Any country’s healthcare provider or healthcare facility recognise your rights while you are receiving medical care and that you respect the healthcare provider’s or healthcare facility’s right to expect certain behavior on the part of patients. You may request a copy of the full text of this law from your healthcare provider or healthcare facility. A summary of your rights and responsibilities follows:
A patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity, and with protection of his or her need for privacy.
A patient has the right to a prompt and reasonable response to questions and requests.
A patient has the right to know who is providing medical services and who is responsible for his or her care.
A patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
A patient has the right to know what rules and regulations apply to his or her conduct.
A patient has the right to be given by the healthcare provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.
A patient has the right to refuse any treatment, except as otherwise provided by law.
A patient has the right to be given, upon request, full information, and necessary counseling on the availability of known financial resources for his or her care.
A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate.
A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.
A patient has the right to receive a copy of a reasonably clear and understandable, itemised bill and, upon request, to have the charges explained.
A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
A patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
A patient has the right to express grievances regarding any violation of his or her rights, as stated in Florida law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.
A patient is responsible for providing to the healthcare provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalisations, medications, and other matters relating to his or her health.
A patient is responsible for reporting unexpected changes in his or her condition to the healthcare provider.
A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
A patient is responsible for following the treatment plan recommended by the healthcare provider.
A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the healthcare provider or health care facility.
A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider’s instructions.
A patient is responsible for assuring that the financial obligations of his or her healthcare are fulfilled as promptly as possible.
A patient is responsible for following healthcare facility rules and regulations affecting patient care and conduct
Medical second opinion in India is gaining tremendous popularity -. Before any surgery people are preferring to take a 2nd opinion, “Every patient has a right to a 2nd opinion,” says Joseph Fins, chief of medical ethics at New York-Presbyterian and Weill Cornell Medicine, “and it would worry me if a physician was opposed.” Asking for a 2nd opinion doesn’t necessarily mean you’re questioning a doctor’s recommendation. For many, it’s seeking the peace of mind that comes with leaving no stone unturned.Recently all renowned centres in India have realised the importance of offering a medical second opinion.
How did you manage to get here.
As for asking your present doctor for a referral, Fins warns of “an inherent bias effect,” meaning your doctor may suggest someone who is “comparably predisposed in the same practice group, in the same institution.” Such a physician is also likely to follow the same treatment guidelines, which means you may get a pro forma confirmation of your original diagnosis.
That rang true to me as well. When my mother was diagnosed with lung cancer four years ago, her pulmonologist in New York referred her to an oncologist at the same medical center. Their diagnoses and treatment plans matched up. My indefatigable mother got yet another opinion elsewhere, which confirmed the diagnosis but altered her treatment plan. According to a 2015 studypublished in the American Journal of Medicine, a change in the treatment plan is recommended as much as 30 percent of the time.
There’s almost no excuse for not getting a 2nd opinion today, especially with the prevalence of electronic health records, easy uploading of data and access to video conferencing. All of these technological advances are reducing “the geographic barriers to care,” Cleveland Clinic’s Schaffer told me.
Data show that most people—70% in fact—don’t feel the need to seek a 2nd doctor’s opinion. That says high confidence in our doctors. However, a 2017 Mayo Clinic study showed that 88% of people who went for a 2nd opinion received a different or refined diagnosis from their first one.
For any condition, effective treatment relies first on an accurate diagnosis. That’s why getting a medical 2nd opinion can be critical when weighing your options and making sure you’re finding the best care possible. Take note of these factors and advice on how to get a 2nd opinion.
2nd opinions help you make informed decisions.
2nd opinions help you in making sure that the proposed surgery is the only right thing to do. Although medical training is somewhat standard, doctors may see things differently. They can have different philosophies or approaches to diagnosis and treatment. As a result, 2nd opinions can give you a new perspective. On the other hand, when two doctors share the same view point, a 2nd opinion can reinforce information and help you feel more confident about your decisions. Both ways –only you stand to gain.
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Reasons for seeking a second opinion-
1.Doubts about what your doctor is telling you.
2. When you receive a serious diagnosis
3.Have a complex problem
4. You are considering major surgery,
5 or have multiple treatment options.
Does your Insurance cover it ?
If you’re thinking about a 2nd opinion, it’s smart to contact your health insurance company first. Find out if your coverage includes second opinions. In some cases, insurance companies may even require a second opinion before starting treatment. It’s also important to know if there are any limitations. For example, some companies require you to pick from a certain group of doctors. Or you may need a referral.Anyway – even if your insurance doesn’t cover second opinion, it makes sense before subjecting yourselves to a surgery –you are not sure of !
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Find the right doctor for a second opinion.
Your doctor is the best place to start when you’re seeking a 2nd opinion. He or she may be able to recommend a qualified doctor or steer you to other resources. You want a doctor with the expertise to make it worth your effort. You can also research specialists near you at Healthgrades.com. And don’t worry about offending your doctor. Responsible doctors understand the value of another opinion.
