There is a vast secret in the in-clinic hemodialysis community about the abuse perpetuated by the clinics on their patients and their caretakers.
This is because if you dare to complain to the higher authorities, you can be punished in the clinic. These people stick two large needles in your veins every other day. These people monitor your treatment, and can shorten it or otherwise cause it to be inadequate and make you ill as a result. If that should happen, they will claim it is the PATIENTS FAULT they are ill, and they will get away with it, since they have been for the last 30 years or more.
If you complain you will be labeled UNCOOPERATIVE. If you refuse unnecessary treatments or drugs you will be labeled UNCOOPERATIVE.
This label, UNCOOPERATIVE, is also used on patients who are not mentally competent, who can become violent and threatening. SAME LABEL. So when you try to move to a new clinic - suddenly they have no openings. They don't want an UNCOOPERATIVE patient who will make trouble.
Hemodialysis clinics have the power to BAN 'UNCOOPERATIVE' patients, their caretakers, and family. This is a good thing when it is used to protect the clinic personnel from violent, threatening people. It is a bad thing when it is also used as a threat to keep people from complaining about improper treatment.
Because if you are BANNED by one clinic for being UNCOOPERATIVE, then other clinics will not treat you either.
If you do not receive your hemodialysis treatment, YOU WILL DIE.
How potent a threat is that?
So patients, caretakers, and families, keep quiet when the patient, or family and caretakers are abused. For fear of in clinic retaliation. For fear of being left to die.