Medical care is becoming a for-profit business even among nonprofit providers. Despite huge advances in technology, care is increasing impersonal, primary care physicians are getting harder to find, and patients are constantly being hit by “surprise charges” from medical procedures that are financially devastating. Many of these charges are unexplained up front and may be incurred by physicians, residents and fellows who are not part of your network. In this environment, it’s up to you to be your medical advocate, or ask someone you trust to serve in the role of healthcare proxy to come with you to appointments to ask key questions you may be too overwhelmed to ask yourself. When evaluating primary physicians or specialists, ask questions such as “Is your practice independent, or owned by a larger conglomerate?” “Does you or your practice receive compensation or special benefits from pharmaceutical companies?” “Are there ways for me to reduce costs, such as paying one co-pay that covers multiple visits?” “Can we meet virtually, and can I contact you via text or email?” Before you agree to any kind of potentially costly procedure, ask both your physician and your healthcare provider questions such as “How much will this procedure cost me out of pocket?” “Will all the physicians involved be in my network?” “Are there less expensive alternatives to an operation, such as physical therapy or prescriptions drugs?” And if it’s a major operation, you’ll want to be assured that the surgeon you’re consulting with will perform it, rather than a resident. If you or your healthcare proxy doesn’t feel they have the knowledge to sort through these issues, consider hiring an independent professional patient advocate or billing specialist.