Like in any other sphere, the main goal of any health care facility and any health care service in particular should be to satisfy the customer, i.e. the patient. It goes without saying that meeting patients’ expectations and needs is first and foremost task of the medical personnel, without this task the service has obviously no sense. “Patients’ satisfaction with the health care they receive is an important health outcome which has been given particular emphasis in the current review of the National Health Service,”¯ McKinley with colleagues (2002, 333) note. However, there is still not much understanding of the problem and rights of the patients are still severely violated by different reasons. Therefore, scholar and field research is actively being conducted to analyze the existing situation and to find the necessary solutions to improve this situation.
In general, each patient first of all expects to receive qualified and proper assistance and to improve his or her state whatever the diagnosis. There is a symbolic belief sometimes that each representative of health care service is a god and can do something incredible. Of course, it is impossible to work miracles, but there is a minimum of obligations one should fulfill to satisfy the requirement of profession. Working with people is not working with something else, and here responsibilities are extremely high. Patients have the right to be heard and accepted, to receive timely and courteous treatment, to agree or to refuse to participate in research and any investigations. Further, patients usually have the right to receive all the full information on his or her own state of health and probable/detected diagnosis, on who and how is going to treat them, and what outcomes he or she can expect. Naturally, confidentiality and ethics consultations are also among the patients’ rights.
What is more, according to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, each patient, regardless of sex, age, race, religion, color, national origin, sexual orientation and even ability to pay should be provided at least with the emergency assistance and usually further necessary care (Bostan et al., 2007, 62). Finally, each patient has a right to receive full information on drugs he is receiving or prescribed, their uses and anticipated side effects as well. There is an expect for safety and effectiveness; the patients deserve and believe that the drugs they acquire were manufactured with the highest standards of quality.
In the Robert Courtney Case this last right was severely violated. Robert Courtney, working as a pharmacist, acquired medicines at grey market. He diluted chemotherapy drugs (oncologist prescriptions) and sold them to the patients. His intentional tort led to dissatisfaction of the patients, while they thought that they were taking Taxol, Gemzar, Neupogen and Roferon and had certain expectations on those drugs. Actually they received absolutely other products, with no outcomes known for certain. “Pharmacists have an independent duty to protect their patients from harm, and must consult with prescribing physicians in a positive way so that mistakes and misunderstandings can be avoided or corrected,”¯ O’Donnell (2005, 657) warns. Instead of fulfilling this duty, Courtney vice versa created a mistake intentionally.
The deciding factor was that for Courtney his own profit was more important than his obligation of a patient advocate, and thus, to make a profit he neglected his professional duties. “Cancer victims are sustained by two things: trust and hope ”“ trust in the health profession, in whose hands they’ve literally placed their lives, and hope that the prescribed treatment will be effective. Robert Courtney stole the trust and hope of his victims,”¯ Todd P. Graves, the U.S. Attorney for the Western District of Missouri stated (O’Donnell, 2005, 665). That is why the tort by Courtney was approached not simply as malpractice, but as a serious crime against all the American society. It took much time to find all the necessary evident to prove the suspicions, and after that a lot of Courtney’s victims began to apply for compensation. Courtney was arrested in 2001 and tried for 20 federal counts. Suits for fraud accounted about 300 by number. Wrongful death was also listed. The sentence was 30 years of imprisonment, and in fact that is enough, on the one hand. On the other hand, such severe crimes against the whole medical system and the society on the whole should be punished in the way to prevent other specialists from such unprofessional behavior.
The matter is, this practice is rather wide spread, and there is still not enough federal control for safety and effectiveness of the drugs the patients receive throughout the States. And thus a lot of people are at risk, that is why the Courtney Criminal Case has become a serious stimulus to take more preventive measures. Unfortunately, the Federal Drug Agency (FDA), which is responsible for managing drug manufacturing in the United States, has no regulatory authority over compounding pharmacists. “FDA officials suspect a growing number of compounding pharmacists are doing just that ”“ illegally manufacturing large quantities of drugs without conducting the rigorous tests that pharmaceutical manufacturers must perform,”¯ O’Donnell (2005, 668) notes. What has been done already is a list with prescriptions intended to help the pharmacists avoid federal investigations. But still the system of control has to be reformed.
Bostan, Sedat, Acuner, Taner & Yilmaz, Gokhan (2007). Patient (customer) expectations in hospitals. Health Policy, 82(1), 62-70.
McKinley, R. K., Stevenson, K., Adams, S. & Manku-Scott, T. K. Meeting patient expectations of care: the major determinant of satisfaction with out-of-hours primary medical care? Family Practice, 19(4), 333-338.
O’Donnell, James T. (2005). Pharmacist Malpractice and the Infamous Courtney Case. Drug injury: liability, analysis, and prevention. Ed. James O’Donnell. Tucson, Arizona: Lawyers & Judges Publishing Company, 657-669. Print.