THE PATIENTS’ BILL OF RIGHTS

When I decided to write a blog on the PATIENT BILL OF RIGHTS, I learned a few things I didn’t know. First, I didn’t know this document/policy was originally introduced in 1973 by the American Hospital Association. Second, it was expanded upon and redefined in the Affordable Care Act (Obama Care) in 2010. Third, the AHA replaced, or upgraded, it with the Patient Care Partnership. Fourth, state governments and healthcare facilities have adopted their own versions of the Patients’ Bill of Rights pertaining to those specific entities. Fifth, and last, it is far more complicated than I anticipated.

This confusing sentence complicates the issue because there are many versions of the Patients’ Bill of Rights. State governments and local facilities have their own Bills of Rights, but they pertain to their specific situations. In this article, I will focus on the provisions of the American Hospital Association’s patients’ Bill of Rights because it affects a larger percentage of the population. The Patients’ Bill of Rights in the Affordable Care Act impacts millions of people, but the AHA states it’s Bill of Rights provides “guarantees for anyone who seeks medical care in the United States.” That applies to anyone and everyone who goes to the doctor, goes to the ER, is admitted to a hospital, has a blood test, has surgery, or gets a prescription filled. 

“The AHA’s Patients’ Bill of Rights is a set of 15 guarantees for anyone who seeks medical care in the United States. They promote respect for patients and providers, open dialog about diagnosis, treatment, and fees, and the delivery of effective patient care.”

The list of 15 RIGHTS and brief comments follows:

1. The RIGHT to be treated fairly and respectfully.
2. The RIGHT to get information you can understand about your diagnosis, treatment, and prognosis from your healthcare provider.
3. The RIGHT to discuss and ask for information about specific procedures and treatments, their risks, and how they will affect you. You have the RIGHT to discuss other options.
4. The RIGHT to know the identities of all your healthcare providers, regardless of their status.
5. The RIGHT to know the cost of current and future treatments
6. The RIGHT to make decisions about your care and treatment. You have the RIGHT to refuse medical care. The hospital must inform you of consequences of refusing treatment. You have the RIGHT to choose other treatments or transfer to another hospital.
7. The RIGHT to an Advance Directive—living will, power of attorney, etc.
8. The RIGHT to privacy in medical exams, treatments, case discussions, and consultations.
9. The RIGHT to confidentiality of your medical record.
10. The RIGHT to review your medical records and have them explained.
11. The RIGHT to be transferred to another hospital and acceptance at that hospital. The RIGHT to be accepted at any hospital.
12. The RIGHT to ask and be informed of any business relationship between the hospital and providers, payers, and educational entities.
13. The RIGHT to consent or decline to participate in research studies. Effective care cannot be denied if you decide not to participate.
14. The RIGHT to expect reasonable continuity of care and be informed of other options after hospital care is no longer appropriate.
15. The RIGHT to be informed of hospital policies and practices related to patient care, treatment, and responsibilities. The RIGHT to know who you can contact to resolve conflicts, disputes, grievances. The RIGHT to know hospital costs. 

The list above is long and cumbersome. The AHA decided to simplify these rights so they developed a program called The Patient Care Partnership. It provides the same guarantees, but in a shorter format. These guarantees are:

     High quality hospital care—with skill, compassion, respect.

     A clean and safe environment

     Involvement in your care—shared decision-making.

     Protection of your privacy

     Help when leaving the hospital

     Help with your billing claims

That is a whole lot simpler, but it still gets the point across. You’re entitled to respect, quality care you’re informed of, a safe place, direct involvement in decision-making, privacy, help after hospitalization, and assistance with affording and paying for healthcare. 

The Bill of Rights in the Affordable Care Act can be summarized into several short phrases. The intent is the same, but “government-speak” can be overwhelming so the following will suffice. 

Patients have the RIGHT to the following:

Reject DISCRIMINATION

Understandable EXPLANATION

PRIVACY

DEMAND INFORMATION AND MEDICAL RECORD

Be fully INFORMED—results, diagnosis, plans

CHOICE—of provider and facility

SELF-DETERMINATION—advance directives

RELIGIOUS BELIEFS—not denied

MEDICAL RECORD—right to view

Right to LEAVE if informed of consequences

Refuse MEDICAL RESEARCH 

COMMUNICATE with family, visitors

EXPRESS GRIEVANCES

Inform of RIGHT AND RESPONSIBILITIES as a patient.

Many, if not most, of the “Rights” presented here are common sense courtesies. They are expressions of respect and human kindness shown to our fellow man. The old school paternalistic method of interaction between patient and provider was one of the reasons this BILL of RIGHTS came into existence. Abuse often occurred. Today, patients are intimately involved in care decisions, sometimes too much so. But human dignity is important to the proper interaction between patient and provider. It is very difficult, though, not to get angry with that belligerent drunk who’s not cooperating and calling you all sorts of nasty names. But you must do your best. 

I do know that every time my wife or I have been admitted to the hospital or a surgery center, we are offered a copy of the Patients’ Bill of Rights. If we refuse to take it, we have to sign a form saying it was offered to us. I wonder how often people actually take a copy and read it? Again, most of these principles are courtesies we extend one another. One wonders why a Bill of Rights is necessary, but preserving such rules/guidelines/principles in written form gives it credence and authority.

References: https:/www.samch.doh.gov.ph/index.php/patients-and-visitors-corner/patients-rights

https://www.good rx.com/insurance/health-insurance/patients-bill-of-rights

https://www.cms.gov/affordable-care-act/patients-bill-of-rights

American Hospital Association. “The Patient Care Partnership”2003.