14 Patient Rights Terms to Know
Key takeaways:
The healthcare industry uses words and phrases that may be hard to understand.
It’s important for you to understand certain terms so you can make informed medical decisions and stand up for your rights as a patient.
Understanding terms like “informed consent” and “right to treatment” can help you make better decisions for your health.
If you spend any time in a medical setting as a patient or caregiver, you're bound to come across words or phrases you don’t know. These terms may sound familiar like “privacy” and “continuity of care” but you may still have questions about what they mean.
When it comes to your rights or the rights of a loved one, it’s important for you to know what certain terms mean. Otherwise, you may miss opportunities to stand up for yourself or make the best decision for your health. In this article, we’ll look at terms you should know when it comes to your rights as a patient.
Patient rights terms to know
Many patient rights terms can be found in healthcare laws and regulations that are in place to protect you. Because of this, they may have specific definitions within the legal system.
How these terms are applied to your care can be specific to the service you’re receiving. For example, the American Medical Association (AMA) Code of Medical Ethics provides guidance on how some of these terms apply to medical practice.
While there are many patient rights terms to know, below are 14 terms to get you started:
1) Confidentiality
Confidentiality is your right to privately discuss medical information about yourself with your healthcare provider. And it’s your provider’s duty not to share the information without your approval. This is based on a practice of “good faith” between you and your provider.
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2) Continuity of care
Continuity of care is defined as high-quality, cost-effective care you get over time from your healthcare provider and their team. It promotes trust and confidence between you and your providers as you develop a long-term relationship.
This also applies to situations where your healthcare provider will no longer be providing services to you. They should give you enough notice so you have time to find another provider. They should also be ready to help you with this transition process when needed.
3) End-of-life care
End-of-life care includes the physical, emotional, and spiritual care you receive when you stop getting treatment to cure or manage a disease. The goal is to make you as comfortable as possible toward the end of your life. This is also sometimes referred to as palliative care or supportive care.
4) Fiduciary relationship
A fiduciary relationship means your provider must act in your best interest at all times. They also shouldn’t influence your decisions. And they should never abuse or take advantage of you.
5) Grievance
A grievance is a complaint you file about the quality of care or other services you receive. Grievances can be filed with entities like your health insurance plan or state medical board.
If you have Medicare, you can use this locator to find your state’s Beneficial and Family Centered Care-Quality Improvement Organization to file a grievance.
6) Informed consent
Informed consent is when your healthcare provider tells you about the risks, benefits, and options of a procedure or treatment. It’s important that you understand this information and ask questions if anything is unclear. This helps you make an informed decision about your care. Your provider must keep a record of their informed consent conversation with you.
7) Patient advocate
A patient advocate is a trained professional who can guide you on your healthcare journey. They can provide you support as you’re navigating your diagnosis, receiving treatment, and more.
Some of their responsibilities include making medical appointments and solving billing issues with your health plan. Patient advocates also go by the following titles:
Care or case manager
Health advocate
Patient navigator
Ombudsman
Health navigator
8) Personal representative
A personal representative is someone who acts on your behalf. In healthcare, this can involve getting medical information, making medical decisions, and exercising your patient rights. Your healthcare team must respect their authority as your representative. State law usually determines who can act as your personal representative.
9) Pre-existing condition
A pre-existing condition is a medical issue you had before you got health insurance coverage. Examples include cancer, diabetes, or heart disease. Your health plan can’t deny you coverage or charge you more if you started your plan with a pre-existing condition.
10) Privacy
The Privacy Rule under the Health Insurance Portability and Accountability Act (HIPAA) establishes the standards for keeping your personal health information private. This includes when, to whom, and how your information can be shared.
The AMA Code of Medical Ethics says that several other types of privacy must also be protected when it comes to patient care. This includes protecting your privacy when it comes to personal space, religious and cultural beliefs, and your personal relationships.
11) Refusal of treatment
Refusal of treatment is also known as refusal of care. It’s your right to make informed medical decisions about your health, even if it means saying no to your medical options. It also means your provider must respect your decision.
12) Right to appeal
A right to appeal means you have the right to ask a third party to review a decision made by your health plan if you don’t agree with it. It gives you the chance to ask your insurer to reconsider a decision.
13) Right to treatment
The right to treatment is your right to get emergency care even if you can't afford to pay for it. For example, if you go to a hospital with a serious condition that could worsen if left untreated, then the hospital must stabilize your condition. This was established by the Emergency Medical Treatment and Labor Act (EMTALA) in 1986.
14) Second opinion
A second opinion is the opinion of a healthcare provider other than your regular provider. They review your medical records, discuss your condition with you, and give you treatment options. They may agree with your regular provider. Or, they may present you with a different diagnosis and treatment plan.
A second opinion isn’t always necessary. But there are certain situations where it might be a good idea. For example, you may receive a rare diagnosis and would like another provider’s opinion.
The bottom line
You have the right to understand healthcare terms, especially as they relate to your medical care. The more you understand these terms, the better you can stand up for your patient rights and take care of your health.
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References
American Academy of Family Physicians. (2020). Continuity of care, definition of.
American Medical Association. (n.d.). Code of Medical Ethics overview.
American Medical Association. (n.d.). Confidentiality.
American Medical Association. (n.d.). Privacy in health care.
American Medical Association. (n.d.). Terminating a patient-physician relationship.
Bourke, J., et al. (2008). Competent Novice: Confidentiality.
Centers for Medicare and Medicaid Services. (2021). Emergency Medical Treatment & Labor Act (EMTALA).
Committee on Family Caregiving for Older Adults. (2016). HIPAA and caregivers' access to information. Families Caring for an Aging America.
Healthcare.gov. (n.d.). Grievance - HealthCare.gov glossary.
Medicare.gov. (n.d.). Rights & protections for everyone with Medicare.
National Cancer Institute. (n.d.). Definition of end-of-life care.
Pirotte, B., et al. (2021). Refusal of care. StatPearls.
Quality Improvement Organizations. (2019). Locate your BFCC-QIO.
Shah, P., et al. (2021). Informed consent. StatPearls.
U.S. Department of Health and Human Services. (2013). Personal representatives.
U.S. Department of Health and Human Services. (2017). Appealing health plan decisions.
U.S. Department of Health and Human Services. (2017). Pre-existing conditions.
U.S. Department of Health and Human Services. (2020). The HIPAA privacy rule.
Zilber, C. (n.d.). Ethics and the doctor-patient relationship.
