But we've learned some secrets over the years that might make your medical encounter a safer one.

1. "Will You Take My Picture?"

Thousands of Americans have gallbladder removal with a high tech "laparoscope." It is a relatively safe procedure, but one SERIOUS complication is cutting the common bile duct, the "highway" between the liver and the stomach transports bile. When this occurs, the surgeon has likely mistaken the common bile duct for the cystic duct. The common bile duct should NEVER be cut or damaged. The cystic duct, the "exit ramp" on the duct highway that connects to the gallbladder, should be cut. Common bile duct injuries require major reconstructive surgery and can significantly damage the liver.

A cholangiogram is a simple x-ray taken during surgery that can identify the common bile and cystic ducts before anthing is cut.

If you are having laparoscopic gallbladder surgery, ask your surgeon: "If there is any doubt in your mind as to what you are cutting, will you take an x-ray picture to make sure before anything is cut?"

Although most surgeons do not perform cholangiograms routinely, they SHOULD perform one if not completely sure of the bile duct anatomy. Good surgeons should explain under what circumstances they will use a cholangiogram or take other steps to avoid bile duct injuries. If your surgeon is offended by your medical knowledge, get another surgeon!

2. Beware of Ghosts . . .

You meet with a surgeon you trust and he or she explains what is going to happen during the surgery. After the surgery, you discover that while you were under anesthesia, your surgeon allowed a resident to perform the surgery. Or, your surgeon left the room to start three other surgeries, and delegated your surgery to someone else. You're told none of this before surgery.

The American Medical Association coined this practice "ghost surgery." It happens more than you think, and is more common in teaching hospitals. In 1995 the Cleveland Clinic was sued when a surgeon (who had four surgeries scheduled AT THE SAME TIME) allowed a resident to perform nasal surgery and the patient became comatose. In 1998, a jury returned a substantial verdict in negligence and fraud damages because these facts were not disclosed to the patient beforehand.

You have the right to know if, and under what circumstances, somebody other than your surgeon will be responsible for any part of your operation. This is called "informed consent," which means you have the right to be informed about the medical details before giving consent to that procedure. It's one thing to have a hospital intern listen to your heart or lungs or palpate a lump. And it's quite another to become an unknowing participant in someone's medical learning curve while you're under anesthesia.

Because you deserve the right to know, don't be afraid to ASK about this practice, or even REFUSE to participate in a surgery with a doctor you don't know. Besides, your surgeon shouldn't take offense. After all, it's the ultimate compliment to a surgeon to say: "I want you and you only to operate because I've come to know and trust you."

3. "Can We Reschedule This for a Tuesday?"

Avoid major surgery on Fridays if at all possible. We have seen a significant correlation between Friday surgeries and serious mistakes that occur over the weekend. Perhaps the physician is called on a Saturday evening and doesn't want to come in, directing important medical decisions to others who aren't as familiar with all the medical details. Staff may be reduced; the possibilities are endless. And we're willing to bet that if you asked your physician or nurse friend about this issue, they might agree.

4. Got Allergies? Speak Up.

Don't assume that the hospital bracelet you're wearing will be seen by staff. Yes, your allergies to medications should be plastered all over your chart, but despite that AND your bracelet, we have seen instances where patients are still given medications they're allergic to, with disastrous results.

So don't be afraid to say before receiving medication: "I'm sure you're aware of this, but I am allergic to ________." If the nurse says, "Yeah I know," compliment him or her for being attentive.. And if you're told, "Uh . . . I'll be right back," and the nurse leaves with the medication in hand, pat yourself on the back for speaking up!

5. When No News is Not Necessarily Good News.

Test results showing a major problem, like cancer for example, are sometimes not communicated to a patient for months or years because of an avoidable communication breakdown between the lab and the physician.

Any unacceptable delay in failing to inform you of your test results is negligence. But don't assume that your physician's silence means the results were negative. The miscommunication possibilities between a busy laboratory and a physician's office are real and unfortunately all too common.

If a reasonable amount of time passes (a week, for example), and you haven't heard from your doctor, call or stop by the office and get a copy of the test results. Why get a copy? If you have a common name, there might be 3 or 4 of you in your geographic area. How do you know that your doctor received YOUR results and not some other George or Jane Smith's? Make sure either the lab or your physician has given you the right test results, and not somebody else's!

6. Get a Second Opinion On That Mole.

Many times the need for surgery is obvious and your doctor is the right person for the job. But if there is time, you may want to explore getting a second opinion (that is, if your insurance will allow it).

You may find out about alternatives to surgery, or you might come away with a better appreciation of some of the risks.

Specifically, if you've had a skin growth or mole removed and sent to the lab, you may want to consider getting a second opinion of the lab's findings. The reason? One pathologist (a physician trained to read and interpret tissues and specimens) may interpret the findings differently than the original pathologist. This tip comes directly from a pathologist we consulted with on a failure to diagnose a skin cancer case. If it's good enough for pathologists who interpret these growths daily, it's certainly worth knowing and sharing.

7. Morphine Will Kill the Pain, But . . .

Morphine can also cause respiratory depression that, if not detected, can cause brain damage by suppressing the body's ability to supply oxygen to the brain. Thankfully, most hospitals will hook up the patient to a pulse oximeter, a painless device attached to the patient's finger that will monitor oxygen levels. However, not all hospitals use pulse oximeters routinely, particularly small or rural hospitals. If your loved one is receiving narcotic drugs, make sure he or she is hooked to a pulse oximeter, and don't be afraid to ask for one.

8. "It Was Just a Little Ulcer and Now Look at It!"

Frequently the elderly are subject to longer hospital stays. This means longer times of immobility, which can lead to pressure sores and debilitating decubitus ulcers. These are largely preventable with diligent monitoring and observation by hospital or nursing home staff.

But due to staffing problems or inattention, many times these sores are neglected. Do not hesitate to check for signs of developing sores and report them to staff immediately. And always get the name of the staff person you spoke to. Your diligence may prevent a potential problem from getting worse, even though it is the staff's responsibility to look for these problems.

9. "These Don't Look Like My Blood Pressure Pills . . ."

If you receive a prescription that looks different in color or shape than what you've been taking, do not assume you've received some other version of your drug! Not only have we seen patients receive the wrong drug, we have seen pharmacies put the correct label on the pill bottle along with the wrong medication! If you're unsure about the medications you were given, call your pharmacist or your doctor immediately, or even show them the drug you received.

Why are these medical safety tips important? A recent study from the Institute of Medicine revealed that 98,000 people die in hospitals each year due to medical errors. Translated, you are much safer driving in your car or flying every day than entering a hospital, which is hard to fathom.

Hopefully, one or more of these tips will increase your odds of leaving the hospital in better health than when you entered.