Whether you are going to the hospital for an outpatient procedure or whether you will be admitted to the hospital for medical illness or surgical procedure, there are certain things you must know and certain things you must do in order to ensure that your reasonable expectations will be met.

1. You must become informed about the terms and limits of your health insurance policy. See if the fees you are being charged can be negotiated ahead of time. If you do not know the terms and limits of your policy, you will not know the financial field upon which you are playing, and the end result may be significantly displeasing to you.
2. Do not be afraid to ask questions of your doctor. By accepting you as a patient he or she has made a contract with you to provide you with the best possible care. This means that the doctor must make time to answer your questions. On the other hand, you must realize that doctors do not have much time in today’s medical environment owing to the system under which they currently work. Therefore, prepare a list of questions for the doctor each day, and set a time during the course of the day that you and the doctor can meet so that these questions can be answered. If possible, e-mail the questions to your doctor before hand.
3. As communication with the doctor is critical, it is important to understand that his office staff is the gateway to the physician. Take time to get to know the office staff before the hospital admission. It wouldn’t hurt to send the office staff some flowers or a note on the day your loved one is admitted to hospital thanking them for their efforts on your behalf in the preadmission process. As my grandmother said, if you want a kiss, you have to give the kiss.
4. While your physician is your best advocate during the hospital admission, in reality you are your own best advocate. If there are issues regarding the room or the floor on which you are staying, difficulty with the nursing or with the timing of medication, or with any concerns that you may have, your first step is to discuss these concerns with the attending nurse. Be firm, but polite. If your needs are not met, then your next step is to discuss the situation with the Charge Nurse. If your needs are still not attended to, you must communicate your concerns to the doctor. If the issues are still unresolved, then you should seek the offices of the hospital administrator or the hospital ombudsman, state the issues and demand to be seen. It is highly unlikely that you will have to get beyond the second step in this process. Most professionals want to meet your needs.
5. Do not feel that any of the staff or your physician will treat you in any less a manner if you raise the aforementioned issues. It is the job of the nursing staff and your physician to attend to the patient, and any lack of attention to you in the context of proper medical treatment for you or your loved one is a serious breach of professional protocol of which no physician or nurse wishes to be accused.
6. Make sure that you see the hospital social services worker or hospital Discharge Planner assigned to your case at least 48 hours before your discharge so that arrangements can be made for any equipment or durable medical goods that your loved one may require while at home.
7. It is also necessary to understand the medications that you or your loved one will be taking upon discharge from hospital, and how they are to be taken, with what frequency and what dosage. If possible, arrange to have the prescriptions written by the doctor or the P.A. a day before the discharge, so that you may arrange to have your pharmacy fill them and they can be picked up before returning home.
8. Make sure that you speak with your doctor prior to the discharge and that you go through the discharge instructions with the physician or his representative so that you understand each of them. If there are dressings to be changed, make sure that if you are the one to change those dressings, you completely understand the process to follow and have the necessary goods to perform the task (gloves, dressings, ointments, disinfectants, etc.)
9. At the time of your discharge, you should request your hospital records for the visit. You are entitled to these records and it is important that you have at least a summary of the visit, an operative note if applicable, any imaging reports, laboratory studies and a discharge summary. These records should be kept in a place that is accessible should it be necessary to refer to them in the future. Having the records may very well save redundant and unnecessary treatment going forward.
10. Make sure you understand the final hospital bill in the context of the limits of your insurance policy. If you have any doubt about the amount that you owe then you should make an appointment with a hospital representative and have them go through your bill item by item so that you understand everything. If you have any question as to whether a charge or drug or item was actually utilized or supplied, you can refer to the hospital records that you have received at the time of discharge.

Mitchell Brooks is an orthopedic surgeon and the host of Health of the Nation on Talk Radio 570 KLIF in Dallas, Texas.  He blogs at Health of the Nation.

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