1. Patient’s Bill of Rights L. Kay Garrison, PT, DPT

2. Let’s talk AUTONOMY This principle is the basis for the PBoR Autonomy = “to make one’s own choices” As in our nation’s Declaration of Independence, patients have certain obligatory rights that we as health care providers should not violate Each patient or their appropriate representative should have should have control over their own care

3. There are 7 Rights, but unlimited interpretations We have to consider each patient’s individual circumstance Remember that each patient is entitled to EACH Right, at all times If you are unsure of how the Right applies to a patient, consult an experienced colleague, supervisor, or ethical committee

4. (These apply to you too!) So what are our Rights?

5. Number 1 People want the best health care there is A patient’s opinion can be swayed by the quality of your service or your attitude Patients can be our BEST or WORST referral source “Treat others like you want to be treated” Patients do not have to earn respect, it is their right The patient has the right to considerate and respectful care.

6. Number 2 The patient should know what is going on at all times “Because I’m the therapist and I said so” DOES NOT respect the right of your patient Patients should have access to their health records. They should know their own progress and expected outcomes. If not the patient, then the appropriate entity should be properly informed The patient has the right to obtain, from their certified provider, complete current information regarding their diagnosis, treatment, and prognosis in terms the patient can reasonably be expected to understand. When it is not advisable to give such information to the patient, the information should be made available to an appropriate person on their behalf.

7. Number 3 INFORMED CONSENT = a must; the patient should know what to expect from any treatment They should be active participants in the creation of the plan of care If the patient does not agree to one form of treatment, and alternative should be made available to them- with all of the facts provided The patient has the right to receive from their certified provider information to make informed consent prior to the start of any procedure or treatment. This shall include such information as the medically significant risks involved with any procedure and probable duration of incapacitation. Where medically appropriate, alternatives for or treatment should be explained to the patient.

8. Number 4 You can not force any patient to participate in physical therapy treatment The patient has the right to know the consequences of their refusal If a patient does refuse, be sure to document EVERYTHING The patient has the right to refuse any and all treatment to the extent permitted by the law and to be informed of any of the medical consequences of their action

9. Number 5 Expectation that any discussion or consultation involving the case will be conducted discreetly and that all communications and other records pertaining to the care, including the sources of payment for treatment, will be treated as confidential Basically, you can not discuss any part of specific patient care with anyone that is not part of the team working with that patient The patient has the right to every consideration of privacy concerning their own medical care program limited only by state statutes, rules, regulations, or imminent danger to the individuals or others

10. Number 6 We are not allowed to use patients as subjects without their knowledge and informed consent. Demographic information that is not patient specific can be used The patient has the right to be advised if the clinician, hospital, clinic, or others propose to engage in or perform human experimentation affecting their care or treatment. The patient has the right to refuse to participate in such research projects.

11. Number 7 If you are charging a patient for a service, you should be able to justify why that service was necessary and show how it was beneficial. This is why documentation is so important! A patient may not receive their bill until well after you have discharged them from therapy service The patient has the privilege to examine and receive an explanation of the bill.

12. Case studies How does this apply in practice?

13. Case 1 You are a male PTA named Sydney working in a subacute setting. Your 85 year old female patient has difficulty with toilet transfers. When you introduce yourself to her in her room, she refuses to work with a male provider in the bathroom and becomes aggressive. SCENE!!!!

14. Case 2 You are a PTA treating Miss So N. Sew for the 3 rd time. She says she is going to the doctor next week and wonders why someone else will be seeing her on her next visit. “You’re my therapist!! You’re the best!!!”, she boasts. “I thought you were my PT!??!”. SCENE!!!!

15. Case 3 Its your first day on the job in an outpatient clinic. Your PT supervisor, Martha Washington, tells you that her first patient is a referral from her husband George’s orthopedic practice. SCENE!!!!

16. Case 4 You are a PT. You realize the patient you are evaluating has severely impaired cognition due to late stage Alzheimers. His wife dropped him off to go get her nails done. You understand that it is important to put your patient first, but you realize that he can not agree to his plan of care. SCENE!!!!