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July 6, 2022, 5:02 a.m. EDT

A veteran medical practitioner offers tips for how to navigate America’s confounding health care system

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By Barbara Sadick

This article is reprinted by permission from  .

The American healthcare system is complicated, difficult to navigate and can kill you if you aren’t prepared, proactive and knowledgeable. From finding good doctors to being able to afford medication, the hurdles can feel insurmountable.

So says  David Wilcox , who has spent nearly 30 years working in various capacities in hospitals and recently wrote a guide for patients, “How to Avoid Being a Victim of the American Healthcare System.”

Wilcox, who holds a doctor of nursing practice degree, has been a bedside nurse, intensive care nurse, nurse administrator, hospital administrator and has worked in health-care technology. He believes his experience and inside knowledge can shed light on how patients can work to get better results when they find themselves dealing with hospitals, insurance companies, drugmakers and medical personnel.

I have interviewed Wilcox several times and am editing those interviews to point out information that may not be widely known and to help readers learn how to use that information to improve care and health outcomes.

Question: Recent studies have indicated that medical errors are the third leading cause of death in the United States, after heart problems and cancer. How can patients prepare before a medical procedure to reduce their risk?

David Wilcox:  I’ve seen so many bad situations that could have been prevented had people prepared by doing research. Always ask questions. Know exactly what a procedure involves, why it needs to be done, how quickly it needs to be done and what the recovery will entail. Remember that patients and doctors should be equal partners, and patients have a right to ask as many questions as they want or to refuse treatment.

Make sure to find out about doctors and hospital ratings. Good evidence-based sources are available to use when doing this research ( healthgrades.com  for doctor ratings and  CMS.gov  for hospital ratings). Don’t just ‘Google’ for information. There is much misinformation on the internet. If you’re lucky enough to know a nurse working at the hospital where you’ll be treated, ask about which doctors are highly regarded. They’ve observed and can tell you who has consistently good outcomes and who to stay away from.

Read: Don’t trust everything you buy on the internet: The ugly truth about online pharmacies

A recent nurse-staffing company survey indicated that more than one-third of nurses plan to leave their current jobs by the end of the year. In addition, the American Association of Critical Care Nurses says that about 66% of acute and critical care nurses are considering leaving the profession entirely. In this overworked, understaffed profession where nurses are in short supply, patients may be getting less careful hands-on care. Nurses have too many patients to care for at one time. How can patients and families deal with the situation?

Patients who are able need to ask lots of questions. If they can’t, and even when they can, it’s wise to have a family member or friend who knows the patient’s situation on hand to advocate for them. Patients and advocates should question everything and anything, including anything that looks or seems suspicious. Ask until you understand.

Medication errors happen to nearly 5% of patients. Before taking any medication, understand what it is and what it’s for. It can be confusing, as drugs have generic and brand names. If the drug name begins with a capital letter it’s a brand name drug. If it starts with a lowercase letter, it’s a generic.

Some of the drugs you’re given in a hospital are the same drugs you take at home. To keep costs down and if you haven’t been admitted through the emergency room, you have the right to bring your own medication to the hospital, give it to the healthcare team and not end up paying $15 for a headache pill.

Because nurses are overworked, you and your advocates should be friendly and polite, because that will get you better care. But if there’s a problem, speak up and ask questions. If you aren’t getting satisfactory answers, keep pushing or ask to speak with the nurse supervisor. If your nurse seems rushed and you can wait, ask them to come back when things are calmer. That’s one way you can prevent medical error. It’s not difficult for an overworked nurse with too many patients to confuse one with another.

On any given day, about one in thirty-one hospital patients has at least one infection they acquired at a hospital or other healthcare facility, according to the  Centers for Disease Control and Prevention . What can patients and advocates do to reduce that risk?

First, make sure that every person who comes into the room washes their hands. That includes visitors, family members, doctors, nurses and other hospital staff. To prevent bed sores, a patient needs to be turned or to turn themselves every two hours. Pillows should be put between the legs to decrease pressure. The sooner a patient is safely released from a hospital, the less the chance of coming out with an infection.

You say that Americans spent about $535 billion on prescription drugs in 2018. That’s 25% more than was spent in 2010. Pharmaceutical companies increased prices on their most prescribed medications by 40% to 71% from 2011 to 2015. What’s going on here?

Pharmaceutical companies say they need to keep hiking drug prices to raise money for research and development of new drugs. But the government, not drugmakers, funds a lot of research either directly through research grants or indirectly through tax breaks. The publicly funded research is your tax dollars at work, yet you are still being charged again and again. Since 1930, the National Institutes of Health has invested nine-hundred billion dollars in research. Despite that, a typical consumer in the U.S. spends more for prescriptions than consumers in any other nation.

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