Being a good patient may be dangerous to your health.

Good patients, who try not to complain and not to take up too much of their doctors' time, tend to feel sicker and even die sooner than pain-in-the-neck patients, says Consumer Reports on Health.The newsletter cites a variety of studies showing that being more assertive with doctors improves people's health.

The average office visit lasts less than 15 minutes. This gives the doctor little time to listen, diagnose and explain. One study found that doctors interrupt patients' opening statements within 18 seconds on average, often before they can convey critical information.

A Harvard Medical School study tested about 500 doctors with a hypothetical case of a patient who complained of stomach pain and for which tests showed inflammation of the stomach lining. More than one-third of the doctors said they would start treating the patient at this point, usually prescribing an ulcer medication. But those who enquired further learned that the patient took heavy doses of aspirin, an easily correctable problem.

In clinical trials, researchers helped patients formulate questions and encouraged them to be assertive. The coached patients got more information from doctors and showed significant improvements in health compared to others. People with hypertension controlled blood pressure more effectively, and diabetics had lower blood-sugar levels.

The Consumers Union publication recommends that patients write their symptoms and questions before the visit; bring a friend who can help cover everything and remember the doctor's instructions; insist on describing problems fully and request time for questions; think critically about tests and treatment and ask about risks, complications, discomfort, cost and alternatives; and if not satisfied, get a second opinion.

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It also suggests becoming informed by keeping a health encyclopedia and guide to medications at home; calling nonprofit organizations such as the American Cancer Society or American Diabetes Association; and researching medical books in the library.

The newsletter says patients can request free publications on recommended treatments for certain diseases by calling the National Institutes of Health at (800) 644-6627, or the U.S. Public Health Service's Agency for Health Care Policy and Research at (800) 358-9295. It also suggests that patients join a support group, which can be located through the American Self-Help Clearinghouse, (201) 625-7101.

- Jane Baird

(Houston Chronicle)

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