biuro@onsen.eu

Product information: +48 509 940 633 | Order support: +48 512 999 218

BLOG ONSEN® / Expert advices

Discover patient rights and fight for your health!

10 kwietnia 2024

Contents

Treatment is free of charge

Dignity above all

Information about health status

Secrets of medical confidentiality

Informed consent for treatment

Access to medical records

Presence of loved ones

Spiritual care during treatment

Objection to the proposed treatment

Medical consultation or second opinion

Other patient rights

Undoubtedly, health is one of the most important aspects of life for every organism, so access to high-quality healthcare is crucial for each of us. Therefore, it is important for every patient to be aware of their rights, which are guaranteed by regulations. Patient rights serve both to protect patients and to ensure an appropriate level of healthcare.

Patient rights constitute a set of principles that enable patients to fully participate in the treatment process, allowing them to feel safer. These rights are essential to enable everyone to consciously and effectively take care of their health and to properly respond to various situations when difficulties arise.

Each specific patient right has its deep justification and purpose. They start from ensuring safety and comfort during treatment. Other patient rights concern, for example, the protection of personal data, including sensitive data. But the most important of them is state-funded healthcare, which is in line with the latest medical achievements. They also reflect respect for the autonomy and freedom of the patient, allowing them to make informed decisions.

Patient's right, treatment, patient protection

Treatment is free of charge

In Poland, there is a social healthcare system where the most significant right of every citizen is access to free healthcare, as stated in article 68 of the Constitution of the Republic of Poland. This right ensures that every citizen can receive necessary medical services, which are financed by health insurance contributions, thus funded by public resources. Therefore, healthcare is not free but socially funded.

Additionally, every patient has the right to receive healthcare services in line with current medical knowledge, as specified in article 6 section 1 of the Patient Rights Act. At any time, they can avail themselves of a wide range of medical services provided by public and private institutions cooperating with the National Health Fund. The cornerstone of these services is the primary healthcare physician, who can refer patients to specialists. They have the ability to conduct basic examinations to provide initial diagnoses.

At present, a primary care physician can independently refer patients for various laboratory tests such as:

complete blood count with platelets;
complete blood count with differential and platelets;
reticulocytes;
erythrocyte sedimentation rate (ESR);
sodium;
potassium;
ionized calcium;
iron;
iron – total binding capacity (TIBC);
transferrin concentration;
glycated hemoglobin (HbA1c) level;
urea;
creatinine;
glucose;
glucose tolerance test;
total protein;
protein electrophoresis;
albumin;
C-reactive protein (CRP);
uric acid;
total cholesterol;
HDL cholesterol;
LDL cholesterol;
triglycerides (TG);
total bilirubin;
direct bilirubin;
alkaline phosphatase (ALP);
aspartate aminotransferase (AST);
alanine aminotransferase (ALT);
gamma-glutamyltransferase (GGTP);
amylase;
creatine kinase (CK);
total acid phosphatase (ACP);
rheumatoid factor (RF);
antistreptolysin O titer (ASO);
thyroid-stimulating hormone (TSH);
HBs-Ag antigen;
VDRL;
free triiodothyronine (FT3);
free thyroxine (FT4);
prostate-specific antigen (PSA);
prothrombin time (INR);
activated partial thromboplastin time (APTT);
fibrinogen;
urine culture with antibiogram;
general urine analysis including assessment of physical and chemical properties and microscopic examination of sediment;
quantitative determination of protein in urine;
quantitative determination of glucose in urine;
quantitative determination of calcium in urine;
quantitative determination of amylase in urine;
stool examination;
general examination of feces for parasites;
occult blood in stool (immunochemical method);
stool culture for Salmonella and Shigella;
throat swab culture with antibiogram;
SARS-CoV-2 antigen test.

Moreover, they can also perform resting electrocardiography (ECG) and refer patients for imaging diagnostics, including:

thyroid and parathyroid ultrasonography;
salivary glands ultrasonography;
kidneys, ureters, and urinary bladder ultrasonography;
abdominal and retroperitoneal ultrasonography, including preliminary assessment of the prostate gland;
peripheral lymph node ultrasonography;
chest X-ray in AP and lateral projection;
spine, limbs, and pelvis X-ray – in AP and lateral projection;
skull X-ray;
sinus X-ray;
abdominal survey X-ray;
gastroscopy;
colonoscopy;
chest CT scan.

