Emphasizing Thorough Patient Consent Forms For Surgery

Continuing my discussion of the medical record, I think it is important to briefly discuss the consent form in regard to surgical procedures.   

For any procedure we perform in our office, we use a consent form adopted from the standard consent forms as presented on the American Podiatric Medical Association (APMA) website at: https://www.apma.org/YourPractice/content.cfm?ItemNumber=9793 .

I have trained my staff to write the involved procedure on the consent form after discussing with me the surgery I will be performing.  

We use a more in-depth surgical consent form for procedures that we are performing in an operating room. You should realize the importance of having your own consent form in the office where you are spending time with the patient reviewing all aspects of the procedure and risks involved. Many hospitals and surgery centers will then have their own consent form. These forms will sometimes present the procedure in a really generalized manner, which could just be copying the procedure order that the surgeon used to schedule the surgery. This needs review and one should change it if it is not the correct procedure.

The consent form in our office is really thorough and explains the procedure in both medical and layman's terminology. It is really crucial to describe the procedure both in layman’s terms as well as medical terms for the sake of completeness. Some patients will want to research the procedure in more detail and if your consent form simply says, “correction of bunion deformity,” this can open the door for many unnecessary questions from your patients as well as anxiety for them. If it is possible that intraoperative findings could change the procedure you are performing, list all of them for that particular condition and specifically state that the procedure may or may not happen depending on the intraoperative findings. We then list the reasons for performing the surgery as well as all potential risks, benefits and possible outcomes.

Our office form contains two pages of diagrams. One page has a diagram showing incision placement and a second page contains an osseous diagram depicting all bone cuts and hardware. This is really helpful for patients to get a more complete understanding of what is going to happen during surgery. We give them a copy of the consent form to take home with them the day they sign it.  

It is my belief that you can never be too thorough on a consent form. Most bad outcomes end up becoming worse when a patient is not informed well enough before the surgery. If the patient knows exactly what is going to happen and all potential risks involved, then any poor outcomes will most likely not be a surprise to the patient.