I am a neurologist treating disorders of brain, spinal cord and nerves. I like educating public and doctors about various aspects of neurological illnesses. This blog is an attempt towards the same. I work at Apollo Hospitals, (Jubilee Hills and Kukatpally branches), Hyderabad (phone-0091-40-23607777/60601066/9618204512; firstname.lastname@example.org)
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Tuesday, July 5, 2011
RIGHTS OF A PATIENT IN A DOCTOR-PATIENT RELATIONSHIP
What are the rights of a patient, in a doctor-patient relationship?
The relationship of a patient and doctor is a very special one and is different from any other professional relationship. The patient shares a lot of personal and private details with the doctor, which at many times are not even known to close family members or relatives. The doctor is one of the most important persons in a patients’ life, as the doctor is responsible for the patients’ good health (contributing to an increased productivity at work and greater happiness in family life).
There is a need to maintain a healthy and cordial patient-doctor relationship, keeping in view the importance of this relationship. Both the patient and doctor have certain rights and responsibilities towards the success of patient-doctor relationship. In this blog, I shall focus on the rights of a patient.
1. Right to get listened to by the doctor
It may seem very basic, but several patients are not allowed to tell their complaints to the doctor. Several senior doctors spend hardly 3-4 minutes per patient, and give a prescription containing 7-10 medications to the patient! History (description of illness as given by the patient to doctor) is the most important step towards arriving at a correct diagnosis; and a patient has the right to insist that a proper history be taken. Today, several doctors over-rely on investigations (such as blood tests, X-rays, CT scan, echocardiogram, etc) to make a diagnosis (ignoring history and clinical examination of the patient). Over-reliance on investigations can lead to an error in diagnosis. For ex- epilepsy can be diagnosed only by a good history, as CT scan and EEG may be normal in true cases of epilepsy. On the other hand, 5% of normal people may have abnormal EEG.
2. Right to receive information about the illness:
Patient can ask anything about the illness to the doctor (such as why did it occur, can it spread to other family members, how long will it take to improve, any likely complications of the illness, can it recur, etc). A good doctor has enough time to answer all the illness-related queries.
3. Right to know all the possible treatment options:
A single disease may have more than one treatment options. There may be more than one medication effective for the same illness. For ex- there are several medications effective for epilepsy. The doctor selects the best anti-epileptic medication depending upon the type of epilepsy; age & sex of the patient; expected drug-related adverse events and cost. The patient has a right to understand why one medication was preferred over another. In diseases requiring surgery, patient has the right to understand different surgical options available and why a certain surgical procedure is preferred over another.
4. Right to know possible treatment-related adverse events:
Many medications may cause adverse effects, which can range from simple nausea/vomiting to liver & kidney damage. A patient has a right to know about all the possible harmful effects of the drug from the doctor. A good doctor would patiently explain them to the patient. Similarly, in patients undergoing surgery, all the possible complications of the surgery will be discussed by the surgeon with the patient.
5. Right to refuse any investigation or treatment:
A patient has the right to accept or refuse any investigation or treatment offered by the doctor. A doctor can only advise, and not force a patient to undergo an investigation or procedure. An informed consent from the patient is mandatory prior to an investigation or procedure.
6. Right to take second opinion:
The doctor’s opinion regarding the treatment is not binding on the patient and a patient can opt for a second opinion before accepting the treatment. The patient can take the second opinion from a doctor suggested by the treating doctor or any other doctor of his or her choice.
7. Right for a referral:
If the treating doctor is not competent in handing the disease, the patient has a right to be referred to another doctor who is a specialist in treating the condition. For ex- if the patient has suffered from an ischemic brain stroke (causing paralysis) and the concerned doctor is not competent in thrombolysis (clot-buster therapy), the patient can ask for referral to a stroke neurologist.
8. Right to know about any modifications in lifestyle, diet or job:
Treatment of a disease involves modification in diet, lifestyle and job. For ex- patients with kidney failure or very high blood pressure should take a low salt diet, patients with recent heart attack should avoid oily/fatty food, patients with epilepsy should avoid driving/swimming, etc. Patients have a right to know these details.
9. Right of confidentiality/privacy:
Patients details (personal or medical) can not be disclosed by the doctor to anyone else including close friends or relatives of the patient without patients’ consent.