Rosa Nash knew something was wrong with her body just as surely as she knew when the timing was off on her old Mercedes coupe.

The family doctor sent her to a specialist.

Despite some classic symptoms, she says, a diagnostic test wasn't scheduled for two months, so she began to think it might be no big deal.

But when she woke up from emergency surgery to remove a cancerous tumor from her colon a couple of weeks later, surgery she says required a temporary colostomy because her condition had gone so far, she wished she had trusted her instincts.

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"If you feel your body is not right, don't take no for an answer," the Greenville woman said. "Keep going until you find a doctor who sees you as a person and takes care of you."

With thousands of people dying from medical errors every year, more and more experts are advising that patients need to be their own advocates.

"The health-care encounter is a complicated encounter, so lots of things could go wrong," says Dr. Georges Benjamin, executive director of the American Public Health Association. "But there are some ways you can prevent some of those things from happening."

At the hospital, the most important step, experts agree, is having someone at the bedside 24/7.

"Always have somebody there with you to help keep track of things and make sure you get what you need," says Lisa McGiffert of Consumers Union.

"The medical system is fragmented and really broken, and the people who work in (hospitals) are really too overworked," adds Jonathan E. Fine, a retired physician in Massachusetts who's launching Bedside Advocates, which offers retired health professionals as volunteer patient advocates.

Fine says he decided to form the nonprofit group after spending many hours "running interference through the medical labyrinth" for a hospitalized friend.

"I have great confidence in the medical profession and hospitals. But they are as human as you and I, and sometimes they're wrong," he says. "We (advocates) can smell trouble, provide comfort, help the family know what's going on, and help the medical team as well."

Most health care providers are caring people who want to do a good job for their patients, says Patti Smoake, spokeswoman for the South Carolina Hospital Association.

"Health care providers are not perfect," she says. "And I think people understand now that mistakes do happen and you have to keep your eyes and ears open."

With the nursing shortage, hospitals don't always have as many nurses as they'd like, says Dr. Melanie Greene, director of the Division of Women's Health in the Department of Medicine at Greenville Hospital System.

"It's a good idea to have a strong voice of a relative or friend who can speak up for you," she says.

Patients need to be empowered with information, says Bill Wright, a retired educator from Maryland. So he's teaching a course at Chesapeake College this fall called "Surviving Your Health Care Experience."

Government and watchdog groups estimate preventable medical errors claim the lives of between 98,000 to 195,000 Americans every year, costing the health-care system $38 billion. And hospital-acquired infections afflict another 2 million, killing at least 90,000 of them, according to the U.S. Centers for Disease Control and Prevention.

That makes those infections the fourth-leading cause of death in the country, killing as many people every year as AIDS, breast cancer and highway fatalities combined, according to the nonprofit Committee to Reduce Infection Deaths.

Helen Haskell of Columbia believes those numbers are conservative. She founded Mothers Against Medical Error after her 15-year-old son, Lewis Blackman, died when hospital staff failed to recognize the gravity of his condition. Her efforts led to last year's passage of South Carolina's Lewis Blackman Hospital Patient Safety Act to improve safety and quality of care.

The law requires hospital staff to wear identifying badges and give patients written information about the roles of medical residents and other trainees. It also requires a mechanism for patients to get assistance if they feel urgent concerns are not being addressed.

But confronting doctors or nurses can be intimidating. But Smoake says patients "should not be afraid to speak up."

"Keep going up the chain," says Haskell.

Experts also suggest taking your medications to the hospital to avoid interactions with new drugs there and asking the staff to wash their hands and change gloves before caring for you.

"Fifty percent of the time physicians in hospitals ignore this rule and do not wash their hands or change their gloves between treating patients," Wright says.

McGiffert suggests asking what the staff does to prevent infection and errors. She also advises logging all treatment, the names of the caregivers, and being assertive about pain relief. And if you're having surgery, she says, have the physician sign the site beforehand to be sure they work on the right area.

Smoake says the hospital environment is changing and becoming more focused on safety. And last week, the 100,000 Lives Campaign reported that its 3,000 participating hospitals prevented more than 122,000 deaths nationwide by adhering to recommended care guidelines in the last 18 months.

"With infection control and patient safety and ensuring accuracy of medications, we've all been made much more aware of our deficiencies in those areas," adds Greene. "And we're all trying to be better."

But patients need to be advocates outside the hospital as well. Greene advises going to the doctor with a list of questions and concerns. And Benjamin recommends asking lots of questions to fully understand the diagnosis, treatment and complications.

The medical community also should pay more attention to communicating in plain language instead of jargon, says Benjamin.

In her book After the Diagnosis -- How to Look Out for Yourself or a Loved One, Donna L. Pikula says patients need to do their homework. "They also need to learn to listen to their instinct -- that little voice inside them that tells them whether something seems right or not."

Nash, 58, says those are two important lessons she learned. She is grateful to be alive and spends her days playing golf, working in her bridal shop, enjoying her grandchildren, and traveling with her husband, Rick, whose support helped her through the rough days.