By Patrick Malone
When you need to advocate for the health care of yourself or a loved one, it helps to know where and how to raise your concerns. In this Health Care Advocates’ Power Kit, our firm works to empower you, the health care consumer, to be an advocate. We cover many important issues:
- Quality of care, patient safety, abuse and neglect, injuries and similar issues.
- Getting your own medical records and keeping them private and accurate.
- Billing problems.
Background on Quality of Care
Consumers often have serious issues with quality of care and other problems with health care. It isn’t always the right thing to involve lawyers like our firm, and we don’t have the ability to represent everyone with a complaint, so many consumers decide to take action on their own. My firm has developed this guide to help consumers find the right agency to complain to – and how to do it effectively.
Government agencies which investigate complaints of poor quality health care include:
- The state licensing board has the power to revoke or suspend any health care provider’s license. This is done typically only in egregious circumstances, such as illegal drug use or other criminal behavior. Most boards are grossly understaffed and unequipped to deal with ordinary negligence or carelessness that hurts patients. You can find a list of licensing boards at the umbrella organization for licensing boards: the National Board of Medical Examiners. You will also find specific places to write for complaints in Maryland, District of Columbia and Virginia on the Resources pages in our site.
- For problems that Medicare patients have with hospital or nursing home care, the local Medicare Quality Improvement Organization (QIO) is federally empowered to investigate. Never heard of it? Most people haven’t. But these groups, which were set up by Congress and funded by the taxpayers to improve the quality of care given to Medicare beneficiaries, have the muscle to get to the bottom of incidents in hospitals. And patients have a right to find out what the QIO learned. You will also find specific places to write for complaints in Maryland, District of Columbia and Virginia on the Quality of Care: Medicare page on our site.
- The state or local health department can investigate outbreaks of infection to find if proper sterilization procedures were followed. Unfortunately most health departments have no ability to go beyond infections to other issues, nor do they have the manpower or expertise. See our Resources pages for specific places to write for complaints in Maryland, District of Columbia and Virginia.
Consumers can also find valuable resources from non-profit groups advocating for patient safety. An example of such groups is the Empowered Patient Coalition. On its website consumers can report adverse medical events with drugs and medical devices, and locate the agency in their own state to report a physician, nurse or hospital.
We cover other important issues like privacy of medical records, how to get and review your own records, and billing disputes.
If you’re thinking about a lawsuit, pay careful attention to the local deadlines for filing the lawsuit in court and other requirements of state law. We have pages on this website for all the applicable deadlines in Maryland, the District of Columbia and Virginia. Always consult a lawyer for specific advice about your own situation in your own state.