Revisiting Patients’ Rights and Responsibilities

by Joan Bristow, Vice President, Patient Safety and Loss Prevention

In the effort to keep pace with changing times in health care, it is easy to overlook some of the tried and true practices for promoting patient safety. The issue of patients’ rights falls into this category, along with its equally important counterpart—patients’ responsibilities.

All health care providers can benefit from this reminder, and patients should also be made aware of their rights and responsibilities. By revisiting these issues, providers can improve their patient outcomes through coordinated medical care, cooperation, and compliance by both parties. Achieving maximum provider care relies on patient understanding and agreement.

The following lists of rights and responsibilities are provided for use in physician offices, clinics, and even urgent care centers. We recommend that every practice post both lists prominently in waiting areas or examination rooms, on its Web site, and, perhaps, even include the lists in printed patient handouts.

A Patient’s Rights

We respect the rights of our patients and recognize that each person is an individual with different needs. We recognize and support patients’ rights to participate in health care decisions—including the right to discontinue or refuse treatment to the extent permitted by law.

As a patient, it is your right to:

• Receive considerate and respectful care by competent personnel in a safe environment.
• Be treated without discrimination as to your race, age, religion, sex, sexual orientation, national origin, ability to pay, or illness.
• Be informed of the names of your health care providers.
• Be assured that you will receive physical privacy that is appropriate to the medical care.
• Receive complete and current information concerning your diagnosis, treatment, and prognosis in understandable language. If you cannot understand these elements, we will provide the information to a person you have designated, or we will provide the services of an interpreter.
• Participate in the informed-consent process for any and all treatments and procedures (with the exception of emergency medical care). The informed-consent process includes an explanation of the treatment or procedure; any alternative treatments or procedures; the intent, risks, and possible complications of the treatment or procedure; and the anticipated outcome.
• Formulate advance directives and appoint someone else to make health care decisions to the extent permitted by law.
• Refuse medical treatment, drugs, or procedures, and to be informed of the consequences of your decision.
• Receive complete and adequate discharge instructions after treatment.
• Know that the confidentiality of your medical record contents and the care provided will be protected carefully.
• Expect reasonable continuity of care.
• Participate in the referral process when it is necessary to consult with another health care provider.
• Access the information contained in your medical record. This right may be delegated to another person of your choosing and might include exceptions (such as those pertaining to mental health care or to sensitive materials).
• File a written complaint without fear of retaliation or discrimination.

A Patient’s Responsibilities

In acknowledging the personal worth and dignity of each individual, we also recognize that you, as the patient, have certain responsibilities that support the health care we provide. In order to ensure your proper care with the best outcome, it is your duty to comply with our office protocols, which have been designed to promote optimum patient safety.

It is every patient’s responsibility to:

• Keep scheduled appointments (or to tell the office when you are unable to keep an appointment).
• Cooperate with the planned treatment program prescribed by the provider (or to explain why cooperation is not possible).
• Take an active role in your medical care.
• Request additional information or clarification when any detail of your medical care is not understood.
• Be honest and accurate in all health care information that you provide to us.
• Update your personal information as necessary to ensure the accuracy of our records.
• Show consideration for other patients and for your health care providers in this office with respectful conduct.
• Be patient when an appointment is delayed; keep in mind that an emergency may be taking place.
• Maintain the same level of confidentiality and privacy for others that you would expect to receive.
• Inform office personnel of any unsafe conditions.
• Be prompt in fulfilling financial obligations to this office.

Our goal is to keep you, our patient, in the best health possible. If you feel that you are being treated unfairly or improperly, please bring it to the attention of your physician or the office manager.

The Golden Rule

To understand why we feel this refresher is necessary, we’ll present a number of points based on observed behavior or on conduct that was brought to light through claims reviews. It is easy to see why lapses occur: providers often feel rushed, deadlines are a constant pressure, and tempers can prevail.

We urge all health care providers to consider the following:

• Avoid calling the patient by his or her first name if the patient prefers to be addressed as Ms., Mrs., or Mr.
• Don’t ignore waiting patients in order to continue a personal call at the front desk.
• Never delegate telephone triage of medical advice to the receptionist (or to any other inappropriate unlicensed provider).
• Don’t forget that the patient in Room 3 at the far end of the hall has been waiting for over an hour.
• Don’t delay a patient to chat with a pharmaceutical representative.
• Never file new test results before they have been seen by a licensed professional.
• Don’t interrupt the patient while he or she is explaining why medical care is needed.
• Do not disclose the intimate details of one patient’s visit to another, and never discuss the identity of HIV-positive patients. Keep private information private.
• Don’t ignore waiting patients if there is a delay. Keep patients informed of the reason for the delay. (And never tell waiting patients that the doctor is late because he or she is being deposed for a lawsuit.)
• Never discuss a patient’s financial obligations at the front desk if other patients are within earshot.
• Avoid hovering in the doorway while speaking with a patient who is in an exam room. Body language and positioning are both signs of your level of attentiveness.
• Never allow anyone except authorized health care providers to write prescriptions or refills.
• Don’t leave prescription pads in plain sight (especially when pre-signed by the physician).
• Refrain from complaining in front of patients of being overworked or about financial matters.

Practice the golden rule of giving your patients the same courtesy that you would wish for yourself and your family members.

Take the time to listen to all patient complaints and comments. You can also walk around your office during the busiest hours to observe the interactions between patients and staff and between staff and physicians. We call this “LBWA”—learning by walking around.

Try assigning others to the role of unidentified observer. You might be pleasantly surprised by the outcome, but if you are shocked by the reports you receive, you can take proactive and positive action to correct any problems.