Just Fill Out These Forms – Hospital Edition.

If there was ever a situation of more uneven bargaining power than being asked to fill out hospital forms while lying on a gurney in the emergency department, I cannot think what it could be.  And yet that is precisely when the hospital asks you to fill out pages and pages of forms with closely spaced legal mumbo jumbo that can have huge legal and economic consequences down the road.  You are in no position to get up and leave.  You are in no position to refuse to sign.  So you do what you must; you sign, usually without even reading the forms.

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The hospital knows you are coming.  It may not expect you personally, but it knows patients will be arriving every day needing vital medical treatment.  The hospital wants to be ready for you.  It wants to be ready to deliver good medical care to you, but it also wants to place itself in the strongest possible position to get paid and to defend itself in the event someone makes a mistake and it gets sued.  That is why it has had lawyers prepare detailed forms and why it insists you sign them before it will admit you to the hospital.

The hospital forms are often pretty much alike from hospital to hospital.  Hospitals compare notes.  Their attorneys compare notes.  They read the court cases and change their forms to take advantage of whatever the law allows them.

One of the things the hospital has thought of that you probably have not is who is this person who is providing care to you?  He or she is wearing a name tag.  It may or may not have the hospital’s name on it.  While it may be news to you, the person may not be a hospital employee at all, even though the person is dressed like all the other hospital employees.  If all goes well, you never have to care about whether the person was employed by the hospital or not.  However, if things go wrong and the person injures you, the hospital may inform you that it is not legally responsible for the person it sent to care for you.  Depending on how badly you have been hurt, this may make a big difference in how much money you can recover to compensate you for your injury.

There are lots of people in a hospital who are not actually employed by the hospital.  In the emergency department, the doctors very often work for an outside company that the hospital has hired to work in its emergency department.  Their name tags may or may not alert you to that fact, although there are good reasons why you don’t spend much time examining those name tags while you are lying on your back in pain.  Depending on the hospital, it may hire doctors to see you during the time you are admitted.  These people are called hospitalists.  They don’t do anything other than see patients in the hospital.  The radiologists who review the x-rays, CT’s and MRI’s performed in the hospital are usually not hospital employees.

The hospital may call the emergency department doctors, hospitalists, and radiologists “independent contractors” and take the position that they are not hospital employees.  Were you to walk into any other business in town and be waited on by someone who gives every appearance of being an employee of the business, the law will usually treat that person as an employee, even if the business claims that it was just someone it hired but who wasn’t technically an employee.  The law will hold the business responsible for any mistakes the person makes that cause you injury.  Here is where the hospital’s forms come into play.

Buried deep in the fine print in the admission forms, the hospital will inform you that not everyone who provides you care is a hospital employee and that you should not assume that they are.  Even if you are able to find that sentence, you may not understand it, but the courts will enforce it against you anyway.  The courts also won’t care that you didn’t have much choice when presented with these forms.  This means that the hospital is not legally liable for the mistakes of these people and doesn’t have to pay for them.  Since the hospital usually has many millions of dollars of insurance coverage and the “independent contractor” does not, this can make a big difference, if you are badly injured.

There are lots of other hospital-favorable provisions in these forms.  Among other things they make you promise to pay, in the event your insurance company does not.  They may make you agree to arbitrate certain disputes, instead of going to court over them.  You agree that the hospital may take pictures of you and that the pictures will belong to the hospital and not you.  You agree to have certain information shared.  You give your consent to the treatment you are going to receive, and, if you are in the hospital to deliver a baby, you give consent for the baby to be treated as well.

There is not much you can do about these forms.  The best you can do is read them and ask questions, but you are going to have to agree to what the hospital wants or leave and go on down the street.  Under the best of circumstances, that is a problem and, even then, the next hospital will hand you similar forms to sign.  Just be aware that these are important forms and will be binding on you, even though you never really had a chance to refuse to sign them.


Posted in Doctors, Hospital Negligence, Hospitals, Informed Consent, Lawsuits, medical errors, Medical Malpractice, medical mistakes, Nurses |