Patients and rights

Regarding “Serious deficiencies found at MD Anderson” (Front page, Nov. 5,) I might have added a subtitle: “Serious deficiencies found at Centers for Medicare and Medicaid Services (CMS). The article describes how CMS used conditions of participation to sanction MD Anderson to correct deficiencies. A couple of years ago I attempted to persuade CMS to upgrade the “Patients Rights” section of their conditions of participation. I based the improvements on peer-reviewed medical literature, and my initiative was supported by 90 citizens, including many doctors and nurses.

My supporters and I asked that patients have the right to fully participate in root-cause analysis when they or a loved one has experienced serious harm while hospitalized. We asked that decision aids be made available when these are applicable to the patient’s medical condition. We asked that patients be told when a potentially dangerous drug, such as one that is off-label, has been prescribed. Given the obscene medical bills sometimes imposed on patients, we asked that patients be told of all out-ofpocket costs before elective treatment.

Patients are often good at spotting and reporting medical errors, so we asked for full access to review and write in our medical records while hospitalized. We also asked for a thorough and evidence-based discharge plan with effective follow-up.

The response of CMS, after a year of foot-dragging, was that they were not interested in our proposals for improving patient rights. While CMS does partially protect patients, it is deficient when it comes to the rights of hospitalized patients.

John T. James, founder, Patient Safety America, Houston