A patient's code of conduct

Treatment is usually placed at the doctor's door, but there is a manual of dos and don'ts for patients. Working on this code will improve your well-being, finds Sunday MiD DAY

Last week, services for patients at Mumbai's largest public hospital, the KEM Hospital in Parel, were affected after doctors went on strike following an assault on their colleagues by a deceased patient's relatives. This 1,800-bed hospital treats 5,000 out-patients/day and 250 in-patients/day and provides both basic care and advanced treatment facilities in all fields of medicine and surgery, either free or at nominal cost, mostly to the underprivileged sections of society.u00a0

The efficient and smooth functioning of such a complex organisation requires that the three main players, namely, the hospital, the doctors and the patients, work together with each playing their role and fulfilling their responsibility.

The perceptions and expectations of patients need to be aligned with what the doctors, medical staff and hospital can realistically offer. It is important that these services, facilities, treatment, and applicable rules and regulations are explicitly stated rather than assumed to be understood by those who come to the hospital for treatment. Once these are stated, it also becomes easier for the hospital to receive constructive feedback and suggestions on the same.

A] Patient's Code of Conduct
Patients are responsible for their own personal and environmental well-being. The following code of conduct emphasises the responsibilities of a patient while seeking medical care.

As a patient:
>>You should provide the doctor with accurate and complete information about your medical history, past illnesses, allergies, hospitalisations, and medications
>>You should report changes in your medical condition
>>You should ask for clarity if the doctor's prescription and diagnosis seem unclear
>>You should follow the doctor's treatment plan
>>You should pay your medical bills promptly
>>You should follow hospital rules and regulations
>>You should have realistic expectations of what the doctor can do for you
>>You should help your doctor help you; if something isn't working, be clear and the doctor can advise alternative care
>>You should participate actively in your own medical care (in terms of awareness and preventions)
>>You should treat the doctors with respect
>>You should not ask doctors for false bills or certificates

B] Patient's Bill of Rights
This lists the basic rights that any patient has with respect to his / her own treatment, with respect to the hospital, and in relation to information to be made available. By publicly displaying such a list of rights, the hospital and doctors display their commitment towards the health and well-being of the patients who come there for treatment, and help to build and re-affirm the patient's trust and faith in the doctor and in the medical system.

Each medical facility should display the following Patient's Bill of Rights.u00a0

A] Rights of a Patient related to the treatment
>>To be treated with dignity
>>To obtain from the doctor complete information concerning the diagnosis, treatment, and
prognosis in a language the patient can understand
>>To receive necessary information from the doctor such as long-term effects, side effects etc., before giving any prior consent to a medical procedure and/or treatment
>>To know and understand the hospital procedures involved
>>To be informed about how much time the treatment will takeu00a0
>>To be informed about what the expected overall cost of treatment will be
>>To be informed about the necessary documentation
>>To receive prompt and courteous care
>>To be given, at the time of discharge, all details of the disease, treatment, and the needed follow-up
>>To refuse the suggested treatment and be informed of the medical consequences thereof

B] Rights of a Patient related to the Hospital
>>To have a list of exact services available and corresponding fees (in multiple languages)
>>To have a layout of the hospital (in multiple languages)
>>To have a list of emergency services. (e.g. blood banks and ambulatory services)
>>To have the contact information of the responsible person to register a complaint or give feedback
>>To have access to medical counsellors, donors, volunteers, NGOs or support groups
>>To educational information about medical problems e.g. via a library, counsellor, etc.

Conclusion
The number of patients using the public health system in India is far in excess of the capacity of the system, and hence a number of problems are being faced. The immediate step taken usually is to increase capacity (e.g. from a 100-bed to a 200-bed hospital) to overcome the problems. However, the problems cannot get solved by simply increasing the numbers; rather the situation gets worse, as the same problems are now increased, and become more complex.

Hence, the first step that needs to be taken is to streamline existing systems so that these work smoothly and in a sustainable manner, at a particular patient (number) level. Thereafter, expansion and replication can be taken up. A necessary part of this first step is for the administration, medical staff and doctors, and patients and their relatives to work together.

The 'Patient's Code of Conduct' and the Patient's Bill of Rights' are part of the 'Policy Guidelines for Public Health', prepared by www.karmayog.org and submitted to MCGM in 2006.

The MCGM runs 4 major hospitals (KEM Hospital, BYL. Nair Hospital, Nair Dental Hospital, Sion (LTMG) Hospital), 16 peripheral hospitals, 5 specialised hospitals, 168 dispensaries, 176 health posts, and 28 maternity homes u2014 with a staff of over 17,000 employees. MCGM also runs three medical colleges (Seth GS Medical College, TN Medical College, and LTMG Medical College). MCGM run hospitals have about 11,900 beds in Mumbai city.

Become an informed and aware patient. There are already some resources available such as the Health Education Library for People (HELP) which is one of the world's largest free health education libraries. Visit www.healthlibrary.
com to find out how you can become a better patient today.