I recently found myself in a situation that to most doctors is more terrifying than a malpractice lawsuit -- being a patient myself.

I was obliged to see a physician for a routine physical as a requirement for a new job.

It was a typically humid New York City summer day as I walked into the doctor's office wearing a pair of shorts, a T-shirt and sunglasses. He may have known I was a physician or he may not have.

The doctor directed me to sit, stand, lie on my back, roll over, cough, the usual and sundry maneuvers that make a patient feel like a piece of sirloin being tossed around the barbecue grill. But as the doctor examined my midsection, he pointed to a bump in my belly button and mentioned, under his breath, the possibility of cancer. Somewhat alarmed, I scrunched over to look at and poke my belly button and found it to be no different than it had been for the past 37 years.

Surprised at the doctor's concern, I now voiced my "medical" opinion, informing him that my navel had not changed in size or color and it did not impose any discomfort or medical threat. In a low, stern, paternalistic voice, he warned me of the insidious and cryptic nature of cancer and reiterated his concern that my belly button could be harboring malignant lymph nodes.

Our conversation was cut short as he walked across the room, picked up the telephone and began scheduling an appointment for me to see a surgical oncologist. I scrambled off the examination table and argued against the need for this consultation. Glaring at me, he sent the clear message that a discussion or negotiation was not going to be part of his game plan.

Notwithstanding my medical knowledge and experience, I sat there quite helpless and powerless.

Eventually, as I suspected, I was able to confirm that I did not have cancer.

Although in the past decade or so many medical schools have worked diligently to teach doctors-in-training the importance of listening to patients, it is nonetheless important for patients to acquire their own, more assertive "bedside manner" to equalize the power imbalance inherent in the doctor-patient relationship. A large body of research strongly suggests that there are specific behaviors that patients can adopt to improve their health and satisfaction.

For example, in a study published in the journal Annals of Internal Medicine, diabetic patients who were taught to be more proactive with their physicians ended up feeling healthier and actually being healthier. Within a month of learning to become more involved and willing to negotiate with their physicians, the patients showed statistically significant improvements in their blood sugar control without an increase in medication.

In her book, "Claiming Power in Doctor-Patient Talk" (Oxford University Press, 1998), Dr. Nancy Ainsworth-Vaughn, a professor of sociolinguistics and anthropology at Michigan State University, notes that satisfied patients often assume more control of the conversation by asking questions, changing the topic, and telling stories about their personal lives.

In her seven-year examination of successful patient communication strategies, Dr. Ainsworth-Vaughn observed that people often used verbal strategies such as rhetorical questions and anecdotes as a nonconfrontational yet persuasive way to let the physician know what they were thinking and how they were feeling.

A major finding in this study was that many patient-physician dialogues more closely resembled a friendly, respectful conversation rather than the rapid fire, "just the facts, ma'am" cross-examination style of interviewing.

Dr. Ainsworth-Vaughn emphasizes that mutually respectful and socially appropriate behavior on the part of the physician and the patient is the most essential component of satisfactory encounters.

"The goal," she said, "is that doctors and patients both demonstrate and expect respect from one another."

Physicians often perceive patients' assertive behavior as difficult or hostile. But patients can be assertive without being confrontational, Dr. Ainsworth-Vaughn said.

Another researcher, Dr. Klea Bertakis at the University of California at Davis, discovered in a study of more than 500 patients that the major determinant of patient satisfaction was "patient activation," which meant that the patients asked questions, initiated discussions about what they knew or believed about health and disease, and discussed topics of importance, even if they were unrelated to the major medical focus of the visit.

Despite the hurried nature of doctor visits in this era of managed care, this last point is important because, in this same study, improvements in patients' health correlated to how well the patients and physicians discussed the current emotional state and relationships of the patients and their families.

As a physician, I have found a few other patient behaviors to be particularly helpful. People who spend some time before their doctor's appointment thinking about their symptoms and their concerns create a much more efficient, and mutually satisfactory doctor-patient interaction. It is even worth considering jotting down questions so they are not forgotten in the fast-paced hustle and bustle of modern medical care.

Another suggestion to consider is taking a family member or close friend to the appointment. This other person can act as an advocate, especially if the patient is not feeling well. Family members often remember things that patients, because of illness or nervousness, do not. They can also keep track of what was said more easily than the patient.

In addition, their presence allows the doctor to see the patient as a social being, as being cared for and loved by other people, and not just another disease to be treated or a broken body part to be mended. The author Susan Sontag wrote as she was struggling with cancer that "everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick and sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place."

The health-care system has traditionally been controlling and dehumanizing, and it is up to patients, at least in part, to make it more respectful, collaborative, and understanding of the needs of people and their families. It is a challenge that every one of us will one day face. Even those of us who are doctors.