Patient

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Patients Bill of Rights

• L. Kay Garrison, PT, DPT

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Lets talk AUTONOMY

• This principle is the basis for the PBoR
• Autonomy to make ones own choices
• As in our nations Declaration of Independence,
  patients have certain obligatory rights that we
  as health care providers should not violate
• Each patient or their appropriate representative
  should have should have control over their own
  care

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There are 7 Rights, but unlimited interpretations

• We have to consider each patients individual
  circumstance
• Remember that each patient is entitled to EACH
  Right, at all times
• If you are unsure of how the Right applies to a
  patient, consult an experienced colleague,
  supervisor, or ethical committee

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So what are our Rights?

• (These apply to you too!)

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Number 1

• People want the best health care there is
• A patients opinion can be swayed by the quality
  of your service or your attitude
• Patients can be our BEST or WORST referral source
• Treat others like you want to be treated
• Patients do not have to earn respect, it is their
  right

• The patient has the right to considerate and
  respectful care.

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Number 2

• The patient should know what is going on at all
  times
• Because Im the therapist and I said so DOES
  NOT respect the right of your patient
• Patients should have access to their health
  records. They should know their own progress and
  expected outcomes.
• If not the patient, then the appropriate entity
  should be properly informed

• The patient has the right to obtain, from their
  certified provider, complete current information
  regarding their diagnosis, treatment, and
  prognosis in terms the patient can reasonably be
  expected to understand. When it is not advisable
  to give such information to the patient, the
  information should be made available to an
  appropriate person on their behalf.

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Number 3

• INFORMED CONSENT a must the patient should
  know what to expect from any treatment
• They should be active participants in the
  creation of the plan of care
• If the patient does not agree to one form of
  treatment, and alternative should be made
  available to them- with all of the facts provided

• The patient has the right to receive from their
  certified provider information to make informed
  consent prior to the start of any procedure or
  treatment. This shall include such information
  as the medically significant risks involved with
  any procedure and probable duration of
  incapacitation. Where medically appropriate,
  alternatives for or treatment should be explained
  to the patient.

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Number 4

• You can not force any patient to participate in
  physical therapy treatment
• The patient has the right to know the
  consequences of their refusal
• If a patient does refuse, be sure to document
  EVERYTHING

• The patient has the right to refuse any and all
  treatment to the extent permitted by the law and
  to be informed of any of the medical consequences
  of their action

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Number 5

• Expectation that any discussion or consultation
  involving the case will be conducted discreetly
  and that all communications and other records
  pertaining to the care, including the sources of
  payment for treatment, will be treated as
  confidential
• Basically, you can not discuss any part of
  specific patient care with anyone that is not
  part of the team working with that patient

• The patient has the right to every consideration
  of privacy concerning their own medical care
  program limited only by state statutes, rules,
  regulations, or imminent danger to the
  individuals or others

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Number 6

• We are not allowed to use patients as subjects
  without their knowledge and informed consent.
• Demographic information that is not patient
  specific can be used

• The patient has the right to be advised if the
  clinician, hospital, clinic, or others propose to
  engage in or perform human experimentation
  affecting their care or treatment. The patient
  has the right to refuse to participate in such
  research projects.

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Number 7

• If you are charging a patient for a service, you
  should be able to justify why that service was
  necessary and show how it was beneficial.
• This is why documentation is so important!
• A patient may not receive their bill until well
  after you have discharged them from therapy
  service

• The patient has the privilege to examine and
  receive an explanation of the bill.

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How does this apply in practice?

• Case studies

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Case 1

• You are a male PTA named Sydney working in a
  subacute setting. Your 85 year old female
  patient has difficulty with toilet transfers.
  When you introduce yourself to her in her room,
  she refuses to work with a male provider in the
  bathroom and becomes aggressive. SCENE!!!!

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Case 2

• You are a PTA treating Miss So N. Sew for the 3rd
  time. She says she is going to the doctor next
  week and wonders why someone else will be seeing
  her on her next visit. Youre my therapist!!
  Youre the best!!!, she boasts. I thought you
  were my PT!??!. SCENE!!!!

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Case 3

• Its your first day on the job in an outpatient
  clinic. Your PT supervisor, Martha Washington,
  tells you that her first patient is a referral
  from her husband Georges orthopedic practice.
  SCENE!!!!

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Case 4

• You are a PT. You realize the patient you are
  evaluating has severely impaired cognition due to
  late stage Alzheimers. His wife dropped him off
  to go get her nails done. You understand that it
  is important to put your patient first, but you
  realize that he can not agree to his plan of
  care. SCENE!!!!