs his chemo hung—that’s not right.” —Theresa Brown, RN

Signs Your Doctor Is a Keeper (And 5 Signs They’re Not!)



Charlotte Hilton Andersen




How does your doc stack up?




Keep your doc if: She’s experienced in your particular problem






When it comes to getting quality medical care, experience is the most important factor, says David Norris, CEO of MD Insider, a company that evaluates physicians based on their performance data. Whether you are managing a lifelong condition like diabetes or need a specific treatment like knee surgery, a doctor who specializes in that particular thing is worth their weight in gold, he says. And forget all those fancy plaques on the wall; Norris says their data found no correlation between attending a top-tier, expensive medical school and medical proficiency. “Ultimately it comes down to how many times they’ve done [something], whether it’s diagnosing or surgery or whatever,” he says. “The more they’ve done it, for the most part, the better they are at it.” Here are the secrets to finding the best doctors, according to other doctors.

Ditch your doc if: She has a lot of repeat customers


Ideally, doctors are there to help you get better. While there are some conditions that won’t and just need to be monitored, most of the time you can expect to see at least some improvement. “One of the biggest indicators a doctor isn’t a good one is the number of times a patient has to be readmitted or has to have the procedure or treatment repeated,” Norris says

Keep your doc (even if he has terrible online reviews): As long as you like him

Google may be the first resource you turn to when looking for a good doctor but that may be the least reliable way to find one, Norris says. His company has analyzed hundreds of thousands of online reviews and matched them with the doctor’s actual performance data. Their conclusion? “We’ve found absolutely no correlation between patient reviews, like those found on sites like Yelp!, and medical proficiency,” he explains. “People who’ve had negative experiences are more likely to leave reviews and they’ll often complain about things that have no relevance to their medical care, like bathrooms or parking spaces.” So forget what everyone else online is saying—the only opinion that should matter is yours.

Ditch your doc if: He’s just “nice”





Bedside manner is a great bonus but rapport isn’t the most important thing when it comes to getting the best medical care, especially with specialists. “Being a good doctor doesn’t mean they’re a nice doctor,” Norris says, “but in the end you’re better off with the surgeon who is technically better than the one who’s nicer.” If your doc happens to be nice and well-skilled, you’ve found a true winner. But don’t just stay with someone because you bond over golf scores

Keep your doc if: She is open about her failures

Transparency is one of the attributes patients find most reassuring in their healthcare providers, but one of the hardest to find, according to Norris. “Honesty and transparency build trust, which leads to better patient outcomes,” he says. One example? Many doctors will advertise that they perform a particular procedure or treat a specific condition, he says, but far fewer will provide evidence of how many times they’ve done it or treated it and how it has worked out. You definitely want a doc in the latter camp, even if it shows they’re not perfect.

Ditch your doc if: She’s always ordering tests

Getting every test under the sun may make you feel like your doctor is proactive but that sense of security comes with a price—literally. “Contrary to popular belief, more testing does not generally result in better outcomes,” Norris says. “Often [tests are ordered] because they have a financial tie-back or other business reason for doing so, like the doctor owns a stake in a certain company or has just purchased an expensive new machine.”

Keep your doc if: He tells you “no” sometimes

Doctors are vulnerable to peer pressure too and this is even more true in the age of the internet. Some doctors are so afraid of negative online reviews or of making a patient upset that they’ll allow the patient to bully them into doing something they don’t feel is best. For instance, many patients want antibiotics for cold and flu symptoms even though tons of research has shown they’re not effective and can worsen the antibiotic-resistance crisis. But some doctors will give in to these demands just to placate a patient. This doesn’t mean you shouldn’t ask questions or make concerns known but rather that your demands shouldn’t trump his expertise. A doctor who truly cares about you won’t be afraid to tell you when something isn’t in your best interest.

Ditch your doc if: He’s in and out in two minutes

The average person has to wait nearly half an hour in the office before seeing their doctor and then the average appointment lasts less than 15 minutes. Even worse, a separate study found that patients were only allowed to speak for a mere 12 seconds before being interrupted. But just because this is the standard doesn’t mean you should settle for it. This revolving door mentality leaves patients frustrated and, more often that not, with a prescription, rather than feeling heard and getting advice about lifestyle changes that could help them more than a pill. A good doctor will respect your schedule, take the time to listen to you, and let you finish your sentences

Keep your doc if: He’s accessible




We live in a 24/7 world and being confined to office hours can mean inconvenience at best and a serious problem missed at worst. Many doctors are now offering alternate scheduling (like weekend hours), call lines, online test results, and e-mail access to help patients get the care they need it when they need it. These 21st-century conveniences aren’t necessarily a dealbreaker but they sure do make things easier

Ditch your doc if: He won’t refer you for a second opinion

“Forty percent of patients are misdiagnosed initially,” Norris says. Medicine isn’t an exact science and it’s easy to make mistakes. One of the best ways to avoid this is to have a second (or third) pair of eyes on the patient. A good doctor will encourage you to seek out more information and other medical opinions. Don’t trust a doc who tells you they are the only ones with the answers and you shouldn’t question them.

Keep your doc if: She updates her skills

Medicine as a profession is constantly changing, with new information, research, technology, and treatments emerging all the time. Good doctors will stay abreast of developments in their field and be willing to learn more about new techniques

People take too many drugs

Two out of every three patients who visit a doctor leave with at least one prescription for medication, according to the Institute for Safe Medication Practices. “Drugs are an easy solution,” says Feldman, “but there are other solutions.” Here are things you need to know right now about taking too many medications.

Did you know I can save you a trip to the doctor?



At our in-store clinic, I can treat your child’s ear infection, do a sports physical, diagnose head lice, and more

High health-care costs aren’t lining my pockets

Even though pharmacists counsel patients every day, the federal government does not recognize us as health-care providers. That makes it very difficult for us to get reimbursed by insurance companies and government programs for the clinical services we provide.

Ask me if I can fill your prescriptions for Fido too

As long as the same drug is also prescribed for humans, I typically charge less than your vet—and I can even add chicken flavor to make it taste better. Learn the secrets your veterinarian won’t tell you.

If you’re paying out of pocket for your drugs, shop around

Your generic medication may cost as much as ten times more at some pharmacies than at others, according to a Consumer Reports survey. Check first with GoodRx, a free app that compares local drug prices.

Consider paying with cash

Even if you have insurance, always ask me whether your prescription will cost less if you pay with cash. Sometimes the cash price is less than your insurance co-pay.