Prepare for your appointment.
Once you’ve scheduled a 2nd opinion, make sure you get the most out of it. This takes some preparation. The other doctor needs all relevant medical records and test results. You’ll need to give written permission to your current doctor to release these records. Call the 2nd opinion doctor’s office several days prior to your appointment to confirm that they have received your records. You can also request a set of records for yourself so you have them readily available. Then, make a list of your questions or concerns to take with you. And consider bringing a trusted friend or family member.
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It’s your decision to make.
A 2nd opinion is not automatically better than the first. When they agree, it can give you confidence in your course of action. When they differ, you must weigh the risks and the merits of each. You’ll need to decide which one best suits your goals and addresses issues most important to you. If you still feel unsure, you could seek a third opinion.
It’s smart to ask the 2nd doctor to send his or her written opinion to your first doctor. Then, you can discuss it together. But the final decision is yours to make.
So what should you do when you want a 2nd opinion?
•Don’t be talked out of seeking another opinion by your current doctor or anyone else; this is your decision.
•Be upfront but respectful with your doctor. You are partners in this, and having your doctor on your side makes it easier to transfer your medical records and coordinate care.
•Don’t shop for a specialist who will tell you what you want to hear. You need the unvarnished truth.
•Provide the second doctor with all relevant information in your medical record. Fins warns about the “discontinuity of care if all the facts don’t follow you.”
Second Opinion for Heart Valve Replacement Surgery
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Before you say yes to an operation, you should discuss the following questions with your operating surgeon:
Indications for the operation?
Risks?
How is the operation expected to improve my health or quality of life?
Are there likely to be any side effects from the operation?
Alternative forms of treatment ?
Likely fallout if I don’t have the operation?
Taking an additional opinion has always been a part of good medical practice, and a competent surgeon should not be insulted if you decide to get further second opinion before undergoing a surgical procedure. If you do want a second opinion, here are some things to remember:
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If, after discussing these questions with your surgeon, you feel confident that a surgical procedure is the best treatment for your condition, you probably don’t need a second opinion.
But if you are not so sure — you have doubts about whether the operation should be performed, or if the doctor recommending the operation is not a qualified surgeon, you may want to seek a second opinion consultation.
1. Seek Qualified Advice
A consultation is not worth much unless it is given by someone with the knowledge of and expertise in treating your condition. Always seek consultation from a surgeon who is a qualified surgical specialist. A good way to judge a surgeon’s expertise is by having a look at his /her qualifications and the hospitals where they are associated.
If you are unsure of a surgeon’s qualifications, contact your family doctor, your local or state medical society, the hospital where the surgeon practices, or the surgical department of the nearest medical school.
2. The Decision Is Yours
Remember, the final decision will be yours. It’s a decision that should be made with all the facts, so don’t hesitate to discuss with your surgeon any questions or concerns you may have.Feel free to ask all your doubts and concerns. Taking a well informed decision before embarking on a surgical journey is almost like completing 50 % of the work before actually starting the work.
Its important to know that according to a study done at John Hopkins, 33% of the patients have a change of diagnosis and surgery after a second opinion re evaluation patients symptoms.
The Ministry of Health and Family Welfare, Government of India has proposed a ‘Charter of Patient Rights’ to be implemented by state governments.
What is a ‘Charter of Patient Rights’?
A patient is entitled to a certain amount of protection to be ensured by physicians, healthcare providers, and the state, which have been codified in various societies and countries in the form of Charters of Patient’s Rights.
Legal documents on patient’s rights
In India, there are various legal provisions related to patient’s rights which are scattered across different legal documents, such as:
The Constitution of India, Article 21
Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002
The Consumer Protection Act 1986
Drugs and Cosmetic Act 1940
Clinical Establishment Act 2010 etc.
Why is there a need for this draft?
This document will act as a guidance document for the union and state governments to formulate concrete mechanisms so that the rights of the patients are given adequate protection. Also, operational mechanisms are set up to make these rights functional and enforceable by law.
Another objective of this charter is to generate widespread public awareness and educate citizens regarding what they should expect from their governments and health care providers about the kind of treatment they deserve as patients and human beings, in healthcare settings.
What is the situation of patient’s rights in India?
India does not have a dedicated regulator like other countries.
Some states have adopted the national Clinical Establishments Act 2010, while other states have enacted their own state-level legislation like the Nursing Homes Act to regulate hospitals, and a few other states are in the process of adopting/developing such regulations.
The charter defines 17 rights of a patient listed below:
1. Right to Information
Every patient has a right to adequate and relevant information about the nature, cause of illness, provisional/confirmed diagnosis, proposed investigations and management, and possible complications to be explained at their level of understanding in a language known to them
Patients and their designated caretakers also have a right to know the professional status of various care providers who are providing service to the patient.
