Every day, Canadian patients benefit from remarkable cures of diseases that were previously fatal.We expect a lot from health care, and so we should, because health care takes about half of all government program spending.

Unfortunately, a few patients are disappointed because they suffer from avoidable disability and treatable discomfort.  Sometimes they die because of health system mistakes. Patient suffering is increased when diagnosis is delayed, when laboratory tests are lost or misinterpreted, and when people take drugs that harm, not help. Alarmed, by the rising costs of health care politicians are looking for ways to save money without further jeopardizing your health.

Can patients influence care in ways that improve quality, without increasing costs?  After all, patients are the people most affected by the results of care, and their participation is free of financial cost.

The good news is that everyone is able to participate to improve their own care and help avoid health care mistakes without any additional cost to government. Patients may protect themselves from missed diagnoses by simply asking the doctor “have you considered all of the possible causes for my problem.”

Physicians can easily recall and name the most common causes for most patient problems. However, about 10 per cent of people have rare conditions. Although each rare condition is in and of itself uncommon, together there are many of them.

Some common problems, for example thyroid disease, do not declare themselves in the same way for young and old. Patient engagement and curiosity can help insure that the clinician considers all possibilities and considers that a problem might be an atypical example of a common disease.

If you feel uncomfortable with an explanation ask what other possibilities the doctor or nurse considered. Patients are also harmed when laboratory tests (for example blood tests and x-rays) are mishandled or misinterpreted.

Whenever you have a test make sure that the doctor has at least seen the result. If you have a test and have not heard from your doctor you cannot assume the result was normal. The test might have been mishandled in the lab, sent to the wrong person, or not seen and considered by your physician.

When you discuss the results of tests you can be confident the doctor has seen the test, and also considered its meaning. Patients can also help avoid some of the unintended consequences of drug treatments.  Whenever people take a drug they must weigh the chance of benefit against the possible harms.

Many patients (particularly older people) are prescribed and take several drugs. You can help avoid problems of multiple drug interactions by asking your doctor and pharmacist the simple question “How do all of these drugs work together to help me?”  Many people take daily Aspirin hoping to reduce the risk of heart attack and stroke.

Unfortunately, Aspirin is also associated with increased risk of brain and gastrointestinal tract bleeding. For some groups of people the risk of harm from bleeding is higher than the expected gain from reducing the risk of heart attack and stroke.

Cholesterol lowering drugs (statins) help some people to reduce their chances of having a heart attack or stroke. However, for some people, statins also increase the risk of diabetes, muscle and liver problems. For any drug it is important to know that you are in the group of people more likely to be helped than harmed.

Ask your doctor (and pharmacist) what are your chances of getting a heart attack or stroke in future, with and without the drug, and what are the possible harms from taking the drug. Engaging with your doctors, pharmacists and nurses not only helps to prevent harmful mistakes, but will also make you feel more confident about your care.  Originally published in the Chronicle Herald