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Innovative technology, new medications and a host of websites devoted to consumer health information have both helped and hindered patients when they visit their doctor. There are, however, simple steps that can be taken to better the next physician visit and help patients become their best health care advocates, according to a physician who specializes in patient and physician advocacy.

"Health care has become increasingly complicated," said Michael Cuffe, MD, vice president of medical affairs at Duke University Health System. "Today, the numbers of drugs, the options, and the cost of care are much more complicated than even 10 years ago. That also means it takes more time and it's more complicated to describe options and address concerns the patient may have. All of this coincides with more health information available in the consumer marketplace."

Television reflects this, Cuffe pointed out. "In classic TV shows of the 60s and 70s, doctors were portrayed as all-knowing and very paternalistic, and patients rarely questioned their doctor's advice. Medicine was much simpler then."

Simpler, but tougher on patients who couldn't get access to pertinent health information the way they can today.

"We want patients to be informed consumers. We now have health care spending accounts where people are expected to pick their preventive care, select aspects of their care, and also to be educated about all the costs involved," Cuffe added. "So the demands on the physician-patient interaction are probably greater now than they have ever been before."

There are several ways to maximize the effectiveness of a doctor's visit, he said. The steps require a small amount of planning and organizing, but should reap dividends in a greater understanding of the health concerns.

Cuffe advised:

• Always know your medications and have a list with you when you go for your doctor's visit. "Better yet," he said, "Bring the bottles with you so that there is no confusion over what is being taken or the dosage."

• If you have a trusted relative or friend, someone with whom you are comfortable sharing privileged health information – involve them in your care. This person could be a spouse, an adult child, even a close friend that could accompany you to the visit, Cuffe said. Have them sit in on the discussion with your physician so that both of you have heard the information. That way, if there is a question later on, both of you can be clear on what you heard.

This is especially true for anyone who has been hospitalized, Cuffe said. "The hospitalized patient is often sicker and is less able to fully understand everything that is happening," he said. "Hospitalization is often the most challenging health situation and the pace of care can be perceived by the patient as very fast."

Other tips Cuffe advised are:

• Become knowledgeable about your medical history and current problems. Patients should do their best either through the public library or the Internet to track down additional information about their condition from reputable sources for health information. Cuffe recommends websites such as those of the American Heart Association (for anyone dealing with vascular diseases), the National Institutes of Health, and academic medical centers like Duke and others, for fair and balanced information that is free of commercial bias.

• Write down your questions before your physician visit. Cuffe recommended that patients keep a binder with their health care records and, as they think of questions about their condition or course of treatment, write them down in the binder. Take the binder to your doctor's visit so that you can remember what you wanted to ask and check off the questions as you ask them.

"This actually takes less time and ensures that you get those questions answered rather than risk forgetting to ask your questions and then having to try to get back in touch with your physician later on," Cuffe added. "These are the most beneficial steps I've recommended to my patients, and I've put them into practice for myself and my family."