Recently, patients can also utilize a dedicated diagnostic budget, including tests such as:

ferritin;
vitamin B12;
folic acid;
anti-CCP antibodies;
high-sensitivity quantitative CRP (up to 6 years of age);
anti-HCV antibodies;
total immunoglobulin E (IgE);
specific immunoglobulin E (IgE) for inhalant allergens (hazel, alder, birch, grasses, rye, mugwort, house dust mites, dog, cat, alternaria);
specific immunoglobulin E (IgE) for food allergens (milk, eggs, wheat, soy, peanuts, hazelnuts, fish, shellfish, carrot, apple);
Helicobacter pylori antigen in stool - cassette test;
Helicobacter pylori antigen in stool - laboratory test;
strep-test.

Some facilities utilize a dedicated coordinated care budget, allowing for tests such as:

BNP (NT-pro-BNP);
albuminuria (urinary albumin concentration);
UACR (albumin/creatinine ratio in urine);
anti-TPO antibodies (thyroid peroxidase antibodies);
anti-TSHR antibodies (thyroid-stimulating hormone receptor antibodies);
anti-TG antibodies (thyroglobulin antibodies);
exercise ECG (stress ECG);
24-hour Holter ECG (24-hour ECG recording);
48-hour Holter ECG (48-hour ECG recording);
72-hour Holter ECG (72-hour ECG recording);
24-hour ambulatory blood pressure monitoring (ABPM);
Doppler ultrasound of carotid arteries;
Doppler ultrasound of lower limb vessels;
transthoracic echocardiography (echocardiography);
spirometry;
spirometry with bronchodilator test;
fine-needle aspiration biopsy of the thyroid;
computed tomography of coronary arteries.

It is also important to note that there are specialist physicians who do not require a referral from a primary care physician, including:

psychiatrist;
oncologist;
venereologist;
dentist;
gynecologist and obstetrician.

Furthermore, some individuals do not require a referral to a specialist, including those who:

suffer from tuberculosis;
are infected with HIV;
are war or military invalids, combatants, or repressed individuals, substitute military service soldiers, anti-communist opposition activists, or individuals repressed for political reasons or deported for forced labor;
are civilian blind victims of wartime actions;
are entitled soldiers or military personnel - for treatment of injuries or diseases acquired while performing tasks outside the country;
are veterans - for treatment of injuries or diseases acquired while performing tasks outside the country;
are alcohol, drug, and psychotropic substances addicts - for detoxification treatment;
are co-dependent individuals, i.e., living or managing jointly with an addicted person or whose mental state arose from an emotional relationship with an addicted person - for co-dependency treatment;
want to use psychological, psychotherapeutic, and environmental services for children and adolescents;
are former anti-communist opposition activists or individuals repressed for political reasons;
were deported for forced labor and imprisoned in labor camps by the Third Reich and the Union of Soviet Socialist Republics;
are under 18 and have a certificate from a doctor (health insurance doctor with a second-degree specialization or a specialist title in the field of obstetrics and gynecology, perinatology, neonatology, pediatrics, pediatric neurology, pediatric cardiology, or pediatric surgery) about severe and irreversible impairment or incurable life-threatening disease, which occurred during prenatal child development or during childbirth;
have a certificate of significant disability;
have a disability certificate indicating the need for constant or long-term care or assistance from another person due to significantly limited ability to live independently and the need for daily participation of a child's caregiver in their treatment, rehabilitation, and education process.

The financing system of primary health care facilities appears to be problematic. It assumes that the doctor receives a monthly lump sum for each patient registered with them, meaning those who have submitted a declaration. From these funds, they cover the costs of tests and visits because they do not receive additional funds for this purpose. Therefore, each patient visit results in a loss of time, and each test ordered reduces the facility's income. Therefore, it is financially beneficial for clinics to artificially limit the number of patients seen each day, which they are not entitled to do. Additionally, some facilities impose financial limits on tests ordered by the doctor, which greatly restricts diagnostics, unfortunately at the expense of patients.

