Patient Request for Physician Change

Introduction

Date of Last Review 4/2/07
SME: Director of Nursing

In keeping with the UTHCPC philosophy of care to individualize treatment and to involve patients in their care, UTHCPC is sensitive to patients and their representatives who have legitimate concerns and want to change the treating physicians.

Standards to consider

The following are the standards for physician change consideration:

The patient's right to be involved in all aspects of their care

The continuous assessment of clinical relationships to promote the highest quality of care

The enhancement of patient rights through ethical frameworks of availability including:

Assessment of patient's physical/mental status regarding proposed treatment/unit alternatives

Potential benefits or drawbacks in proposed transfer/changes

Likelihood of success in association with transfer

Probable consequences of refusal to cooperate with suggested treatment

Any significant alternative treatments or procedures

Patient psychosocial, spiritual and cultural values

Process

The following table describes what happens when the patient/representative requests a physician change:

Stage	Person(s) Responsible	Description
1	The treatment team or patient	Informs the Patient Relations department of the request Patient Relations informs the treatment team, as applicable
2	Patient Relations representative	Discusses these concerns with the patient/representative and the treating physician Completes a Patient Relations Follow-up form to document these discussions and any resolution Notifies the patient, family or appropriate representative of the initiation of this process
3	The treating physician	Determines the following: Timeliness of inter-physician consultation Based on ethical considerations, the patient's continued desire for change Availability of alternative solutions
4	Patient Relations representative	Continues to assess the problem for appropriate resolution.
5	The Medical Director	Intervenes if the resolution fails to occur as follows: In a timely manner (Monday through Friday within 24 hours; over the weekend, the next working day), In a manner acceptable to the patient or patient representative

Denial of request

When a physician change is not appropriate, the Patient Relations representative must document the compelling clinical reason for denying the request in the patient's medical record.

Related standard

Related to regulatory standards

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