Ask the Tough Questions

Asking the right questions just might save your life. It's a message that can’t be repeated often enough.

See also: Have a medication question? Ask the pharmacist.

Study after study has shown that good communication and patient safety are inexorably linked. When communication with health care providers fails, patients are less likely to follow medication instructions, are subjected to more diagnostic tests and are more likely to have to return to the doctor’s office, the hospital or the emergency room. And billions of dollars are added every year to the nation's health care costs.

A 2007 report from the Joint Commission, which accredits U.S. health facilities, cited a "breakdown in communication" as the root cause of more than 3,000 unexpected deaths and catastrophic injuries reported to the commission since it started tracking such occurrences in 1985.

"I've seen numerous cases of medical errors and discovered after the fact that the patient or family member knew something was wrong and didn’t speak up," says David Shulkin, M.D., professor of medicine at Albert Einstein College of Medicine in New York and editor of the book Questions Patients Need to Ask: Essential Information Every Patient Needs to Know.

Shulkin tells the story of a woman who was given the wrong ID bracelet upon checking into the hospital and spent an entire day having tests she didn’t need.

"It seems ridiculous,” he says, "but she thought it was her doctor’s name, so every time that name was called, she responded. Ask what tests you’ve been scheduled for, and ask if the test you’re about to be given is really for you," he says. "Simple proactive questioning can prevent a lot of problems."

Silence can be hazardous to your health

Experts agree that the responsibility for effective communication lies partly with the patient. “Patients need to see themselves as the center of their health care team,” says Cathy Ipema-Brown, spokesperson for the Joint Commission. “They can’t be bystanders.”

But too often patients remain silent. One reason is fear of rocking the boat. Another is that patientscanliterally die because of embarrassment, says Vicki Rackner, M.D., a former surgeon who now facilitates patient-doctor communication through her company, Medical Bridges, in Seattle.

"I once had a patient who couldn’t tell her doctor about blood in her stool," Rackner says. "When she was finally evaluated for abdominal pain, her colon cancer had advanced and ultimately took her life. It probably would have been treatable if she had mentioned it sooner."

Next: Don't worry about minding your "medical manners." >>