More Americans are paying more of their health care costs out of pocket every year because they lack insurance, have higher deductibles and co-payments, or have chosen a Health Savings Account plan.

There are ways they can save money without jeopardizing their health and there are steps they should take to ensure they're getting the best value for their dollars, says physician Angel M. Garcia (www.DoNoHarmDrs.com), an internist who has been in practice for more than 25 years.

Garcia, author of Do No Harm: Saving Our Health-Care System, says patients themselves are the first line of defense in an industry where increasing tensions have created new stressors at every level.  "No physician is beyond becoming burnt out," he says. "Physicians who are working mechanically, who are no longer interested, committed and enjoying practicing medicine can be a danger to their patients."

"I've heard many patients excuse their doctors by saying, ‘Oh, he's just burnt out.’  While such loyalty is kind, the issue is one the patient should talk about with their doctor.  "You could just say, 'Hey, Doc, you seem tired. Are you OK?'  You may be surprised how much your doctor appreciates your concern."

Garcia offers these simple ways patients can save money and ensure their health care dollars are well spent:

• For minor illnesses, try over-the-counter medications:  Some illnesses might be resolved with non-prescription drugs.  Caution: If symptoms aren’t resolved in three to five days, or if they go away but keep returning, you must see a doctor.  Garcia recommends Zyrtec-D 12 Hour for allergic sinusitis and upper respiratory infections, hydrocortisone cream for rashes and bug bites.  Prilosec for heartburn, Imodium AD for diarrhea.
• Talk to your doctor – if you can’t, change doctors:  It doesn’t matter whether your physician is nationally renowned or a Harvard graduate; if he or she doesn’t have time to listen to you, or doesn’t seem interested, find a new doctor.  A good place to start is references from friends – but be sure to ask whether they’re happy with their doctor’s bedside manner.  "Arrogant but good" is not what you want.
• Be prepared so you get the most out of your visit:  The doctor will want to know your chief complaint:  when the problem began, how it progressed, what makes it better or worse, any associated symptoms, such as fever.  He or she will also need to know what medications you take, including the drug name, dosage, how it’s administered, and frequency.  If you take more than one or two medicines regularly, you should make a list and keep this information in your wallet.
• Don’t skip the follow-up visit:  When a patient sees a doctor for a medical complaint, a follow-up visit usually is scheduled.  Some patients skip these because they feel better, but that may mean the medications have temporarily relieved the symptoms.  The follow-up is worth the money to ensure the problem is resolved and no abnormalities remain.