The advice about marking up the consent form is similar to the advice given by Elisabeth Rosenthal in her book American Sickness.

It's not fringe advice.

https://www.amazon.com/American-Sickness-Healthcare-Became-B...

I just finished "An American Sickness" (https://www.amazon.com/dp/1594206759) that does a good job of targeting all the specific points of inefficiency, with a little bit of explanatory history and exemplary anecdote sprinkled in.