Your Rights As A Patient

All patients have rights in the health care system.

Most North American hospitals include a Patient Bill of Rights or Patient Charter on their website. Some include a list of patient responsibilities alongside patient rights because it is important for patients to play an active role in their care.

Here are some examples of the rights that patients are entitled to:

• Access to care that is free from discrimination, abuse, and harm.
• Being treated with dignity and respect.
• Giving or refusing consent for any procedure or treatment–for any reason.
• Having a medical professional clearly explain their health diagnosis, prognosis, and recommended treatments in a language the patient understands.
• Knowing the names and roles of the professionals who are directly involved in their hospital care.
• Asking questions, requesting clarification, and discussing any concerns about their condition or care.
• Providing informed consent before the start of any procedure or treatment, including being told about any costs.
• Being involved in decisions about their care and having those decisions respected.
• Receiving care without delay in an emergency.

Patient Responsibilities may ask you to:

• Follow instructions for medication and other treatments and to let your care team know if you have concerns about following them.
• Let your care team or doctor know if you have any advance directives, medical power of attorney, or other legal arrangements that could affect your care.
• Follow the advice and recommendations of your care team.
• Respect care providers, hospital staff, and other patients. 
• Respect hospital rules and regulations.

 

People You Can Contact

Here is a list of helpful resources* for patients, caregivers, and substitute decision-makers to help deal with potential patient issues or concerns. They include:

• Your care team at the hospital, including social workers;
• Hospital-based Patient Care Representatives (also sometimes called Patient Advocates or the Patient Relations Department);
• Patient Ombudsman/Ombudsperson;
• Licensing and regulatory organizations for individual health professionals such as doctors, nurses, occupational therapists, etc.; and
• Other government organizations. For example, if you live in Ontario, you could file a complaint with the Information and Privacy Commissioner if your doctor refuses to give you your health records.
  • In the US specifically, you may also have the option of raising your concern through Medicare, other health insurance plans, or your State Department of Health.

*Note that these groups or organizations don’t usually become involved in issues or complaints that are part of other formal legal proceedings. 

Below is a more in-depth look at how these usually work. Again, we speak generally because specifics will vary between states, provinces, and countries.

Examples Of Patient Rights In Action

Most hospitals suggest you talk with the people in charge of your care to see if they can help resolve the problem. This could include your doctor/surgeon, the head or manager of nursing care on your floor, or the manager of a specific hospital department, such as Physiotherapy or Social Work.

Speaking with the Nurse Manager

This in action: After my eight-hour abdominal surgery, a night nurse forgot to give me my overnight pain medications on two separate shifts. This had a bad impact on my pain levels. I asked the Nurse Manager on my floor if she could assign me a different nurse to help avoid this problem again, and she did.

Hospital-based patient advocates/representatives look into and help solve patient problems. They can help you with issues you aren’t able to solve with your care team, or if you want extra help doing so. They can also help you file a formal complaint, help you understand how the hospital works, and more. You can usually phone or email them. They are also available in person during hospital business hours. Although patient advocates are usually hospital employees, they act as a neutral party, and their services are free. Many hospitals also make interpreters available for patients or caregivers.

Private health advocate agencies also exist in many cities. However, they are not included as part of hospital services and usually charge for their work. You can find them by doing a Google search for “patient advocate” or “health advocate” along with the name of the city or town where you live.

Help from Patient Relations

This in action: My father was hospitalized with sepsis during the first wave of Covid. The hospital was not allowing visitors for in-patients at that time. I contacted the hospital’s Patient Relations office to see if I could be an interpreter for my dad because he had end-stage Alzheimer’s disease and had extreme difficulty communicating. The Patient Advocate facilitated my ability to visit and help care for my father.

About Patient Ombusmen/persons

Patient ombudsmen/persons typically oversee public bodies such as hospitals and long-term care homes. Their role is to be impartial–they do not promote one side over another in a complaint. Once they investigate an issue, they make recommendations for change and promote the implementation of their recommendations. In Ontario, Canada, for example, the Patient Ombudsman oversees the province’s public hospitals, long-term care homes, and home and community care coordination. They allow patients to make a formal written complaint about these care providers if it has been brought to the organization’s attention and has not been resolved to the complainant’s satisfaction. 

This in action: While I don’t have a personal anecdote, you can view case studies from the Health Complaints Commissioner in Victoria, Australia. See the end of this article for a link.

Formal Complaint About a Health Professional

Many health professionals, such as medical doctors, nurses, physiotherapists, social workers, speech-language pathologists, pharmacists, and others are licensed and regulated by “Colleges” in Canada (these are not schools), or “Boards/Authorities” in the US. Other countries have oversight bodies that regulate groups of professionals under a single banner.

What does it mean when a health professional is regulated? For someone to practice a specific profession, the professional must be registered with the regulatory body for their health profession in that province, state, or country. This ensures they meet that profession’s basic entry-to-practice requirements, follow established practice standards, guidelines, and ethics, and remain current in practice. These organizations also have formal processes to investigate and respond to complaints about the conduct or behaviour of the health professionals they regulate.

Here are some examples of health profession regulators in the US, Canada, and the UK:

• Medical Board of California (physicians, surgeons, and some allied health professionals)
• Arizona State Board of Physical Therapy (physiotherapists)
• College of Occupational Therapists of Ontario (occupational therapists)
• College of Pharmacists of British Columbia (pharmacists, pharmacy technicians, and pharmacies)
• The Health and Care Professions Council regulates 15 health and care professions in the UK, from dieticians to paramedics and podiatrists.

Anyone who has concerns about the actions or behaviour of a regulated health professional can make a formal complaint to the regulatory organization for that profession. The organization must respond to your complaint. The investigation of complaints follows a specific, formal process that is often set in law and can be similar to the process used in a legal investigation. 

Most of the organizations that regulate health professionals also must have a free public directory or register. This is where anyone can look up the name of the health professional and find out their education, registration history, and whether there have been any disciplinary findings against them. 

To find who to contact in your area, you can try using a search engine like Google and typing “who regulates [health profession] in [your city/region]”. Note, however, that not all health providers are regulated. It varies by geographic location around the world.

This in action: Several years ago I went to an IV clinic run by a naturopath. This clinic infused vitamins and other supplements intravenously to support people’s health and well-being. I ended up with an infection at the IV site, then developed deep vein thrombosis just above the infection. I sent a written complaint to the naturopath’s regulator because I believed the clinic did not follow the correct infection control protocols. While I did not get the resolution I hoped for, my letter did contribute to improved patient protection requirements and standards for these kinds of clinics.

Many of us were raised not to complain. Patients, families, and caregivers worry that raising an issue or making a complaint will impact the patient’s care. While most hospitals and other organizations work hard to make sure that doesn’t happen, there is, unfortunately, no guarantee. However, in general, bringing the issue to someone’s attention helps the hospital or health professional to improve. This ultimately leads to better care overall.

In Closing

We hope this post has made you aware that most hospitals recognize your rights as a patient. Remember that there are resources to support you when you have concerns about your care or where it was received. Feel free to add a comment if you have a tip or experience you would like to share.

End note: The ways hospitals are structured and how health professionals are regulated vary widely from country to country. This post focuses mostly on Canada since that’s where we are based. However, many of these resources are also available in the US and other countries. (A reminder that this blog doesn’t discuss finances because insurance and health plans are also different depending on where you live.)

Resources:

Link to the Health Complaints Commissioner (Victoria, Australia) for examples of real complaints they have resolved.

More Resources

Be sure to check out more surgery information and resources to support you in the hospital, and during your recovery.