Patient Rights & Responsibilities

Purpose: To promote the patient’s right to be informed of, and participate in, the medical care received. To educate patients, in a spirit of mutual trust and respect, as to their responsibilities regarding their care.

Pavilion Family Medicine has adopted the following statement, which shall include but not be limited to, the patient’s right to:

1. Become informed of their rights as a patient in advance of, or when discontinuing, the provision of care. The Patient may appoint a representative to receive this information should they so desire.
2. Exercise these rights without regard to sex, cultural, economic, educational, or religious background or the source of payment for care.
3. Considerate and respectful care, provided in a safe environment, free from all forms of abuse or harassment.
4. Knowledge of the name of the physician/health care provider who has primary responsibility for coordinating their care and the names and professional relationships of other physicians and healthcare providers who will see them.
5. Receive as much information about any proposed treatment or procedure as they may need in order to give informed consent or to refuse the course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved in the treatment, alternate course of treatment or non-treatment and the risks involved in each and to know the name of the person who will carry out the procedure of treatment.
6. Participate in the development and implementation of his or her plan of care and actively participate in decision regarding their medical care. To the extent permitted by law, this includes the right to request and/or refuse treatment.
7. Formulate advance directives regarding their healthcare, and have medical staff and Practitioners, who provide care in the Practice, comply with these directives (to the extent provided by state and federal laws and regulations).
8. Have a family member or representative of his or her choice be notified promptly of his or her admission to the hospital.
9. Full consideration of privacy concerning their medical care program. Case discussion, consultation, examination and treatment are confidential and should be conducted discretely. The patient has the right to be advised as to the reason or the presence of any individual involved in their health care.
10. Confidential treatment of all communication and records pertaining to their care. Their written permission will be obtained before their medical records can be made available to anyone not directly concerned with their care, billing or healthcare operations.
11. Access information contained in their medical record within 2 business days their request, unless request is for copies of medical records which will be 7 business days.
12. Reasonable responses to any reasonable request they may make for service.
13. Leave the Practice location even against the advice of their physician/health care provider.
14. Reasonable continuity of care.
15. Be advised of the Practice’s grievance process, should they wish to communicate a concern regarding the quality of the care they received, or they feel determined discharge data is premature. Notification of the grievance process includes: whom to contact to file a grievance, and that they will be provided with a written notice of the grievance determination that contains the name of the Practice contact person, the steps taken on their behalf to investigate the grievance, the results of the grievance and the grievance completion date.
16. Be advised if a physician/health care provider proposed 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.
17. Be informed by their physician/health care provider or a delegate of their physician/health care provider of the continuing healthcare requirements following their discharge from the hospital.
18. Examine and receive an explanation of their bill regardless of source of payment.
19. Know which Practice rules and policies apply to their conduct while a patient.
20. Have all patient’s rights apply to the person who may have the legal responsibility to make decisions regarding medical care on behalf of the patient.

As the care a patient receives depends partially on the patient themselves, a patient has certain responsibilities as well. They are as follows:

1. The patient has the responsibility to provide accurate and complete information concerning their present complaints, past illnesses, hospitalizations, medication, and other matters relating to their health.
2. The patient is responsible for reporting perceived risks in their care and unexpected changes in their condition to their responsible physician/health care provider.
3. The patient and family are responsible for asking questions when they do not understand what they have been told about the patient care or what they are expected to do.
4. The patient is responsible for following the treatment plan established by their physician/health care provider, including the instruction of nurses and other health professionals as they carry out the physician’s orders. The patient is responsible for keeping appointments and for notifying the Practice, or physician/health care provider when they are unable to do so.
5. The patient is responsible for their actions should they refuse treatment or not follow their physician/health care provider orders.
6. The patient is responsible for assuring that the financial obligations of their appointment at the Practice are fulfilled as promptly as possible.
7. The patient is responsible for following all Practice policies and procedures.
8. The patient is responsible for being considerate of the rights of other patients and Practice personnel.
9. The patient is responsible for being respectful of the physician/health care provider’s personal property and that of other persons in the Practice.

Please review to ensure the details are correct before completion.