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Your Medical Rights: How to Become an Empowered Consumer.

The public is suffering from exploitation, especially in the treatment of medical problems. Aligned against patients are some doctors who are deceptive about their reasons for unnecessary tests and hospitals that price aspirins like diamonds.

If patients were aware of their medical legal rights, would there be less deception and exploitation by hospitals and physicians? The authors of this important volume are convinced that the victim's vulnerability encourages the pillaging.

In Palm Beach County, Florida, a woman entered a hospital for some tests that resulted in a minor procedure being performed. When it came time for her to be discharged, the hospital accounting office demanded payment for the services not covered by insurance. The amount owed for these services was quite small, for items like a television set and phone calls. The patient asked to be billed and said she would gladly send a check. That was not possible, replied the clerk; hospital policy demanded that patients pay when leaving or they could not be discharged.

The woman's husband stood by, listening in disbelief to the outrageous demands of the clerk. Calmly, he walked over the pay phone and called the county sheriff. He told the sheriff that his wife was being held for ransom, which is illegal in every state. A few minutes later, a sheriff's deputy arrived at the hospital with handcuffs. He warned the hospital administrator to either release the woman or face arrest. She was released.

"Medical consumers - all of us - are constantly intimidated by doctors, hospitals, insurers, and just about everyone else in the health professions," Inlander and Pavalon write. "The intimidation paralyzes us to such a degree that we either forget or are afraid to exercise our rights. Mistreatment and disrespect that we would not tolerate from any other service provider are often the rule."

The practice of medicine, the authors complain, has remained American's last unregulated fortress that withstands forces of consumer protectionism. Laws have been passed to protect people against shoddy service and bad products, not so against everyday medical services.

Disclosure is the heart of consumer protectionism. Banks issuing mortgages must now inform the borrower in writing of the interest rates, the payment amounts, and all fees associated with the loan and all other complex information. Not so with medicine, the book charges. Doctors are required to warn the patient of a medication's side effects, the cost of their services, and the possible outcome of the procedures. But there is no law that they do so without the patient asking.

The book is filled with revelations, the patient's legal rights and a reminder of the medical profession's fallibility. The authors also direct their displeasure at medical lobbying groups like the American Medical Association and American Hospital Association that have developed an almost unassailable power base. "By publishing journals, supporting scientific studies, and developing massive public relations mechanisms, they have created a mystique about health and medicine ... that implies that those who practice or provide medical care are somehow anointed with superior intelligence," the writers say.

Much of the book concerns itself with misdiagnosis and how patients' legal rights are overlooked. The matter of medical records and the ownership of them requires wider scrutiny. Too many valid complaints are locked away and denied patients who should have access and possession of these documents.

That the profession harbors and protects inept doctors is no secret. A Harvard University study of 500 doctors and 504 medical students revealed that 59 percent of the doctors and 78 percent of the students had used recreational drugs, making them often unfit to perform their duties. Seldom are these facts revealed to the public.

The book is abundant with devastating facts about hospital overcharges (98.1 percent of hospital bills of $10,000 or more contain errors, 73 percent in the hospital's favor). The average hospital makes up to 60 medication errors an hour, including giving the patients the wrong medicine, the wrong dosage, or the right medications at the inappropriate time.

How many patients' rights are violated forms the basis of the book's helpfulness in broadening public information. The case of Harry Peters emphasizes a common fault of early discharge practice. After his intestine was resectioned, the hospital authorities wanted to discharge Mr. Peters on the seventh day. Harry, an elderly man, didn't feel that it was safe for him to leave (he lived alone with no one to take care of him). The hospital staff knew this, but they persisted, trying to persuade him to leave. The insurance company also refused to pay for even one more day in the hospital. Harry went home, fainted, fractured his hip, and was readmitted to the hospital.

Subsequently, he filed a successful lawsuit against the hospital because the hospital had no right to put him at risk by premature discharge. In effect, they used the insurance company's refusal to pay to blackmail the patient into leaving.

The book features an extensive list of agencies and public service groups that can be consulted in determining whether a patient's rights have been abused.
COPYRIGHT 1992 Vegetus Publications
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1992 Gale, Cengage Learning. All rights reserved.

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Publication:Nutrition Health Review
Article Type:Book Review
Date:Mar 22, 1992
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