Every patient or his caregiver has the right to access originals/copies of case papers, indoor patient records, and investigation reports (during a period of admission, preferably within 24 hours and after discharge, within 72 hours)
This should be made available after paying appropriate fees for photocopying or allowed to be photocopied by patients at their cost.
3. Right to Emergency Medical Care
As per Supreme Court, all hospitals both in the government and in the private sector are duty bound to provide basic emergency medical care, and injured persons have the right to get emergency medical care
Such care must be initiated without demanding payment/advance, and basic care should be provided to the patient irrespective of paying capacity.
4. Right to Informed Consent
Every patient has a right that informed consent must be sought prior to any potentially hazardous test/treatment (e.g. invasive investigation/surgery/chemotherapy) which carries certain risks
The doctor may proceed only if consent has been given in writing by the patient/caregiver or in the manner explained under the Drugs and Cosmetic Act Rules 2016 on informed consent.
5. Right to Confidentiality, Human dignity, and Privacy
All patients have the right to privacy, and doctors have a duty to hold information about their health conditions and treatment plans in strict confidentiality unless it is essential in specific circumstances to communicate such information in the interest of protecting other or due to public health considerations
Female patients have the right to a presence of another female person during physical examination by a male practitioner.
6. Right to Second Opinion
Every patient has the right to seek the second opinion from an appropriate clinician of patients’ or caregivers’ choice. The hospital management has a duty to respect the patient’s right to second opinion and should provide to the patient’s caregivers all necessary records and information required for seeking such opinion without any extra cost or delay
Any kind discriminatory practice adopted by the hospital or the service providers will be deemed as Human Rights’ violation.
7. Right to Transparency in Rates and Care As Per Prescribed Rates
Every patient and their caregivers have the right to information on the rates to be charged by the hospital for each type of service provided and facilities available on a prominent display board and a brochure. They have the right to receive an itemized detailed bill at the time of payment
It would be the duty of the to display key rates at a conspicuous place in local as well as the English language and to make available the detailed schedule of rates in a booklet form to all patients/caregivers.
8. Right to Non-Discrimination
Every patient has the right to receive treatment without any discrimination based on his or her illnesses or conditions, including HIV status or other health conditions, religion, caste, ethnicity, gender, age, sexual orientation, linguistic or geographical/social origins.
9. Right to Safety and Quality Care According to Standards
Patients have a right to safety and security in the hospital premises. They have the right to be provided with care in an environment having requisite cleanliness, infection control measures, and safe drinking water as per BIS/FSSAI Standards and sanitation facilities.
10. Right to Choose Alternative Treatment Options if Available
Patients and their caregivers have the right to choose between alternative treatment and management options, if these are available, after considering all aspects of the situation
This includes the option of the patient refusing care after considering all available options, with responsibility for consequences being borne by the patient and his/her caregivers.
11. Right to Choose Source for Obtaining Medicines or Tests
When any medicine is prescribed by a doctor or a hospital, the patients and their caregivers have the right to choose any registered pharmacy of their choice to purchase them
Similarly, when a particular investigation is advised by a doctor or a hospital, the patient and his caregiver have the right to obtain this investigation from any registered diagnostic centre/laboratory having qualified personnel and accredited by National Accreditation Board for Laboratories (NABL).
12. Right to Proper Referral and Transfer, which is free from perverse commercial influences
A patient has the right to continuity of care, and the right to be duly registered at the first healthcare facility where treatment has been sought, as well as at any subsequent facilities where care is sought.
13. Right to protection for patients involved in clinical trials
Every person/patient who is approached to participate in a clinical trial has the right to due protection
All clinical trials must be conducted in compliance with the protocols and good clinical practice guidelines issued by the Central Drugs Standard Control Organisation and other applicable provisions.
14. Right to Protection of Participants Involved in Biomedical and Health Research
Every patient who is taking part in biomedical research shall be referred to as a research participant and every research participant has a right to due protection
Any research involving such participants should follow the National Ethical Guidelines for Biomedical and Health Research involving human participants
15. Right to Take Discharge of Patient, or Receive Body of Deceased from Hospital
A patient has the right to take the discharge and cannot be detained in a hospital, on procedural grounds such as a dispute in payment of hospital charges
Similarly, caretakers have the right to the dead body of a patient who had been treated in a hospital and the dead body cannot be detailed on procedural grounds, including non-payment/dispute, regarding payment of hospital charges against wishes of the caretakers.
16. Right to Patient Education
Patients have the right to receive education about major facts relevant to his/her condition and healthy living practices, their rights and responsibilities, officially supported health insurance schemes relevant to the patient, relevant entitlements in case of charitable hospitals, and how to seek redressal of grievances in the language the patients understand or seek the education.
17. Right to be heard and seek redressal
Every patient and their caregivers have the right to give feedback, make comments or lodge complaints about the health care they are receiving or had received from a doctor or hospital. This includes the right to be given information and advice on how to give feedback, make comments, or make a complaint in a simple and user-friendly manner.
(Source: The Ministry of Health and Family Welfare)
