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WHAT A PATIENT HAS A RIGHT TO EXPECT FROM HIS DOCTOR

We believe single payer national health insurance is a floor, not a ceiling. While we are struggling to ensure all of us have access to health care we also each need to work to ensure our physician is our advocate in the current health system.

If there is a conflict between your medical needs and your insurance, your doctor should be expected to be on your side. If your doctor does not agree with this point of view, it is far better for you to find out before you are in the midst of a health crisis and you are dependent on the doctor. We suggest the following as points the two of you should discuss:

  • Diagnosis - The physician should be able to order any diagnostic tests he/she deems necessary whether coverage exists or not.

  • Test results - The physician should personally notify you of the results of significant lab tests in a timely and confidential manner and discuss their significance with you. No mail notifications should be used unless you request it, and no postcard notifications, which would automatically breach confidentiality, should be used in any case.

  • Prescriptions - The physician should prescribe any medications that are required to treat your condition, prescribing specific brand-name drugs if these are known to be superior to generic drugs, or generic drugs if these are equivalent to the more expensive drugs, and should also recommend non-prescription (over-the-counter) medications whenever these are useful. The type of drugs prescribed should be determined by your best interests, not by the financial policies of an insurance company.

  • Therapy - The physician should advise or order any therapy that will help you, including but not limited to physical or occupational therapy, psychological counseling, and drug or alcohol rehabilitation, independent of consideration of what your insurance will pay for these treatments.

  • Treatment options - In case of a medical problem in which several lines of treatment are in the range of accepted medical practice, the physician should ensure that you understand the risks and the consequences of each before you decide on what you will do. The physician may recommend the approach he/she thinks is best, but should also recognize that the possibilities of medical science and your needs and desires are the ones that should determine the choices to be made, not the limits set by medical insurance or by the physician's sole opinion.

  • Hospitalization - If your condition requires hospitalization, the physician should be prepared to advise hospitalization regardless of your insurance coverage. If you have been hospitalized you should not be released until you are actually sufficiently recovered to leave regardless of your insurance coverage. If hospice, nursing home, or home care treatment would be appropriate to your condition, it should be recommended without reference to your insurance coverage.

  • Referrals - If you need the services of doctors or institutions outside the sphere of your insurance coverage, your physician should be able to refer you to them.

  • Confidentiality - If in the course of the doctor-patient relationship, you give the physician information which both parties understand could be used to harm you, this information should be kept out of your medical charts and insurance reports, except of course for cases in which the law requires reporting it.

  • Interference with medical judgement - If hospital administrators, insurance company representatives, government or police officials, or any other persons attempt to affect or influence medical judgement in your case for financial or political reasons, the physician should inform you of the attempt and record the incident in your medical records.

  • Terminal illness - If you develop a terminal illness, your physician should keep you honestly informed of your condition and prescribe medication adequate to alleviate your suffering as needed.

If you use this list as a starting point for discussions with your doctor, we would like to hear your comments. You can e-mail MichUHCAN (almyatt@flash.net) or write 8846 Robindale, Detroit, MI 48239.

This document is copyrighted by MichUHCAN (Michigan Universal Health Care Access Network) 1997. It may be freely copied or distributed by any news or non-profit organization and by any individual so long as no fee is charged for the content and this notice is included.


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This page posted July 27, 1997

Layout revised Sept. 30, 1997

Last revised January 31, 1998