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Sicko US Health Care System Revealed in New Patient Rights Survey

Patient rights are under siege, as evidenced in a recent survey conducted by the National Institute for Patient Rights (NIPR). NIPR staff compiled the results based on responses from one-thousand randomly selected, former hospital patients who took part in the study. The results of the survey show that, despite billions spent on advances in medical technology, patients daily experience an erosion of their rights at the hospital bedside.







Among those responding to essay questions, the following was a typical scenario. A hospital admits a loved one with complications (a medical euphemism for we really don'st know all that'ss going on here, but there are several organs involved). While the loved one rests stable in bed, a line of doctors and nurses seems to form at the door. One after another, doctors enter the room, make a few comments, then turn around and exit. Primary care physicians refer patients to specialists who rely on subspecialists. It seems like each separate organ has its own special doctor.



In the health care industry, this is commonly referred to as component management. It suffers from two shortcomings: (1) specialists and subspecialists tend to segregate organ systems at the expense of the whole patient; and (2) it is inefficient, because it inevitably leads to episodic intervention where if something happens, you see one specialist for a particular organ system; if something else happens, you see another specialist or subspecialist, and so on.



Episodic intervention leads to uncoordinated care that lacks continuity for the patient and for the patient'ss family. Many individual decisions in patient treatment by numerous specialists and subspecialists entail a fragmented delivery system. According to the findings of the NIPR study, this leads to the number one problem in contemporary healthcare delivery: a failure to communicate.



The Top Ten Most Violated Patient Rights:

This failure to communicate is responsible for the #1 spot on the top ten list of violations of patient rights. A full 63% of participants felt that healthcare providers most often violated their right to informed consent. When prompted to explain, many complained about the inadequacy of multiple diagnoses coming from multiple providers. Without a single, complete diagnosis, respondents felt unable to make an informed choice about appropriate treatment options.



The #2 most violated of patient rights was a lack of respect for personal, spiritual, and religious values and beliefs. Participants observed that doctors often failed to acknowledge the unique nature of personal lifestyles in their presentation of treatment options.



A failure to communicate was also the cause of the #3 violation of patient rights, a lack of respect for advance directives. Participants complained about the way in which advance directives are handled by hospitals.



Miscommunication was the cause of violation #4. Despite HIPAA, many participants observed that providers often showed no regard for the privacy and confidentiality of their personal health information. Cell phones were often cited as the main culprit.



Conflicts Abound:

Conflict between team and patient/advocate was the cause of #5 on The List. Patients and their advocates have a right to know realistic care alternatives when hospital care is no longer appropriate. Many respondents complained about how they were made to feel when they disagreed with providers about the continued appropriateness of hospital care.



Conflict was also the cause of violations #6 and #7, violations of a right to know hospital rules on charges and payment methods, and a right to review the hospital bill, have information explained, and get a copy of the bill.



Under violation #8, some participants complained about their inability to identify hospital personnel who could help in resolving discrepancies over billing issues or in disagreement between team and patient/advocate over treatment.



Medical Mistakes and Records:

Although listed at #9, the violation of a patient/advocate'ss right to know the identity and professional status of those who care for the patient contained some of the most poignant responses in survey results.



Quite a number of participants claimed to have suffered significant harm as a result of medical error. They averred if they had had ready access to information about the identity and professional status of their providers, they would have had second thoughts about consenting to treatment.



Coming in at a close #10 was the violation of a right to review medical records and receive an accounting of disclosures regarding health information.



Conclusion:

Despite billions spent on advanced medical technologies such as drugs and devices, patients daily experience an erosion of their most fundamental rights. The rights of patient self-determination and informed consent suffer the most.



Lack of coordination causes anger and frustration among hospital patients and their families by the breakdown in communications. A failure to communicate may not just cause anger and frustration but also unnecessary conflict. Conflict is costly! Finally, miscommunication causes harm when patients suffer underuse, overuse, or misuse as a result of medical error.

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