Shared decision making vs Informed Consent- A battle against time

The importance of not just obtaining informed consent but going beyond that to make a shared decision that fits with a patient’s values is something that I feel needs to be of higher priority. At my home institution, the anesthesia resident that is on call is responsible for pre-oping and obtaining the anesthetic consents from all patients who are currently admitted and scheduled for the OR the following day. It is an arduous task that not many of us look forward to. This task is usually considered lowest priority, and is expected to be accomplished during the residents “free time” during their call shift. If there are, for example, 20 patients that need to be seen, spending 15 minutes with each patient as opposed to just 5 minutes means taking 5 hours to complete the task, as opposed to less than 2 hours.Unfortunately, due to time constraints and the fact that if not all consents are obtained by the end of the shift there will be backlash from staff, very rarely is this done in a way that is consistent with the process of shared decision making. Often the physician directly responsible for the patient’s intraoperative care will be meeting with the patient the next day. Where is the professional pride and ownership of consenting our patients?

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