The situation is different for childbirth and emergencies, where queues do not apply. In such cases, every patient has the right to immediate medical care when their life or health is at risk, or during childbirth. This stems from legal provisions, especially Article 7 of the Patient Rights Act. Importantly, this applies not only to life-threatening situations but also to health-threatening situations, which some medical staff overlook, sometimes refusing to provide emergency assistance within hospital emergency departments.

Healthcare in Poland is publicly funded, not free.

Within the system of free healthcare in Poland, we also have constant access to a wide range of specialist doctors who see patients by referral. They can order diagnostic tests without major limitations. Additionally, they can refer patients for surgical procedures when necessary.

Recently, there have been changes in access to rehabilitation services, allowing patients to be referred by general practitioners (GPs) as well, not just specialists. It's worth noting that any doctor or nurse can refer a patient to a hospital. Also, sometimes obtaining a prescription for medication doesn't require a visit to a specialist, although this is not always the case, so it's advisable to consult a doctor to verify a specific medication.

It's also important to mention that not all medical services are available under the free healthcare system. There are paid services for which patients have to pay, such as non-refundable medications or a single room during hospital stays. However, the social funding system for healthcare is generally efficient and allows for effective treatment without additional payments.

Although the right to free treatment is guaranteed, in practice one may encounter limitations such as long queues for specialists due to limited access to services in certain locations. In such situations, some patients seek alternative solutions, such as utilizing private healthcare services, which, however, come with additional costs.

Patient rights, free treatment, primary care physician, district clinic

Dignity above all

Key to dignity is the proper care provided by healthcare providers. Conditions must also meet the professional and sanitary requirements defined by law. When providing healthcare services, medical professionals adhere to the principles of professional ethics established by the relevant medical professional bodies.

Patients must be treated with respect for their dignity and privacy, as stipulated in Article 20 of the Patient Rights Act, and it also reflects a humanistic approach to treatment. This principle forms the basis of the therapeutic relationship between the patient and the medical staff, ensuring that every individual is treated with due respect, regardless of circumstances.

It's also important to remember the right to pain treatment, which is also related to dignity. It arises from Article 20a of the Patient Rights Act, and it ensures that a doctor cannot refuse pain treatment, including providing the patient with effective anesthesia when needed. Every person has the right to be treated with basic respect, including in relation to pain experienced subjectively. This requires empathy, professionalism, and ethical conduct in every aspect of healthcare.

It's worth mentioning that the right to privacy encompasses both the physical and psychological spheres of the patient. All medical procedures should therefore be conducted in a manner that ensures maximum privacy, with information about the patient's health status being strongly protected and only disclosed to those involved in the treatment process. Medical staff are required to maintain confidentiality of all personal and medical data, ensuring that information is not disclosed to third parties without the patient's consent.

In practice, respecting the dignity and privacy of the patient is manifested in various ways. Fundamental is closing the door to the office, and in the absence of this possibility, ensuring an effective screen or curtain that provides privacy. It's also important to always respect the patient's decisions regarding their body and treatment. This includes providing access to psychological support, especially for patients facing difficult diagnoses that cause tension.

Medical ethics, Hippocratic oath, pain treatment

Information about health status

Throughout the entire process of treatment and healthcare, one of the most important patient rights is the right to receive complete, up-to-date, and understandable information about their health status. This right enables patients to make informed choices regarding treatment options, often dispelling patient doubts. It also allows for active participation in the healing process. This right is derived from Article 9 of the Patient Rights Act, which also categorizes patient groups by age, granting them different rights.

Patients have the right to information about their diagnosis, as well as about the benefits and risks associated with each proposed treatment method, enhancing their involvement in the entire process. Furthermore, patients should be informed about the prognosis of the disease and the consequences of abstaining from treatment. Patients should be aware of the potential complications of treatment and have full knowledge of alternative treatment methods available to them.

