How to ensure you get A-plus medical care

Being a vigilant health care consumer is a challenge.

Before a visit to the doctor, prepare a list of questions in writing and consult it during your appointments. The Agency for Healthcare Research and Quality offers a helpful list of questions to ask before surgery, questions that can be adapted to other medical situations. (visit ahrq.gov)

Don't leave a medical appointment until all your questions have been answered. Even if the doctor you're seeing seems to be getting impatient. It's the physician's job to explain, and your job not to say you understand when you really don't/

It's very easy to tune out the bad news or complicated information. If you're getting test results, bring a friend or family member with you to the appointment to take notes. Or tape the session; a good doctor shouldn't object.

If you're discussing a new diagnosis or treatment, you'll probably want a second opinion; a good doctor will encourage you. Get physician's names from your primary care doctor. your states medical society or your health insurance company.

Bring a list of all the medications you're taking and the dosages, including herbal remedies, vitamins, and over-the-country drugs. If it's appropriate, bring copies of your x-rays.

When you're seeing a new doctor, make sure that your old doctor has sent your records ahead.

To spare yourself the aggrivaton, call the office before your appointment to see if the doctor is running late.

If a doctor calls you by your first name, feel free to use his or hers. You'll make it clear that you will afford the doctor the same degree of respect that he or she offers you.

A few days before any lab test, ask for an instruction sheet so that you can properly prepare for the test.

Once you've been diagnosed, talk to other people who have the same condition. You can also do research on the web. Medline plus (www.nim.nih/gov/medline(plus) is a good place to start. Smart patients become experts on their illness.

In the hospital, treats are a great way to soften hearts, lift spirits, and make yourself real to hospital staff. For instance, if someone brings you brownies, leave some in the staff room.

Stay pleasantly feisty by reminding yourself that the doctors and nurses aren't doing you a favor my taking care of you; you're paying for their services. You're entitled to good care - and a lot more. To view a copy of the patients bill of rights, visit www.consumer.gov/qualityhealth