Concurrent with my duties as a weekly columnist for the Daily Pilot, I provide business development guidance to physicians and dentists.

Since 1998, this work has taken me behind the scenes at countless medical and dental offices, clinics and hospitals. I have consulted for solo practitioners, group practices and large medical facilities and recently spent two years managing my wife's treatment for brain cancer.

As a result, I am in a unique position to make the following statement: Forget everything you know about receiving medical care.

Younger patients, those in their 20s and 30s, may already have adjusted to the new normal in health care but the rest of us are discovering the hard way that in order to get what we want, we are often going to have to speak up — loudly.

The case in point today is a friend, Pat (not his real name), who complained of headaches, which often originated around his left ear. When I asked in which hand he held his cell phone, he said, "My left. I am left ear dominant."

I told Pat that I was concerned about a possible connection between consistent cell phone use and his headaches, which could indicate the presence of a brain tumor. Maybe not, but headaches were the first symptom exhibited by my wife, who died last June. I recommended that he make an appointment with his primary care physician and ask him to write an order for an MRI to rule out or confirm the presence of a tumor.

Pat told me he would make the appointment and said, "I'm sure he'll grant the MRI."

That's when my experience took over.

"It's not a matter of granting it," I said. "You ask him to write the order. Don't ask if he thinks it's a good idea, just say, 'Please write an order for an MRI of my brain.' That's it. If he refuses, we'll find a doctor who will write it." I wanted Pat to understand that he is the customer.

For those readers who believe that the MRI may be wasteful or unnecessary, I want to remind you that in May 2011, the World Health Organization reported that "…there is a possible connection between mobile phone use and malignant brain tumors."

But the cell phone-tumor connection is not the point here. What really matters is the attitude patients must now have before any medical office visit. Today, patients must assume more control over their own care. They must become educated not only on whatever condition they may have, but also the treatment options, insurance coverage and the language required for the successful navigation of an intimidating system.

Gone are the days when the doctor's word was gospel. To combat the changes in their world, which include lower reimbursements, increased oversight and professional competition, doctors are streamlining and consolidating. Some of them are throwing in the towel and going back to work as employees of hospitals or other large medical entities and some are quitting medicine altogether.

Contrary to what you may believe, the best doctors I know welcome the more informed patient as it relieves them of the burden of providing the education, which leaves more time for discussions about treatments and prognoses.

More than ever, medical care is a partnership between the patient and the physician.

STEVE SMITH is a Costa Mesa resident and a freelance writer. Send story ideas to smi161@aol.com.