Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.

Here's a sobering fact: When patients go to doctors' offices, they get the right care only about half of the time. Here's another fact: Every year, 100,000 patients die in hospitals because of medical mistakes.

You want the best possible health care for yourself and for your family. That's what we at the Agency for Healthcare Research and Quality (AHRQ) want, too. Getting involved is one important thing you can do to improve the care you and your family receive.

Part of getting involved is knowing the facts. Here are some things you should know from my Agency's annual report on health care quality:

  • Obesity and the health problems it can cause, such as Type 2 diabetes and heart disease, are getting a lot of attention because obesity rates are rising. But how many obese adults are counseled on their diets by health care professionals? A disappointing 50 percent.
  • About 150,000 new cases of colon cancer are diagnosed each year. The disease kills 56,000 annually. How many patients receive potentially lifesaving tests for the cancer? Only 52 percent.
  • Asthma causes about 500,000 hospitalizations every year. In many cases, the disease can be controlled by taking the right medicines, avoiding tobacco smoke, and limiting household dust. How many patients report receiving a management plan for their asthma from a clinician? Only about 28 percent.
  • To avoid complications, people with diabetes should have regular blood sugar tests plus foot and eye exams. How many receive all three? Just 48 percent.

Even in areas where progress is being made in health care quality, many people are being left behind. Blacks, Hispanics, and poor people are less likely than whites and higher-income people to have access to care and get high-quality treatment, according to my Agency's report on health care disparities.

For example, among people 65 and older, blacks, Hispanics, and the poor were much less likely to have received pneumonia vaccine in their lifetimes. Obese blacks were also less likely to be told they were overweight by their clinicians.

Circumstances that you wouldn't think would be related to health care quality can affect the care you receive. For example, where you live can make it harder to get good quality care.

It would be great, for example, if every woman got prenatal care during her first three months of pregnancy. In reality, prenatal care ranges widely from State to State. In some States, 90 percent of women get prenatal health care in their first trimester; in others, it's only about 70 percent.

Care differs for other conditions, too. In some States, about 80 percent of Medicare patients with pneumonia receive an antibiotic within 4 hours of arriving at the hospital; in other States, it's less than 60 percent.

What can you do? Obviously, you can't overhaul the U.S. health care system. But you can—and should—be aggressive about the quality of your care and your family's care. Here's a great way to start: Be involved. Ask questions—lots of them.

AHRQ offers help for you to get the most out of your medical appointments. For example, with the "Question Builder" tool on our Web site, you can get prepared to talk to your doctor, nurse, or other clinician about medications, surgery, tests, and other topics.

Another resource is our "Be an Active Health Care Consumer" Web site. It features advice on what to do after a diagnosis, five steps to take for safer care, tips on how to avoid medication errors, and other valuable information about being an active health care consumer.

The annual reports I mentioned on health care quality and disparities are also helpful resources and are available for you to read on AHRQ's Web site.

These resources will help you to be more involved in your health care and make sure that you and your family receive the best care possible.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

Question Builder
Getting prepared to ask questions.
http://www.ahrq.gov/questions/qb/

Be an Active Health Care Consumer
Advice on how to take an active role as a health consumer.
http://www.ahrq.gov/patients-consumers/index.html

National Healthcare Quality Report and National Healthcare Disparities Report
Annual reports on health care quality in the United States.
http://www.ahrq.gov/professionals/quality-patient-safety/nhqrdr/index.html

Page last reviewed December 2007
Internet Citation: Facing the Facts--Get Involved to Get Better Care. December 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/120407.html