Since we’re so reluctant to ask doctors about big things—like how to keep from going to an early grave—it’s no surprise that in many cases, we don’t even consider asking them about little things. We worry about looking stupid, or wasting the doctor’s valuable time, or not making the best use of our rare opportunity to talk to a medical professional. So instead of asking a series of questions to verify and clarify the instructions we’ve been given, we nod, feeling that we should understand, whether or not we actually do.

Case in point: During his initial visit with a new HMO physician, my husband Steve was advised to monitor his blood pressure at home. The doctor recommended purchasing a blood pressure cuff, and he mentioned that a well-known drugstore chain—let’s call it Store A—carried them. He didn’t explain why he specified Store A, and Steve didn’t bother to ask.

As it happened, the doctor also gave Steve a prescription that was called in to a different drugstore. On his way home, Steve decided to save time by picking up a blood pressure cuff at Store B along with his prescription. He didn’t think the brand mattered, and the doctor hadn’t said anything about Store B one way or the other.

At a follow-up visit a few weeks later, the doctor was surprised and perplexed to hear that his patient had purchased Store B’s blood pressure cuff. It turns out that this brand of cuff isn’t adequate, at least in the doctor’s view. “You should return it,” he said, reminding Steve that he had specifically directed him to Store A.

My point here isn’t to tell you which blood pressure cuff is better. (Ask your own doctor.) I’m telling this story to encourage you to do what my husband didn’t: Ask experts to explain their advice.

Don’t worry about looking dumb. Don’t assume you already know the answer. Just ask.

Like Steve, many of us go astray when we make assumptions. At the initial visit, my husband heard and understood what the doctor said. But he thought the doctor was just giving an example of where to buy the cuff, not steering him toward any particular brand.

The doctor also made incorrect assumptions. He took it for granted that Steve would hear his words as a recommendation to buy Store A’s model. He further assumed that Steve would do exactly that, not choose some other option. Had he been a better communicator, the doctor might have clearly stated that he thought Store A’s model was the best choice, then taken a moment to explain why.

But Steve can’t control how well his physician communicates—and neither can you. What you can do is use your generalist skills to improve your communication with medical professionals and, as a result, your health (which you own). Remember these points:

• Allow yourself to be important enough to ask questions and get them answered.
• Just because you don’t see a reason for a particular instruction, don’t assume there is none. There might be a very good reason. Find out what it is.
• When receiving instructions, picture carrying them out and anticipate what your actions will be. If for any reason you might not be willing or able to follow the instructions exactly, explain why and ask, “Would it be okay if I . . . ?”
• Don’t leave the office until your questions have been answered and any issues resolved. Yes, the doctor’s time is valuable, but you are paying for that time and should receive the appropriate value. What’s more, your time is valuable as well—as is your health.

In any construction project, all of the technical experts work hard in their own areas of specialty. But without a generalist who can see the big picture, coordinate the various technical aspects, and keep everyone focused on the needs of the owner and end user, sometimes the entire project suffers. I experienced such an example recently at a new medical center and emergency care facility near my home.

I was scheduled for a medical test at the center, which had been open only a short time. I’d driven past the facility during construction and observed people gathering for a tour just before it opened. However, without a need to visit, I hadn’t actually seen the facility up close.

I pulled into the parking lot in plenty of time for my appointment and drove toward what I assumed to be the main entrance. However, as I neared it, I saw that it was marked by a stone pillar with a large, red, illuminated “EMERGENCY” sign.

Life experience says that one never takes up space associated with emergencies (or handicapped access) when not necessary. So I drove to the other end of the facility in search of the medical center entrance. All I saw was a small, unmarked door on the side of the building. I drove across the front of the building a second time and found no other entrance.

Since the emergency entrance was the only obvious public door I could find, I returned to that area and parked. All told, I had wasted ten minutes trying to find the entrance. And if people can’t figure out how to enter a building, why build it in the first place?

When I walked in, no one greeted me; the reception desk was unattended. I saw no signage indicating where to report for the test I had scheduled. Looking through a glass partition to my left, I could see a sign saying “Emergency Triage” over a glass window. Clearly that was not where I wished to be. So I waited ten minutes until someone returned to the reception desk and asked to assist me.

Upon inquiring, I learned that, yes, this was the correct entrance (there is only one). And I wasn’t the only patient to have trouble figuring that out. I was told that some individuals had used the unmarked door on the side of the building, unexpectedly entering physicians’ offices by mistake because of the unclear signage.

Apparently, the general contractor had allowed the signage contractor to design and install signage without a Three Bears test. By that I mean the process of analyzing proposed solutions and judging which one is “just right” for the intended user. (Read more about how generalists use the Three Bears test.)

The signage chosen for this facility may have been the right choice for paramedics and people needing emergency care. But it didn’t address the needs of another key group of users—patients like me, who come to the facility for tests and other appointments.

This construction project could have used someone with strong generalist skills to advocate for the end users, place a high priority on their needs, and ensure that those needs were met. One would think a “general” contractor would be able to coordinate (read “generalize”) at a high level. Good ones do!

My most recent surgery is a fairly typical example. When I asked to discuss scheduling arrangements, the surgeon referred me to his scheduler. His physician assistant (PA) was responsible for general medical and procedural questions. His nurse was responsible for preparation for the surgery.

Because I was aware of the team approach, I was not annoyed that the surgeon didn’t take the time to discuss scheduling arrangements with me. However, the division of duties is not necessarily clear to many patients. Hence the growth of professional patient advocates, who help consumers navigate the health care system.

My husband and I could have used a patient advocate a few years ago. When we moved to Indiana, Steve, who has some chronic conditions that require careful monitoring, sought out a physician for his routine medical care. He called a local practice that was accepting new patients and was given an appointment.

When he arrived for the appointment, Steve was informed that he would be seeing “Dr. Joe” instead of the physician whose name was on the practice. “Dr. Joe” continued to be the primary source of Steve’s medical care for the next several years, including a rather harrowing episode of gallstones.

At some point during all this, Steve learned that “Dr. Joe” was not, in fact, a physician, but a physician assistant. And he was the only care provider Steve had seen in that office. So essentially, my husband had not been examined or treated by an actual physician in over three years.

I’m not opposed to receiving care from physician assistants, nurse practitioners, and other medical professionals who are not physicians. But I do want to know exactly what credentials my heath care provider has.

Perhaps “Dr. Joe” had a PhD; I don’t know. But I believe that referring to an individual without an MD as “doctor” in a clinical setting is misleading and inappropriate. It gives the impression that patients are being treated by an individual with a medical degree and the expertise that implies.

Steve and I learned a valuable lesson through this experience. When it comes to the professionals who provide our medical care, it’s our responsibility to know with whom we are dealing.