MAE Physicians Surgery Center, LLC

Pre-notification

When you are scheduled for a procedure, you must review the following document before the date of surgery.

NOTIFICATION OF OWNERSHIP

I hereby acknowledge that MAE Physicians Surgery Center, LLC is owned by a collaboration of organizations. These organizations include:

Mississippi Sports Medicine: Jeff D. Almand, MD, Gene R. Barrett, MD, Chris Ethridge, MD, Larry D. Field, MD, Rhettson Hobgood, MD, Brian P. Johnson, MD, Penny J. Lawin, MD, James W. O'Mara, MD, James R. Ramsey, MD, and Walter R. Shelton, MD

Jackson Eye Associates: Richard Blount, MD, John Ford, MD, Ronald G. Herrington, MD, Robert Mallette, MD, Robert May, MD, John McVey, MD, Wilson Moak, MD, Troy Newman, MD, Younghyun Grace Oh, MD Philip Smith, MD, Ken Toler, MD, & Curtis Whittington, MD

Mississippi Retina Associates: Michael Borne, MD, James D. Fly, MD, Joel H. Herring, MD

Jackson Pain Center: J. Edwin Dodd, MD and Carroll McLeod, MD

*for a more detailed listing, please ask the surgery center receptionist

Jackson Anesthesia Associates: is a contracted service provider and they do not share ownership nor are they employees of MAE Physicians Surgery Center, LLC.

ADVANCE DIRECTIVES

I understand that MAE Physician's Surgical Center, LLC (MAE PSC) provides outpatient, same day surgery for elective patients. Although, I have assigned Advanced Directives, I understand that during my stay at MAE PSC, my request for a "No Code" or "DNR" status will not be honored. I understand that in the case of a life-threatening emergency, the staff will employ any and all life saving measures for me. Therefore, I am waiving my rights to have a "No Code" or "DNR" status during my stay at MAE PSC. If I am transferred to another facility for any reason, my Advance Directives will be part of my record and communicated to the receiving facility.

A PATIENT'S BILL OF RIGHTS

  1. The patient has the right to considerate and respectful care.
     
  2. The patient has the right to obtain from his physician complete current information concerning his diagnosis, treatment, and prognosis in terms the patient can be reasonably expected to understand. When it is not medically advisable to give to give such information to the patient, the information should be made available to an appropriate person in his behalf. He has the right to know, by name, the physician responsible for coordinating his care.
     
  3. The patient has the right to every consideration of his privacy concerning his own medical care program. Case discussion, consultation, examination, and treatment are confidential and should be conducted discreetly. Those not directly involved in his care must have the permission of the patient to be present.
     
  4. The patient has the right to expect that all communications and records pertaining to his care should be treated as confidential.
     
  5. The patient has the right to voice any grievance without discrimination or reprisal and to be free from abuse and harassment.

The pre-surgery preparation- Doctor’s direction/guidance was great. The nurse who prepared me for surgery could not have been better.

M.K.