When patients go to the hospital seeking help, they are vulnerable and fully trusting of the modern hospital system to do only what is needed and nothing more. And with good reason—patients are well aware of the incredible sacrifices doctors have made, including the oath to do no harm, and their passion to save lives. What is less known by patients is the fee-for-service model of health care that awaits them—a system that incentivizes doing as much as possible to the patient. Patients are treated more like customers and may be prescribed unnecessary tests, procedures, and medications. It’s like going to a fancy restaurant where the waiter gets to order for you.

The problem is that the more that is done to the patient, the greater the chance for something to go wrong, potentially setting off a cascade of new health issues. This is not a unique occurrence, and the stats are concerning. A January 2023 study in the New England Journal of Medicine reviewed a random sample of 2,809 admissions to 11 Massachusetts hospitals and found adverse events affecting nearly one in four patients, with some such events resulting in death.

Being a good patient and blindly trusting the system can sometimes have devastating consequences—as it did for my son. At 19, he entered the hospital seeking help for pectoral chest pain. He suffered adverse effects from inappropriately prescribed medications. Less than 48 hours into his hospital stay, he had suffered paralysis from the neck down, was put on ventilation, and soon after contracted life-threatening hospital-acquired infections. He spent five weeks in the ICU, several months in inpatient care, and years rebuilding his life after release—and the vast majority of his care had nothing to do with his initial chest pain, the reason he went to the hospital in the first place.

And yet, his situation was not unique. As just one example of the widespread nature of experiences similar to that of my son, a February 2020 editorial in JAMA Network entitled “Overuse of Broad-Spectrum Antibiotics for Pneumonia” describes how “up to half of hospitalized patients treated for pneumonia may not actually have pneumonia.” Moreover, broad-spectrum antibiotics can wipe out the good bacteria in addition to the bad, leaving the patient extremely vulnerable to hospital-acquired infections, in addition to a range of serious conditions brought on or exacerbated by dysbiosis.

Until doctors are free to practice as they intended when they went to medical school, patients must be prepared and know what to expect when seeking care at a profit-driven hospital system. It is possible to get only the help you need and nothing more. Here are a few tips that might help you avoid some of the traps and pitfalls that could leave you more sick:

• If it is not truly an emergency, try to stay out of the hospital. Contact your primary care doctor or go to urgent care.
• If you need to go to the hospital, try to have an advocate with you. An advocate can be another set of ears, make sure each medication or test is necessary, and help you check out.
• Avoid IVs if you can swallow pills instead. IVs can cause more complications and increase the risk of infection.
• If antibiotics are prescribed, and if the suspected infection is not an emergency, hold off and request a culture or bloodwork to confirm that it is indeed a bacterial infection that should be treated with antibiotics.
• With regard to any treatment, you have the right to say no.
• If you develop any new symptoms, make sure to rule out medications administered as a possible cause.

Laura Buchman is a patient advocate and author of NERVE: Surviving Medical Madness.