What to Check On Before Your Next Check Up

When she found an unusual lump on her body two years ago, Trisha Torrey became so concerned she immediately scheduled a doctor’s appointment. Soon she was being wheeled out of an operating room after having the mass removed.

“Of course I was scared,” Torrey says. “Then came the diagnosis. That rocked my world.”

A surgeon told Torrey the mass was a rare form of lymphoma, a cancer that attacks the body’s lymphatic system. An oncologist confirmed the diagnosis. Both insisted she begin aggressive chemotherapy.

But Torrey says she was confused. She felt healthy and was still playing regular golf games. A battery of blood and other tests seemed to show no signs of cancer.

“My doctor asked if I was having hot flashes,” Torrey says. “He said that was a symptom. But I kept saying, ‘I’m a 52 year old woman, of course I have hot flashes.’”

Instead of accepting the chemotherapy, Torrey began seeking information about alternative treatments. She obtained copies of her medical records, talked with others who had the disease, and sought another oncologist who specialized in the rare form of lymphoma. Together they concluded she had been misdiagnosed. The National Institutes of Health later confirmed the mass was benign.

“The funny thing is, if I had taken the chemotherapy, at the end they would have told me I was cured,” Torrey says.

Once a marketing executive, Torrey now spends her time as a patients’ rights advocate. She recently launched a website and hosts a radio show in upstate New York where she regularly interviews doctors and patients.

“It is no wonder doctors focus on a single diagnosis,” Torrey says. “A primary care physician—in order to pay his bills, pay his staff, and make a profit—can only spend six minutes with a patient. Otherwise, it starts to cost the doctor money.”

But research now shows saving time is also costing lives. According to a 1999 study by the Institute of Medicine, between 44,000 and 98,000 people die in U.S. hospitals each year as a result of medical errors—far more than are killed by auto accidents, breast cancer, or AIDS. The study says most of the deaths are preventable.

Experts at the Agency for Healthcare Quality and Research (AHQR), an arm of the federal government that funds studies on doctor-patient interaction, say patients must take more responsibility for their own healthcare.

“It’s your body. People need to start thinking about healthcare in those terms and be involved in their own health,” says Judith Hibbard, a University of Oregon professor who advises the government on healthcare issues.

So how should you approach a doctor’s appointment? The AHQR suggests patients arrive prepared with a list of questions or concerns. Be prepared to talk about symptoms, how long they have persisted, and if they have gotten worse. Know what medications you are taking and how much of each. The AHQR says it is often a good idea to bring your medicines with you or to make a list before leaving home.

Hibbard says first and foremost, patients must learn not to be passive.

“Don’t rely just on the doctor. Talk to your pharmacist, nurses, and other personnel when you don’t understand something,” she says.

Hibbard also believes patients should ask physicians about alternative treatments—such as diet and lifestyle changes—rather than simply requesting a prescription.

Doctors who are pressed for time, she says, will often give patients prescriptions for specific, brand-name drugs they request but ultimately don’t need. She says patients often ask for drugs by name after seeing direct-to-consumer television ads. Hurried doctors find it easier to comply than argue, she says.

“People are much less aware of the potency of drugs than they should be and make assumptions about safety that aren’t always true,” Hibbard says.

Torrey agrees. “Doctors are taught that it is better to give treatment to someone who doesn’t need it than not to give it to someone who does,” she says. Instead, she encourages patients to question their doctors’ treatment advice or to seek a second opinion if they are still concerned. In her case, Torrey says it saved her from undergoing months of chemotherapy.

Health advocates also advise patients to ask for detailed written instructions at the end of an office visit, especially if the doctor has prescribed a new diet or other routine.

Both Torrey and Hibbard say the easiest way to improve the quality of healthcare nationwide is for individual patients to act more like consumers. Torrey says Americans should view doctors like any other service professionals they visit.

“You’re not going to go back to a hairdresser that doesn’t listen to what you want and does a bad job cutting your hair,” she says. “If you feel like you’re doctor isn’t listening to you, find a new one.”