After having cataract surgery last year, Virginia Hoffman of Silver Spring returned to her surgeon's hospital for a checkup.

"Without asking me if it was okay," she wrote in a recent e-mail to The System, "the doctor brought in four interns to look at my eye."

"I feel this doctor was wrong to invade my privacy in this way. I walked out, and don't plan to go back."

"Good for her," said George J. Annas. "She's absolutely correct. . . . She was there to find out about her eyes; she wasn't there to be teaching material."

As author of "The Rights of Patients" (Southern Illinois University Press), Annas is familiar with the legalities of cases like Hoffman's.

"You don't go to a hospital to exercise your rights," he said last week, but patients are often confronted with privacy and health challenges that can be difficult to address solo.

"When you go to the hospital, you absolutely need an advocate with you, a friend or a family member," said Annas, a professor of health law, bioethics and human rights at the Boston University School of Public Health.

Annas acknowledged that it can be difficult to have a supporter with you around-the-clock. "I don't want the family members to feel guilty if they can't do it, but I think that should be the goal," he said.

"When I've been an advocate," Annas said, "a number of things have come up [including] a physician's mistake in who the patient is. . . . You may not realize that the number-one thing the Joint Commission on the Accreditation of Hospitals is trying to get doctors to do is identify the patient correctly."

"I've certainly been there when they've tried to give the patient the wrong drugs," Annas continued, so an advocate needs to know what has been prescribed and to verify that this is what the patient is receiving.

Annas's book -- first published in 1975 and recently updated in a third edition -- contains plenty of other advice, including this simple recommendation: "Ask everyone who wants to touch the patient if the person has washed their hands and insist that they either wash their hands or use new gloves."

"Perhaps the most important thing . . . to realize is that few doctors and nurses understand what the law is on patient rights," Annas writes. "Nonetheless, you will encounter people in the hospital who think they know the law, who act like bullies and who will assure you that you must or can't do something because 'it's the law.' They are almost always wrong."

Calls to three hospital gift shops last week revealed that none of them carries Annas's book.

"I'm not surprised at all," he said. "Doctors are pretty ambivalent about patients' rights."

-- Tom Graham

The System welcomes comments from patients, providers, insurers and others about the delivery of health care. While we cannot advocate on behalf of individuals, we are looking for examples of problems and solutions that may direct our reporting. Contact us by U.S. Mail at the address that appears below or by e-mail at thesystem@washpost.com. Do not send original documents.