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Your rights in your medical home
In your medical home, you have the right to choose your primary-care provider and/or to change that provider if you so choose. SETMA, as a medical home, will help you with the decision making about whom you will select as your primary-care provider including discussions about your preference as to gender, age, degree or training and scope of practice.
In fact, you both have the right and the responsibility to participate in decision making about your health and your health care, which in the medical home is referred to as “shared-decision making.” You have the right and the responsibility to select the specialists whom you need to see so that your desire is followed as to whom you do see.
The following lists your right:
- to be treated with respect, consideration and dignity, free from any abuse or harassment
- to be provided appropriate privacy
- to have records and disclosures treated confidentially and, except when required by law, to have the opportunity to approve or refuse the release of your records
- to be provided, to the degree known, complete information concerning your diagnosis, treatment and prognosis. When it is medically inadvisable to give such information to a patient, the information is provided to a person designated by the patient or to a legally authorized person
- to have the opportunity to participate in decisions regarding your health care
- to be informed about procedures for expression complaints and grievances, including those required by state and federal regulations
- to see a specialist if you request to see one and/or if your primary care provider determines that the seriousness of your care requires such.
- to ask for and receive a second-opinion about your diagnosis and/or plan of care
- to receive treatment for pain management. The prescription of pain management narcotics will be done in compliance with Texas Medical Board Rule 170. You have a right to review of copy of this Rule which may be obtained from the Board’s website or from your SETMA provider.
- to receive a written response to a written complaint which you lodge against a practice or a provider.
- to have information available to patients and staff concerning
- patient rights
- patient conduct and responsibilities
- services available at the organization
- provisions for after-hours and emergency care
- fees for service
- payment policies
- the right to refuse participation in experimental research
- advanced directives
- credentials of health care professionals
Just as your medical home has the responsibility to be guided by your rights and to fulfill the goals of your rights, you have responsibilities to your medical home and to your healthcare provider. As a patient you have the responsibility:
- To actively participate in the formulation of your plan of care and treatment plan, including sharing in the decision making about your care. This responsibility is key to your healthcare being delivered in a medical home.
- To become an “activated” patient by learning what is necessary for you to know in caring for your health.
- To become an “engaged” patient by assuming responsibility for your care.
- To engage in a conversation with your healthcare provider where you address all of your concerns.
- To notify other treating clinician (s) of your participation in the Medical Home and of your desire for the other clinicians to communicate with your Medical Home of your health needs as assessed by you and the other clinician (s).
- To adhere to the plan of care and/or treatment plan which you participated in establishing and with which you agreed to participate.
- To recognize that your failure to adhere to your treatment plan and/or plan of care may result in treatment failure and/or with the worsening of your health.
- To notify your provider, preferably in writing, if you determinate that you are unable or unwilling to adhere to your plan of care or treatment plan.
- To notify your provider, preferably in writing, if a barrier to your adherence to your plan of care or treatment plan exists and/or if you have determined that you cannot or will not follow your plan.
- to make full and complete disclosure of your medical history, medications including over the counter and dietary supplements, allergies and symptoms before and during the course of treatment
- to accept personal financial responsibility for charges not covered by his/her insurance
- to respect the rights of other patients, the health care providers and staff
- to understand your health problems to your satisfaction
- to notify your doctor about any unexpected changes in your health
- to follow the treatment plan prescribed by his/her provider
- to inform his/her provider about any living will, medical power of attorney or other directives that could affect care
How to contact your medical home
In a patient-centered medical home, there are multiple ways in which to contact your healthcare provider:
- You can make an appointment
- You can text your provider. (See part IV of this series as to how to send an encrypted text which is HIPAA compliant.)
- You can access SETMA’s web portal in order to send a secure e-mail to your provider.
- You can call your provider at the office or through the answering service. Remember, there are multiple people available for your healthcare needs 24 hours, seven-days a week.
Some providers will give you their personal cell phone number which allows you to contact them directly. As the CEO of SETMA, I have found that patients do not abuse the privilege of having this direct contact.
The new phenomenon, with which SETMA disagrees called “concierge medicine,” has the patient paying a premium to the doctor, sometimes as much as $2,000 a year for this privilege. In your medical home, if you would feel more secure, ask your provider if he/she will give you their cell phone number. Reward this privilege with the courtesy of not abusing it.
You can also contact your medical home by:
- Dropping by the office. You are always welcome at your medical home.
- Other providers can contact your medical home through SETMA’s Health Information Exchange which will also give you a means of proving your healthcare information to providers other than your primary care provider.
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