Follow your doctor’s advice. No­where in our surveys did doctors’ and patients’ perceptions diverge more than on how well patients followed their prescribed course of treatment. Patients almost unanimously said they “completely” or “mostly” followed their doctor’s medical advice. But 59 percent of doctors said their patients often fail to adhere to the prescribed course of treatment. In fact, patient nonadherence ranked first among the troublesome patient behaviors we asked doctors about.

However good patients’ intentions, a vast body of scientific evidence says the doctors are closer to the mark. If anything, “physicians dramatically overestimate patient compliance, especially with medications,” says Ira S. Ockene, M.D., professor and director of the Preventive Cardiology Program at the University of Massachusetts Medical School. Studies show that as many as 75 percent of patients fail to take medications as prescribed, for reasons including forgetfulness and lack of explanation from the doctor of the medication’s benefits and side effects. About half of patients stop taking any given medication within one year; some never fill the prescription in the first place.

The penalty for nonadherence is real. In our survey, large majorities of patients who conscientiously followed their doctors’ advice on lifestyle changes such as weight management and quitting smoking reported “good” or “excellent” improvement in their health, while only a minority of patients who ignored doctors’ advice felt better.

If your doctor prescribes medication, take it exactly as instructed. Don’t stop any medication, even if it’s causing side effects, without consulting the doctor.

Strategies that might help you stick to your drug regimen, especially if you take multiple drugs, include keeping a written schedule posted prominently in your home and the use of prefilled pillboxes.

But if you haven’t followed medication instructions, fess up to your doctor. Not doing so could get you into trouble. For example, your doctor might increase your dose of a blood-pressure medication under the impression that the original dose didn’t work, leading to a potentially dangerous drop in blood pressure.

Be persistent. Some of the most dissatisfied patients we surveyed were those in the worst physical or emotional health. These patients were particularly unlikely to feel that their doctors communicated well or cared about knowing them as people. Among them were patients with poorly understood and difficult-to-treat ailments such as chronic fatigue, irritable bowel syndrome, or recurring headaches. They were more likely to have switched doctors at least once in the past year.

Such conditions frustrate physicians, too. “We went into medicine to fix things,” said Sharon Levine, M.D., who helps oversee 6,000 doctors as associate executive director of the Permanente Medical Group of Northern California.

In a 2005 Consumer Reports National Research Center survey of readers’ use of alternative medicine, people who had the least luck with conventional treatments--including those with fibromyalgia, low-back pain, and neck pain--were the most likely to report relief from therapies such as massage and chiropractic treatment. “In the absence of good treatment, what patients are looking for is time and understanding,” said Beckman, at the University of Rochester, who has also studied alternative medical care.

If you suffer from a chronic, hard-to-treat condition, talk with your doctor about whether complementary therapies might be worth trying.

Marilyn Bellezzo, 55, of Glen Ellyn, Ill., did just that. Plagued for 17 years with crippling stomach pains and diarrhea from irritable bowel syndrome, Bellezzo went through four specialists, two internists and at least 10 different medications in her quest for relief. “They would just run out of answers for me,” she said. In 2000, with her gastroenterologist’s blessing, she tried an intensive five-part, 100-day audio hypnotherapy program recommended by several fellow sufferers. “It was subtle at first,” she said. “Then over time the symptoms diminished substantially.” Today, Bellezzo’s condition is “95 to 98 percent” under control.

But don’t abandon any of your current treatments without first consulting your doctor. Also check with him or her before trying any new herbal or dietary supplement: They can interact with numerous medications or have other potentially dangerous side effects.

Change doctors if you have to. Seven percent of respondents to our annual questionnaires had switched doctors. Their top reasons for doing so included feeling rushed during visits, feeling the doctor didn’t listen, and not trusting the doctor’s technical competence. Deter­mining why you want a new doctor can help shape what you should look for in a new one.

If it takes too long to get an appointment, look for a practice that offers open-access scheduling, in which doctors typically leave part of each day’s schedule unbooked so that they can offer some same-day appointments.

If your visits feel rushed, look for doctors who encourage e-mail communication to address nonemergency matters such as a question about a drug dose or minor symptom.

If you just don’t click with your current doctor, consider your particular needs and preferences and what might fit them better. For example, our survey and other research suggest that female patients may have slightly more satisfactory experiences with female doctors. If you have a strong interest in nondrug or alternative treatments, consider a physician who practices “integrative medicine,” an approach that combines complementary and traditional therapies.