How can you stay out of the hospital?

Here are some thoughts from many doctors and health workers:

* The most important one of all: Try to establish a regular relationship with a doctor you feel you can trust, one who candidly tells you the advantages and disadvantages of a course of treatment or a hospitalization.

* If your doctor advises hospitalization and it is not an emergency (all these rules may be off in an emergency), discuss it thoroughly with him or her. Ask: Why am I really going to the hospital? It should never be for convenience, yours or the doctor's. Or rarely so -- there are some patients whose circumstances just don't permit care elsewhere.

* Ask: What are the alternatives? You may be able to get care at home from a home care or visiting nurse agency.

* If you are to be hospitalized for diagnostic tests to seek the cause of a problem or illness, ask: Can all or most of the same tests be done outside the hospital or in the hospital's outpatient department? Even when there is to be a hospital stay, many hospitals now do preadmission testing on an out-patient basis.

* If an operation is advised -- virtually any operation -- get a second opinion from another qualified doctor. Even if it is to be a nonsurgical hospital stay, it may make sense to get a second opinion.

* If you are convinced surgery is needed, you may be able to have the operation without being hospitalized. Many hospitals have "in and out" surgical suites, where you can go home the same day. Some hospitals, and some doctors or firms, operate competent surgical centers where some operations can be done just as well as in a hospital.