All of the above information must always be conveyed to patients in a manner that is accessible and understandable to them. Medical staff must take into account the patient's age, education, and level of development, which affect cognitive abilities. They should also ensure that the patient truly understands the information provided and provide the patient with the opportunity to ask questions and express doubts at every stage.

Patient rights, conversation with a doctor, diagnosing diseases

Secrets of medical confidentiality

Medical confidentiality is one of the oldest patient rights and has been a key element of professional ethics in medicine for centuries. It entails the obligation to maintain the confidentiality of all information obtained from or about a patient while practicing medicine. This right provides patients with privacy protection, ensuring that sensitive data will not be disclosed to others without the explicit consent of the patient.

Keeping information confidential is governed by Article 13 of the Patient Rights Act. It applies to all medical professions, not just doctors. These regulations require the confidentiality of information regarding the health status, diagnosis, or treatment, as well as any other patient data.

It's worth emphasizing that medical confidentiality encompasses not only information directly related to the patient's health status but also all personal data that the patient may disclose during consultations, examinations, or treatment, as well as during ordinary conversation. This also applies to information about seeking medical assistance and everything the patient has said.

Adhering to medical confidentiality is essential for maintaining trust. It assures patients that they can openly discuss their health without fearing a breach of their privacy. It is indispensable for diagnosis, treatment, and the broader welfare of the patient, making it a universal right.

Medical confidentiality, professional secrets, doctor-patient relationship

The cornerstone of the system is informed consent to treatment, as without it, the procedure cannot be conducted. There are certain exceptions regulated by the law. This principle respects the patient's autonomy, including their right to decide about their own health. Informed consent requires the application of the right to information, as mentioned above. Only then can the patient make a conscious and free decision regarding treatment.

The right to express informed consent arises directly from Article 16 of the Patient Rights Act and is related to international conventions concerning human rights. These regulations also require that before any medical, diagnostic, or therapeutic procedure, the patient must be fully and clearly informed about all aspects related to the proposed treatment.

Informed consent is a fundamental patient right that strengthens their autonomy and participation in the treatment process. It is not only a legal requirement but also an ethical element aimed at building a trustful atmosphere between the patient and the physician. Respect for the right to give informed consent is evidence of a humanitarian approach to medicine, which prioritizes the patient's well-being.

Patient rights, consent to treatment, formalities before surgery

Access to medical records

The patient has the right to access their medical records, which cannot be restricted. It happens that the staff of the facility refuses this access, instructing the patient to wait for the doctor's decision. This is illegal behavior because this right does not depend on anyone's decision. The patient can at any time review the documentation concerning their health status, including diagnoses or treatment history, if they express such a desire. This is derived from Articles 23 and 26 of the Patient Rights Act, and the realization of this patient's right cannot be deprived.

Medical documentation is kept for 20 years, allowing for obtaining important information about the patient. The patient can also request a copy of the documentation, and if anything in it is incorrect, they can also request a correction to be made in the desired scope. As a rule, the preparation and issuance of a copy of medical documentation are subject to a fee, but once a year, it is provided free of charge.

Obtaining a copy of medical documentation can be done in various ways, usually by submitting a written application to the medical facility. The facility cannot inquire about the purpose for which the medical documentation is needed by the patient. Most often, it is needed for continuation of treatment, and less frequently for legal or insurance purposes. The patient can also authorize another person to obtain it on their behalf.

Hospital visits, close person in the office, patient's family

Presence of loved ones

Although all over the world, medical staff knows how important the support of loved ones is in the treatment process, in Poland, we still too often encounter the opposite. Many doctors ask close individuals to leave the office during patient examinations. This is especially noticeable in hospital emergency departments, where patients are examined alone, while their families wait for hours in the corridors. However, this is a significant violation of rights that is worth fighting against.

Every patient has the full right for a close person to be present during the provision of healthcare services, as designated by the patient. This stems from Article 21 of the Patient Rights Act, which also mentions certain exceptions to this rule. However, these exceptions are objectively extremely rare, as a medical professional can refuse the presence of a close person only if there is an objective risk of an epidemic threat or due to the objective health safety of the patient. Furthermore, any refusal is always recorded in the medical documentation, with justification.

