How to Be a Patient

1. Patient Agency is Your Ultimate Power

If I am emphatic about one thing, it’s that I believe in patient agency more than any other force in the healthcare system that stands to alter it.

Empower yourself. The healthcare system often operates with a power imbalance, treating patients as passive recipients. However, the author argues that patients hold the ultimate power and can actively shape their care. Recognizing this agency is the first step to better health outcomes.

You have choices. Despite feeling powerless when sick or navigating bureaucracy, you have choices at every turn. You can:

• Say no to recommended treatments.
• Seek second opinions.
• Change providers or hospitals.
• Question decisions and plans.
• Walk away if necessary.

You are a consumer. Think of yourself as a paying customer in the medical system. Just as you wouldn't accept faulty goods or services elsewhere, you shouldn't accept substandard or unnecessary care. This perspective empowers you to demand value and transparency.

2. Unlearn the Passive Patient Role

All of it adds up to a misguided message: that a patient’s role begins and ends with being compliant.

Challenge old paradigms. We are conditioned from a young age to see medical professionals as infallible authorities and our role as patients as simply following instructions. This "white-coat syndrome" can lead us to suppress questions and accept care without full understanding.

Shift to prevention. Instead of only reacting to illness, adopt a proactive, preventive mindset towards healthcare. Routine checkups, screenings, and building relationships with providers before you need urgent care can prevent more serious and costly problems down the line.

Adopt health rituals. Reframe necessary healthcare tasks (scheduling appointments, reviewing bills) as rituals rather than chores. Pair them with enjoyable activities to make them less daunting and more consistent, like a "Champagne Sunday" for household tasks.

3. Proactively Build Your Healthcare Team

Gather a team that will look out for you in sickness and in health, and do it while the waters are calm.

Find a North Star. A primary care provider (PCP) is crucial for navigating the medical world. Don't choose one based on superficial factors like pedigree or convenience; vet them based on their willingness to explain, curiosity, listening skills, and accessibility.

Consider female providers. Research suggests female physicians often provide superior care, adhering more closely to guidelines, counseling on prevention, and achieving better patient outcomes (lower death rates, fewer complications). This challenges the cultural bias favoring male doctors.

Expand your network. Your team should include more than just a PCP. Proactively find:

• A mental healthcare provider before a crisis.
• Dental and vision specialists, recognizing their link to overall health.
• A pharmacist you trust for medication questions.
• An advocate (friend, family, or professional) to accompany you to appointments.

4. Gather and Organize Your Medical Information

Presiding over this information ensures that your care is coordinated and based off a central source of complete, up-to-date information.

Create a medical dossier. Maintain a centralized collection of your health information. This includes:

• A dedicated "healthbook" for notes and questions.
• A directory of your providers and their contact info.
• A compilation of your medical records from all past providers (a federal right to obtain).

Know your history. Compile a detailed family health history tree, noting chronic diseases, cancers, and causes/ages of death for blood relatives. This helps identify your personal risk profile for inheritable conditions.

Leverage technology. Use smartphone features like Medical ID for emergencies, photos of medical equipment, and voice memos for appointments. Utilize online portals like MyChart to communicate, access records, and grant proxy access to advocates.

5. Master Communication with Providers

Questions are a critical expression of a patient’s power.

Ask questions strategically. Medical encounters are often rushed Q&A sessions. Use questions not just for information, but to steer the conversation, clarify thinking, and ensure you are heard. Studies show patients asking more questions have better outcomes.

Use the "teach-back" method. After receiving instructions or a plan, repeat it back to the provider in your own words. This ensures you understood correctly and gives the provider a chance to clarify.

Share your narrative. Provide context beyond just symptoms. Share stories about your life, environment, stressors, and what gives your life meaning. This helps providers see you as a whole person, not just a diagnosis, leading to more personalized care.

6. Be Vigilant Against Medical Errors

What sets the healthcare industry apart when it comes to flawed systems? Little, except the cost in life.

Recognize system flaws. Medical errors are common, stemming from human fallibility, poor communication, and system inefficiencies. Be aware that mistakes can happen, even in the best hospitals.

Guard against medication errors. Be an active participant in medication administration. Verify the "five rights" with your nurse: Right patient, right medication, right indication, right dose, right time, and right route. Request a copy of your Medical Administration Record (MAR).

Watch for red flags. Learn to recognize signs of common complications or deterioration, especially in the hospital. Pay attention to vital signs using tools like the MEWS table. Don't hesitate to call for help (e.g., the rapid-response team) if your concerns are not addressed.

7. Advocate for Yourself and Vulnerable Populations

If you can’t trust a system to take care of those who are most vulnerable, you shouldn’t trust it to take good care of you.

Understand systemic bias. The healthcare system is not immune to societal biases, including racism, sexism, and discrimination against LGBTQ+ individuals, older adults, and those with substance abuse histories. These biases lead to measurable disparities in care and outcomes.

Know your rights. Familiarize yourself with patient rights, including the right to informed consent, privacy, second opinions, and respectful treatment regardless of identity or background. Legal resources are available for those facing discrimination.

Speak up for others. If you witness discrimination or communication barriers (like lack of interpreters), speak up. Advocating for vulnerable populations helps normalize patient agency and pushes the system towards greater equity for everyone.

8. Navigate the Complexities of Insurance and Costs

Medical bills are rife with error. Studies indicate four out of five bills contain at least one.

Understand the basics. Familiarize yourself with key insurance terms like deductible, premium, co-pay, coinsurance, and maximum out-of-pocket. This knowledge empowers you to anticipate costs and spot errors.

Use the Healthcare Bluebook. Before any test or procedure, get the specific CPT code from your provider. Use resources like Healthcare Bluebook to find a fair price range for that service in your area and compare costs across different facilities.

Comb over your bills. Medical bills frequently contain errors (duplicates, incorrect codes, charges for services not rendered). Review every bill carefully and call your insurance company or the provider's billing office to dispute discrepancies using the relevant codes.

Last updated: May 8, 2025