“Do no harm” may have been a standard in medicine at one time, but our modern healthcare environment is geared toward maximum profits with less emphasis on quality patient care. More and more doctors are employees instead of entrepreneurs in today’s healthcare market and to get maximum reimbursement on services rendered, they are allowing insurance agencies dictate the model of care. As a result, patients are getting substandard care and doctors are leaving the field and taking up other occupations.
As patients, we tend to forget we are paying for a service. We are consumers of healthcare services but we are treated more like the enemy than the customer. In order to advocate for patients in the past, I have likened healthcare to auto mechanic service. If you put your car in the garage and the mechanic fails to fix the car do you just say “okay”, pay him and accept your broken car? If the receptionist at the auto mechanic’s office fails to communicate that your car was ready on Friday but it’s now the following Tuesday do you say, “okay?” or do you complain about the hardship their incompetence caused you? That may seem silly but it is the same for your body which is priceless compared to a car. So, why do we accept this as the way things are in healthcare and just go on? I would suggest that we are part of the problem.
The chronically ill accept sub-standard service in healthcare because of fear. We need healthcare which makes us a vulnerable group. As sick as we are with RA and all it’s ugly step-sister diseases we are afraid if we complain the doctor will dismiss us as patients, the medical staff will drag their feet even more, and we will be labeled as a difficult patient which can get us blackballed as a potential patient for a alternate physician/group. We fear these things with good cause because they happen but not as frequently as you might think. It is not too much to ask that the standard of care be met. We shouldn’t have to be frustrated, afraid, and voiceless. There are steps we can take that do not involve filing a law suit to make a difference when we encounter problems in today’s healthcare environment:
- Understand your patient rights. As the patient, you should always be treated with respect. Good customer service practices should not be lacking in healthcare nor should you be discriminated against based upon your sex, race, or financial status. Many times these rights are presented to us at the point of new service for healthcare but we blindly sign where instructed without reading or knowing our rights as patients.
- When a grievance arises, register a complaint with the appropriate manager of the medical office, hospital, or treatment center. These days, physicians rarely own their own practices. That means the physician along with the medical staff are employees of the medical facility. For example, clinics generally allow 15 minutes per patient in the office. If you spend that time complaining about the billing clerk then you have misused your time with the physician who in most cases can do nothing about your bill.
- Consider firing your physician if you are unhappy with his/her services, have fractured trust, or a personality conflict. You have the right to fire your physician. My advice would be to seek and obtain another healthcare provider before firing your existing one to prevent a lapse in prescriptions and to make a smooth transition. You may hear that doctors can “fire” patients, but what that really means is they can refuse care. Refusal of care should never be a threat as that involves manipulating the patient/doctor relationship which is unethical.
- File a rating with healthgrades.com and/or vitals.com which are two of the most widely used physician rating and review sites on the internet. You may not receive resolution to your issue but you may help a potential patient steer clear of the trouble you experienced. Physician practices look at these sites. They do not want poor scores because it has a direct impact on their ability to attract new patients. On a positive note, if you have a doctor that rocks then give them a good score on these rating sites.
- Register a complaint with your state licensing board for grievous misconduct. A simple online search will provide you with the licensure board information for your state. This type of complaint goes for doctors, nurses and other healthcare providers who carry a professional license. Complaints are investigated and should the license holder be in violation of negligence, unethical behavior, or a host of other violations of condition of licensure their license may be revoked, suspended, or tagged for disciplinary action all of which can include a hefty fine and/or education courses to correct the deficiency if warranted. When disciplinary action is filed against a physician the mandatory medical malpractice insurance premium is sure to increase significantly for that practitioner if they are continued to allow to practice. If the violation of the license violates state law, criminal charges may also be levied by the State District Attorney.
- File a complaint with Medicare at medicare.gov if you are a Medicare recipient and feel your rights have been violated. The Centers for Medicare and Medicaid take complaints very seriously. Medical providers do not want to loose their Medicare contracts! For example, complaints can be filed online with Medicare about:
- improper care or unsafe conditions
- hospital conditions
- your doctor
- drug errors
- unnecessary or inappropriate surgery or treatment
- not getting treatment after your condition changed
- incomplete discharge instructions and/or arrangements
- Write your legislature. As healthcare is being shaped by our government, we need to have an active voice in this arena. Contacting your elected officials about your unique experience with the healthcare system makes you a person, not a number and can help them as they shape law that applies to medical licensure, healthcare insurance, standards of care, and patient rights.
Sometimes healthcare professionals make mistakes that can impact our lives adversely. When should you consider a case for malpractice? When the substandard conduct of a physician results in injury that is a breach of reasonable care. As an example, there are two women who have autoimmune disease in my circle of friends, that have received substandard care. Each have given me permission to give a synopsis of what happened to them for purposes of giving an example of what may be deemed medical negligence.
- Case 1: After a cat bite to the finger, medical care was sought for a resulting infection and inflammation. The bite was not treated with the autoimmune condition in mind and the inflammatory response advanced to the point surgery was required to straighten the finger. A external fixation device was applied to the finger which the patient had to have adjusted at regular intervals. Again, autoimmune disease was not taken into consideration although the patient’s specialists for said disease was consulted. The fixation device attached to the bone drove infection into bone which resulted in several surgeries to clean out, replace the joint, then remove the replacement. Ultimately the patient had to undergo a amputation of the finger.
- Case 2: Patient sought treatment with a pain management doctor who performed radio frequency ablation in two procedures to the nerves in the back as a treatment for RA/OA pain in the spine. Following the second procedure the patient had increased pain beyond the time period of healing. On follow up she was not allowed to see the physician who performed the procedure and was directed to a Nurse Practitioner who failed to perform an examination but instead ordered a drug screen, issued a lecture about pain management, dependency, and suggested counseling when none of these applied to this case. Seven weeks post procedure, the patient went to her orthopedic office and a x-ray of the spine revealed a severe compound fracture about 7 weeks old approximate to the area radio frequency ablation procedures had been performed. During the time the fracture was untreated, a piece of the broken spine migrated toward the spinal cord rendering stabilization with medical cement inappropriate. Twelve weeks post procedure, the patient is in a back brace and the fracture has not healed. The outcome is uncertain.
Although physicians violated the standard of care due these women, to date they have chose not to file a malpractice suit against their healthcare providers. Both have moved on from the physicians who caused them harm and they have shared their stories in support groups on social media and urge others to advocate for themselves in today’s healthcare system. As you can see these cases go beyond that of a disgruntled patient. Each woman has received a permanent injury due to a breach of the standard of care being met. (The standard of care is the treatment that other physicians of equal training would deliver in the same circumstance.)
If we just sit back quietly and accept that sub-standard service is the way of things nothing will ever change. Somewhere along the way, “do no harm” was pushed aside and a patient focused approach was lost. We stopped becoming the customer along the way. Collectively we can take a stand. This kind of healthcare reform starts with us and what we are willing to accept as appropriate treatment from our medical providers.