The patient's right to respect their private and family life, including the right to the presence of close individuals during examinations, is a fundamental entitlement directly derived from human rights. The presence of loved ones during examinations and treatment can have a tremendous impact on the patient's well-being, thereby enhancing the effectiveness of the treatment process, which should also be acknowledged.

The presence of close individuals is recognized as a therapeutic element that positively influences the treatment process. Therefore, medical facilities should enable the presence of loved ones in a flexible manner, taking into account the patient's needs, rather than refusing it for the sake of convenience. Therefore, requesting loved ones to leave medical offices is entirely unacceptable.

The patient's right to the presence of close individuals during treatment is a key element of healthcare that emphasizes the importance of emotional support in the treatment process. Respecting this right requires medical facilities to have adequate work organization but also empathy towards the patient's needs. Allowing the patient to be surrounded by close individuals is a sign of respect for their dignity and support for their private and family life, which impacts the effectiveness of treatment.

Patient rights, pastoral care, hospital chaplain

Spiritual care during treatment

A patient staying in a healthcare facility providing medical services, such as a hospital, has the right to pastoral care, regardless of their religion. Some patients consider spiritual care during treatment to be an integral part of a holistic approach to health. Therefore, the right to pastoral care emphasizes the importance of spiritual support for these patients.

Pastoral care can be particularly important for patients facing difficult life situations, mainly in the face of serious illness or before surgeries, when it helps them find peace. For some patients, spiritual care provides support in seeking answers to difficult questions about suffering, illness, the meaning of life, and death, complementing the role of psychological consultations.

It is worth emphasizing that this right is independent of religion, so healthcare facilities should strive to provide access to representatives of different religions and denominations so that everyone can benefit from the form of support that corresponds to their own beliefs, not the decisions of the staff. Spiritual care should be tailored to the individual needs and wishes of the patient, so it is not provided without a clear request.

Opposition to treatment, refusal of therapy, consent to treatment

Objection to the proposed treatment

Every patient has the right to object to a doctor's opinion. This is also an important aspect of patient autonomy, as it allows them to participate in the treatment process. The patient, as a central figure in the medical process, has the right to freely express their beliefs, including deciding about their health. This includes the possibility of refusing consent to proposed treatment methods. This right is derived from Article 17 of the Patient Rights Act, and certain elements of consent to treatment depend on age.

The patient should inform the doctor of their objection to treatment in a clear and understandable manner. Sometimes this requires submitting a written statement in which the patient confirms this preference. Regardless of the form, the objection should be recorded in the medical documentation to avoid potential accusations. Every decision made by the patient must be respected by the doctor. Even if the decision is contrary to treatment standards, they are obliged to acknowledge it.

When deciding to object to treatment, the patient should be fully aware of the possible health and life consequences. Therefore, the doctor is obligated to have a conversation with the patient to inform them of the risks and consequences of discontinuing therapy. However, they must also inform them about alternatives to treatment to which the patient did not object. It is important to emphasize that objecting to one treatment method does not mean renouncing treatment altogether. Also, deciding to discharge oneself from the hospital at one's own request cannot result in discontinuation of treatment. The patient must receive referrals and prescriptions to continue treatment.

Patient rights, medical council, second opinion

Medical consultation or second opinion

It is also important to mention the right to consultation and to obtain opinions from other doctors, nurses, or midwives. This is a patient's right derived from Article 6 of the Patient Rights Act. Although the medical staff may consider it unjustified, every refusal must be documented in the medical records. Therefore, a request for consultation is often accepted, sometimes out of fear of consequences.

This is an important patient's right because it provides them with a certain level of involvement in the treatment process. It gives the patient the opportunity to obtain additional medical or nursing consultations, which sometimes have a significant impact on decisions regarding further treatment. It is also helpful when trust in the doctor is low. The purpose of this patient's right is to protect individuals from poor decisions. Decisions should be conscious and individually considered, not made routinely.

Medical consultation involves a meeting of multiple specialists from various medical fields. Their goal is to collectively review the patient's documentation, and often to examine the patient as well. Based on this, they propose the best possible treatment plan, which is based on knowledge from multiple fields. Importantly, the patient has the right to participate in the consultation, and therefore has the opportunity to engage in discussions. Consultation is also convened for doubtful diagnoses or when the patient's condition is so medically complicated that it requires such a meeting.

