Let’s talk about consent. Yes, informed consents are in place to cover healthcare providers’ tails. Period. Theoretically, consent should involve an extensive conversation between a provider and a patient. That’s good consent. That’s real consent. Not just legal consent. I’m not an attorney, but I am patient experience snobs. So, let’s talk about how consents help or hurt the patient experience.
I’m generally talking about consent in a clinic setting, not before surgery or admission. But, the same principles could apply. If you are just having someone consent to everything under the sun that could possibly happen and they aren’t having a conversation with a provider about it, I hate to break it to you but it probably won’t hold up in court. It will probably scare the patient. And it might even piss them off. Let me tell you a story.
I went to a medical office for a very specific treatment – cold laser therapy on my foot. When I scheduled, I made sure they clearly understood that I was coming in for that specific treatment.
I used to be a patient in this office, so they already have all my information. But I haven’t been there in a few years. I get there and they literally hand me a stack of papers that is over half an inch thick to fill out. I let them know that I have been a patient in their practice and that they should have most of my information, but I’m happy to update anything for them. Teachable moment #1: Send paperwork ahead of time. #2. Don’t make a patient fill out the information that you already have. Just enter it into the new EMR.
They gave me the song and dance that they are owned by a new company now and so I have to fill out all this paperwork again. Did my name change? No. Did my date of birth change? No. So why do I have to fill out all this paperwork? Enter the information into the new system and then asked me to sign off on it so that you have the proper signature. But don’t ask me to fill out all that stuff again. They held firm that I had to fill it all out.
So, I’m already annoyed and then I start going through the paperwork. There are three different consents. One for evaluation, one for treatment, and one specific to chiropractic care. I signed the first two. I get to the third one and I just can’t bring myself to sign a consent that says I might get rib fractures and other things that are normally covered on a chiropractic consent because I’m not getting an adjustment.
I give the paperwork back to them and let them know why I’m not signing the third consent. They proceed to tell me that I have to sign the consent. And I explain to them that I’ve already signed consents for evaluation and treatment. They fought me on it. I said fine I’m either going to leave or y’all can figure it out.
So, multiple people have several conversations about me and how I don’t want to sign the consent form all of which I hear. Super awkward. Teachable moment #3: When you talk about a patient, be discreet and do it where they can’t hear it.
The chiropractor comes out and was so nice. He explained to me that the way their practice works he would actually evaluate me and then technically he would refer me for the cold laser therapy. I said no problem and I’m happy to have you evaluate me, but I don’t need an adjustment. So, I signed the consent for evaluation and signed the consent for treatment. But I’m not signing a consent that talks about rib fractures and lung punctures for cold laser on my foot. I told him that if he wanted to cross out the things on the chiropractic consent that didn’t apply and leave the things that apply to cold laser therapy then that would work for me. He handled this well and agreed that would work, then had to deliver the news to me that their cold laser was broken. I honestly felt bad for the provider. His staff didn’t set him up to succeed at all in this situation. Teachable moment #4: When you won’t be able to provide scheduled services, proactively let the patient know so they can reschedule or change services.
Back to the point of this story. Good consent isn’t a blanket statement. It isn’t signing three different forms covering services that won’t even be provided. Good consent is about an informed decision on benefits and risks. If you want your consent to hold up in court and actually inform your patient, take the time to be thoughtful about it. This thoughtfulness will also minimize disrupting the patient experience. I didn’t return to this office for a cold laser. They had frustrated me and wasted my time enough over the consent process that I just couldn’t bring myself to go back. If you practice in a competitive market, patients have choices and will exercise them. Don’t let your informed consent be the reason they choose another office.