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Message #641 Consumer rights: Medical care

mp3 #641 Medical Care - Your Rights as a Patient (mp3 file)


Doctors are like experts in any other field---their competence and methods of treatment vary considerably. Obviously, however, since your life may well rest in their hands, you must choose physicians very carefully. Finding the right doctor may be difficult, but ultimately your doctor should be someone you like and with whom you can be completely honest.

The time to see a doctor is now, before any symptoms become serious. Unfortunately, many people fail to establish a link with a health care provider before they need attention. You should try to find a general practitioner (G.P.), family practitioner (F.P.), or a clinic to coordinate your health care, rather than only choosing different specialists for different parts of your body.

For general health care and checkups, usually a G.P., F.P. or the more specialized internist is sufficient. Many of these physicians practice general medicine and minor surgery. In addition, an internist deals with the non-surgical treatment of internal organs; this field has many subspecialties pertaining to the different organs of the body.

You should be aware that any licensed physician can practice any surgical or medical specialty without being certified in the field. You can check to see if your "specialist" has passed the American Board Exams for his particular specialty.

It is almost impossible to evaluate fairly the medical service you receive from a doctor because there is no uniformity of treatment and care. Medicine is both a science and an art, and the method of treatment varies from doctor to doctor and from patient to patient. Don't hesitate to ask questions about your health problems. Although some doctors may shun the questions, you are paying for their services, so use your time to your benefit.

One of the most important traits to look for in a doctor is thoroughness. Make sure your doctor takes your history--including personal and family information. He or she should ask specific questions about your past illnesses, diseases, and hospitalizations, such as:

-the past and present illnesses of your family members.

-any recurring symptoms such as headaches, eye trouble, sores.

-your reaction to certain types of medication and injections.

-your work, hobbies, diet, sleeping habits, and living conditions.

-throughout the physical examination, which should include looking at you from head to toe (unless, of course, you specifically decline a complete exam and request that only specified areas of the body be examined), the doctor should inform you what is being done and why.

After an exam, the doctor should go over the findings -- and not merely hand you a prescription without explaining things to you. The thorough physician should follow up on observations with appropriate tests, make as precise a diagnosis as possible, follow up on your illness by phone or otherwise, talk in terms of probabilities when he or she is not sure, and admit the limitations of medical technology and his or her own knowledge.

While at the office, pay close attention to the cleanliness and the level of hygiene practiced. Is the office neat with well marked bottles and specimens?

Note if you have any privacy as a patient, and if there is a private spot for talking with the physician. In fact, note whether or not the doctor does talk to you. The physician should keep you well informed, help educate you about your health, and actively pursue preventive medicine.

When recommending surgery or treatment with drugs, the doctor should explain alternatives and reasons, as well as the risks and benefits.

Under certain circumstances -- for instance, a very rare condition or if you are told your symptoms are emotionally caused -- you might want to get a second opinion. Doctors should not feel threatened if you tell them you want another opinion.

Do patients have rights?

You do have rights, which stem from a California state supreme court decision by the name of Cobbs vs. Grant. Included are the rights to:

Receive careful, professional service with the right to confidentiality of all records and communications concerning your care.

Get complete, current information on your diagnosis, treatment, and prognosis--in language that you can understand.

3. Know exactly what a prescribed drug is supposed to do, including any known side effects you may encounter.

4. Accept or decline what the doctor suggests be done to you. That is, you have the right to refuse treatment and be informed of the medical consequences of your action. Remember that the doctor has to get your "informed" consent before doing something to you.

5. Be told all possible alternatives to treatment favored by the physician. Insist on this.

6. Seek out the opinions of other physicians concerning your health problems.

You also have the right to inspect and receive copies of your medical record, or a summary of your medical record, and any test results must be in plain language. Your doctor is required to let you inspect your record within five working days of receiving your written request and reasonable fees, and to provide copies within fifteen days. A medical provider must allow you to inspect records even if you have failed to pay a bill for health care services. You may find further details about patients' access to health records in health and safety code sections 1795 to 1795.26.

What to do if you have a problem,

First, the doctor may be unaware of your dissatisfaction because most problems are handled by the doctor's staff. Make it a point to ask to speak directly with the doctor, whether by telephone or in person.

Second, complain to the Medical board of California, which is composed of 12 physicians and 7 "public" members. Upon receiving a complaint, it checks whether the complaint falls within its jurisdiction. It cannot set or modify fees. The following complaints come under its jurisdiction:

-gross negligence, or repeated, similar negligent acts.

-repeated negligent acts.

-incompetence.

-commission of any act involving dishonesty or corruption relating substantially to the duties or function of a physician or surgeon.

-abuse of alcohol or drugs.

-sexual abuse, misconduct, or relations with a patient.

-misrepresentation.

-divulging professional, confidential information.

-mental illness.

-prescribing dangerous drugs, without a prior medical examination,

-or unlicensed practice of medicine.

The board also handles the following kinds of grievances:

Payment of fees for services not performed by the physician; and

Excessive prescribing or administering of drugs or treatment which are detrimental to the patient as determined by the customary practice and standards of the local community of physicians.

If your complaint involves any of the above acts, the disciplinary action which may be taken includes: placing the physician on probation, suspending the physician's right to practice for a period not exceeding one year, and/or revoking the physician’s medical certificate.

You may contact the Medical Board of California at its offices in Cottonwood, Fresno, in the Los Angeles area at Torrance and Woodland Hills, Sacramento, San Bernardino, San Diego, San Mateo, and Santa Ana.

The Medical Board of California also has jurisdiction over various allied health professions, in addition to physicians. These other health care providers include acupuncturists, hearing aid dispensers, physical therapists, physicians' assistants, podiatrists, psychologists, registered dispensing opticians and contact lens providers, respiratory therapists, and speech pathologists and audiologists.

Third, the county medical society handles both fee grievances and professional conduct grievances regarding physicians. After receiving a written complaint, it contacts the doctor named and informs him of the complaint. The county medical societies have special grievance committees comprised of doctors who review each case and try to obtain positive action. Although not all doctors belong to a county medical society, the grievance committees usually handle complaints about non-society members in the same way.

Lastly, if repeated efforts fail, the physician's name should be reported to the state board of medical quality assurance.

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