Under the Indian healthcare system, a patient enjoys several rights. It’s the advocate’s responsibility to understand them all and tailor their services accordingly
The Supreme Court of India set aside a writ filed by the Indian Medical Association (IMA) in 1995 and decreed that the medical profession is a “service” that should be covered under The Consumer Protection Act, 1986. This implied that patients are to be considered as consumers of healthcare services. A lot of water has flown down the Ganga since then. Although malpractice still happens, thanks to the fact that medical services are now covered under The Consumer Protection Act, 1986, there is evidence that patients’ rights are better protected these days.
An advocate’s checklist for processing a Patient’s Complaint about medical services
- Name and Address of the complainant in full.
- Name and Address of the doctor/surgeon/hospital/nursing home, pharmaceutical company etc.
- What is the primary cause of the complaint?
- Particulars of the complaint in detail, along with supporting documents. Spell this out in chronological order
- Relief prayed for – for example, replacement of malfunctioning device/removal of defect /compensation for expenses incurred & physical/mental suffering, if any.
- Ensure that the patient has a copy of all the documents with him.
A landmark judgment
A huge leap for patients
In November 2012, a renowned cancer surgeon was asked to deposit a fine of Rs 50,000 with the metropolitan magistrate’s court in a case of “medical negligence.” This case makes for interesting reading, because it highlights the fact that the lack of a good ‘bedside manner’ in the doctor was perceived as a personal snub by the patient’s husband, and this slight caused him to pursue the matter doggedly through the labyrinthine Indian judicial system for many years. Ironically, in this case, the deceased was not even officially registered as the surgeon’s patient. Yet her husband hauled the surgeon to court and has been ‘patiently’ fighting this battle for over two decades, simply because he is upset that the surgeon allegedly did not attend to his wife in the operation theatre (where he was present as a bystander) and did not bother to meet the family after the surgery. Throughout the course of his fight, the patient’s husband has steadfastly maintained: “Had the doctor apologized or even shown some remorse, I would have forgiven him.”
What is an Advocate’s Role in the Healthcare Delivery System?
- Be an active partner in creating the patient’s treatment plan.
- Ask questions.
- Keep appointments.
- Be respectful towards other people.
- Follow the hospital’s rules.
- Ensure that the patient follows the doctor’s instructions.
- Share information with the patient and his family
- Record changes (improvements or deterioration) in the patient’s condition and keep the doctor and his family well-informed about these changes.
Even though this may come across as an extreme example of a patient’s expectations from a doctor, the fact cannot be denied that a doctor’s job is ultra-sensitive and as health care providers, the buck stops with them. Further, as with the delivery of any service, doctors are accountable for deficient deliveries, especially since they are dealing with human life, where decisions once made are often irreversible. The demand for efficient and error-free service is therefore legally and morally justified in their case, especially as surgeons these days command a hefty premium for the services they render.
from seeking a second or third opinion from another doctor. Often the patient and her family place blind faith in one doctor, only to have their hopes dashed.
While busy doctors lament that they do not have enough time to look into individual complaints, patients are unhappy over how long they have to wait to see a doctor - and even when they do manage to get their chance, they are often very dissatisfied about the quality of the doctor’s communication, most of which goes over their head because it’s replete with medical jargon.
Following are the monetary limits of compensation that can be granted by the consumer courts in India:
District Consumer Court: Up to Rs 20 lakh
State Commission: Rs 20 Lakhs to Rs 1 Crore
National Commission: Above Rs 1 crore
All complaints against doctors and hospitals should have an expert medical opinion from another doctor, stating that the complaint is prima facie true and needs further probing.. This can be very hard for patients to get, because doctors are understandably reluctant to criticise a fellow professional.
Medical negligence, defined
The apex court’s definition of patients’ rights
According to the Consumer Guidance Society of India, a patient under the Consumer Protection Act, 1986 has the right to be told about his illness and to have his medical records explained. In addition:
- Patients have the right to know a doctor’s qualifications.
- Patients have the right to be handled with consideration and due regard for their modesty when being physically examined by the doctor.
- Patients have the right to maintain confidentiality regarding their illness and can expect the same from the doctors.
- Patients have the right to a second opinion if they are doubtful about the medicines or treatment suggested.
- Patients have the right to know what a suggested operation is for and the possible risks involved. If he is unconscious or unable to make the decision due to other reasons, informed consent needs to be taken from their nearest relatives.
- Patients have the right to get a copy of their medical records and case papers on request from the doctor/hospital.
- If the patient needs to be transferred to another hospital, he has the right to know the reason for this; and also has the right to make their choice of which hospital to go to, in consultation with the doctor.
- Patients have the right to get a detailed explanation of the bills they are asked to pay.
Patient advocates can help patients secure the rights they are legally entitled to in India.The following chapters will explain these rights in greater detail, and how a patient-advocate can help uphold them. Remember Tenzin Gyatso’s wise words, “ It is not enough to be compassionate. You must act”.