Legal access to medical consultation or a second medical opinion gives patients the opportunity to better understand their situation, which greatly assists in making informed decisions regarding further treatment. It also demonstrates respect for patients' rights to actively participate in the decision-making process regarding treatment. This is an element of ensuring high-quality healthcare, as it translates into making the best possible decision the patient could make.

AEFI, Adverse Event Following Immunization, adverse drug reaction

Other patient rights

There are also a number of other patient rights that provide them with additional protection and support. These include the ability to report adverse events related to any type of medicinal products or the right to use a safe deposit box to store valuable items. Of course, patients also have the guaranteed right to enforce their rights in case of their violation.

Every patient has the right to report adverse drug reactions and medicinal product events, including vaccine adverse events, known as AEFIs. Such reports are an important element of wide drug safety monitoring, contributing to the improvement of medical care standards. Reporting procedures are available in medical facilities as well as on the websites of regulatory authorities.

In case of violation of patient rights, it is worth pursuing one's rights. Monetary compensation for damages suffered can also be obtained under Article 4 of the Patient Rights Act. It states that a patient whose rights have been violated may seek monetary compensation. This is a form of compensation for psychological, social, and physical harm suffered by the patient as a result of the violation of their rights.

Patients can also avail themselves of institutional support, primarily from the Patient Rights Ombudsman. It is also worth seeking support and advice from various non-governmental organizations. In case of contractual breaches, information about this should be reported to the National Health Fund. An employee or institution that violates patient rights may be penalized in various ways.

Even partial knowledge of patient rights and the ability to exercise them are key to effectively managing one's own health, which is the domain of responsible individuals. Patients should be aware of their entitlements but also have knowledge of available legal protections that allow for effective enforcement of their rights in case of their violation.

We also encourage you to explore other articles on the best sleep and health blog, as well as the Encyclopedia of Healthy Sleep prepared by the ONSEN® team of specialists. For those who care about spine health, we recommend a set of spine exercises prepared by our physiotherapist.

Foam mattresses, mattress 180x200, mattress manufacturers

FAQ: Patient rights

Where to report a violation of patient rights?

In case of a violation of patient rights, the first step is to direct the matter to the Patient Ombudsman. In some situations, the National Health Fund may also be the appropriate place, as some violations also breach the contract. Actions against a specific doctor can be taken to the relevant local medical chamber. Besides, the patient has the possibility to pursue their rights through legal proceedings, under the general rules of civil procedure.

What patient rights are most often violated?

The most frequently violated patient rights include the limitation of the right to the presence of a close person during the provision of medical services, especially in hospital emergency departments. There is also often a violation of the patients' right to receive medical services at an appropriate level and within a reasonable time. These violations can have a serious impact on the comfort and satisfaction of patients with healthcare.

Can a primary care physician refuse to accept a patient?

A primary care physician (PCP) should accept a patient on the day of reporting. The exception to this rule is when the patient does not require direct medical intervention, such as in the case of check-up visits or preventive examinations. In such cases, the visit may be scheduled for another date. The facility cannot impose limits on medical visits or refer to other entities.

Does a patient have the right to change their specialist doctor?

Yes, the patient has the full right to choose and change their specialist doctor, nurse, or midwife. No one can force a patient to use the services of a specific medical facility or a specific specialist.

Does a primary care physician have a patient limit?

Formally, there is no limit to the number of patients who can be accepted by a PCP in a day. However, in practice, clinics sometimes set their own limits, which is inconsistent with patient rights and the terms of contracts they have with the National Health Fund. However, there is a limit to the number of people who can declare a given doctor as their primary care physician. No more than 2,750 patients can submit a declaration for one doctor.

Contents

Treatment is free of charge

Dignity above all

Information about health status

Secrets of medical confidentiality

Informed consent for treatment

Access to medical records

Presence of loved ones

Spiritual care during treatment

Objection to the proposed treatment

Medical consultation or second opinion

Other patient rights