Health care in the United States is very good but very costly. There is no national medical care system or national insurance program. An enormous amount of money is invested in research, medication and technology to prolong the lives of people with serious illnesses or unusual injuries. To protect yourself physically and financially, it is essential to understand how to utilize this system.

When you go to see a doctor in the United States, whether for routine or emergency treatment, the first thing you will be asked to do is to fill out forms. These forms ask not only about your medical history, but also that of your family, and the information becomes part of your permanent file in the office. Because you must provide information about your insurance, always carry your insurance ID card.

Nurses in the United States are well educated and have highly sophisticated training. They perform many functions that may be carried out only by doctors in other countries. You may initially be seen by a nurse rather than a doctor when you are called to the examination room. The nurse proceeds with routine measures of your health by taking your weight, blood pressure, and temperature and asking questions about your health. The nurse adds the information to your patient chart before leaving the room. You may also be asked for a urine sample, which is one way a health care provider evaluates certain patient health signs. If it is the first time you have done this simple test, let the nurse know so s/he can give you clear instructions.

The doctor comes in next, often scanning the chart while introducing him/herself. Doctors have high status in the United States and are routinely addressed by their title, while they may call patients by their first name. The doctor may ask some of the same questions the nurse already asked. Usually, a doctor listens to your heartbeat and examines your eyes, ears and throat, often while continuing to ask questions. A nurse may or may not be present in the examination room at this time. If you prefer a nurse to be present you may request this.

In the United States, nurse practitioners and physician assistants also serve as health care providers under the supervision of physicians. They are licensed and practice under the rules and regulations of the state in which they work. They have advanced medical education and clinical training and many are nationally certified in their area of specialty. Nurse practitioners and physician assistants may specialize in areas such as adult ambulatory care, adult acute care, women's health, pediatrics, family and geriatrics, to name a few. They are qualified to obtain medical histories and perform physical examinations; diagnose and treat acute health problems, such as infections and injuries; diagnose, treat and monitor chronic health problems, such as high blood pressure and diabetes; order, perform and interpret diagnostic studies such as laboratory work and x-rays; provide health maintenance, including annual physicals; and promote positive health behaviors and self-care skills through education and counseling. In the United States, you may see a doctor, nurse practitioner or physician assistant for your health care.

It is important to organize any questions you may have about your condition or the treatment. It is a good idea to write them down ahead of time and then record the answers the doctor gives as well. If you do not understand something the doctor says, ask him or her to repeat it. Write down all of the doctor's instructions or ask to have a family member present to help. The doctor may ask you blunt questions about your personal habits, including your sexual activity. The doctor asks these questions to make determinations about your health, not to make judgments. If you do not understand why a question is being asked, you may ask the doctor to explain how this question is relevant to your medical care. It is not likely the doctor will spend time conversing with you about any aspect of your life other than health issues.

It is also important that you educate the doctor. That is, if you have been self-treating any illness or health condition, bring the medication with you so the doctor can understand what you have been doing. The doctor may ask you to discontinue the medication you have been using, so that it does not adversely mix with what s/he prescribes.

Normally, a doctor diagnoses an illness, prescribes medication if needed and describes how long you should feel ill or uncomfortable so that you will know what to expect and when to seek further treatment if the illness is prolonged. The doctor may administer tests or have you go elsewhere for testing. In this case, you may be told to call back for test results, which the doctor will give over the telephone or in another appointment. Many doctors' offices have a policy that only the doctor can give test results to the patient, whether they are positive or negative.

In addition to seeing a general practitioner, women should also see a gynecologist. A woman over 18, even if she is a virgin, should go to a gynecologist once a year. If it is the first time you are seeing a gynecologist, it is important to let the nursing staff and doctor know this, so they can make the visit as comfortable as possible. Although some aspects of the exam may be uncomfortable, they should not be painful. A sensitive gynecologist explains to the patient what the examination will involve before beginning.

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