Conflict between team and patient/advocate was the cause of #5 on The List of the latest National Institute for Patient Rights survey. Patients and their advocates have a right to know of realistic care alternatives when hospital care is no longer appropriate. Some participants observed that no one ever approached them about realistic care alternatives in the event that hospital care was no longer appropriate.

Not only was there no discussion of alternative care options, but many respondents complained about how they were made to feel when they disagreed with providers about the continued appropriateness of hospital care. One respondent noted, ?They made us feel like we were immoral when we questioned their treatment recommendations!?

Conflict was also the cause of violations #6 and #7, violations of a right to know hospital rules on charges and payment methods, and a right to review the hospital bill, have information explained, and get a copy of the bill. Said one respondent, ?It was like pulling teeth to try to get an explanation of certain charges. I still don?t know why I was charged for things I know we didn?t use.?