As a intern, the endless list of daily consents that I had to complete in the midst of the 50 other tasks, made it a less than perfect process. I celebrated that fact 90% of my patients signed on the dotted line no questions asked. The most common question: What time is my surgery?
As my consents became more efficient, it made room for a more thorough discussion regarding risks; an area I was to uncomfortable to delve too deeply into. The bear necessities to make it “real.” I celebrated the fact the 90% of my patients had no concerns. The most common question regarding risk: What kind of bandage will I have?
Today, when I consent a patient, I start by saying I want you to think of 2 or 3 questions before you can sign. And I take my time. I no longer have any anxiety discussing risks, embrace the discussion of risk and how we mitigate each one. I am far more comfortable with my informed consents; though I submit, it is still my least favorite aspect of surgery.
I want to share with you a case that made a huge difference, and rather unexpectedly. After discussing risks at length, 3 day status post mid-foot arthrodesis my patient asked me “Do you remember when you talked to me about JTV?” It took me a moment, ” You mean DVT, yes.” She said in a concerned voice “I think I have that.” Too put her mind at ease, I ordered the duplex. My suspicion was low, but her suspicion was right on; acute DVT.
I do not take any aspect for granted, and my consent process had evolved and changed. I hope all for the better.