Change at the Federal Level
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"After 120 years of experience regarding informed consent in America, how can we still be sitting in a place where it's not mandated for patients to be told upfront and in writing, WHO will be performing their surgery?" - Heather Steiger We believe current federal guidelines encourage and enable the unethical practice of ghost surgeries. Scroll down to read about the "Interpretive Guidelines" hospitals must follow. Believe it or not, surgeons are not legally required to release the name of the surgeon or surgeon(s) WHO will be performing surgical procedures on you. Instead, they're required to list only one name...the name of the attending surgeon in charge of the overall outcome. Federal law also only requires the attending surgeon, that you specifically hire, to be physically present during the critical part of your surgery. Each surgeon is allowed to make their own decision about what that critical part is and in some cases, hospitals write their own clauses into their informed consent which attempt to take these legal obligations away.
Read the details below which reveal loopholes in current US law. Then write to The Centers for Medicare and Medicaid and your Congressional Representative (contact information to your right). Demand that current "interpretive guidelines" regarding the informed consent be changed. America has prided itself when it comes to citizens having the right to choose what happens to his/her own bodies. Why don't we have the right to be told, in writing, the name and/or names of all surgeons who will be participating in our own surgical procedures? |
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It is critical for changes to be made at the federal level for the protection of patient rights, a decrease in medical errors and to make ghost surgeries, nearly impossible. Current federal guidelines require a patient to be told WHAT procedure will be taking place during your surgery. However, hospitals and head surgeons are NOT required to put in writing "WHO" or "the multiple WHOS" that will be providing the service.
Scarier, the form patients sign prior to a surgical procedure, the "Informed Consent" is EXTREMELY misleading, across the nation. Based on current federal guidelines, only one surgeon's name must be listed on the top and it has NOTHING to do with who is performing the surgery. Instead the purpose of that name is to document the attending surgeon in charge of the residents and fellows under his/her care. Currently, there is no requirement for any hospital, in any state, to list the WHO's participating in your surgery, much less whether they are a resident or fellow, what role each will play or whether the attending will be present from start to finish. Because our son was medically complex, we flew over 500 miles for the skilled hands of an expert surgeon. He met with us the day prior to surgery and acted as though he'd be doing it all. He never touched our son. Nine months and three surgeries later, our son still has one more surgery ahead of him..all four due to malpractice that occurred as a result of his ghost surgery.
The organization responsible for making changes to the current guidelines is The Center of Medicare and Medicaid's Center for Clinical Standards & Quality (link to their page). They are also known as CMS. CMS is a federal agency and a division of our US Health Care System.
CMS is also responsible for writing the "Interpretive Guidelines" that hospitals must use when a each creates their own Informed Consent (link). These "Interpretive Guidelines" have loopholes that we believe enable, if not even encourage, ghost surgeries to occur at teaching hospitals.
As mentioned above, federal law doesn't require hospitals to list the name(s) of the surgeon(s) performing your surgical procedure. Hospital are only required to list one name at the top of the consent form you sign... the name of the provider in charge. This is extremely misleading and sends the message to patient's that the surgeon's name listed is WHO will actually be performing your surgery. That's not what that name is there for at all...only who's in charge.
While current federal law states the attending must be PRESENT for the critical part of the surgery, each attending is allowed to decide what that critical part is. So if Dr. Zebra needs to be in the next surgical room in two minutes, he can decide Suzy's critical part is complete...even though last week, for the same surgery on a different person, he chose a different 'critical part.'
Currently, surgeons don't have to tell a patient if they will be present during the entire part of the surgery or only a portion of it.
Often, surgeons go over the parts of the informed consent and patients never read it. Many hospitals have switched over to obtaining electronic signatures, further preventing patients the opportunity to read the fine print which in some cases, prevents patients from making informed choices.
We believe the written informed consent should only be obtained from paper, not electronically. We believe patients should be required to initial each clause, stating they've read it and are truly informed. We believe 2-3 clauses are typically left out from many surgeons, across the nation, when they go over what's on the form.
CMS is also responsible for creating the manuals that hospitals must follow if they accept medicaid and medicare. Even if you pay with private insurance, hospitals must still comply with CMS standards. CMS allow concurrent surgeries...where the critical parts of different patients are performed at the same time, something The American College of Surgeons has taken a FIRM stance against in both principles and ethics. Current federal standards also allow two patients in one surgical room, having their surgeries performed at the same, so long as the attending and the resident are "face to face." p. 152 (look at 'Physically Present'). Believe it. Write to CMS. Write to your local representative. This must change.
Change at the Hospital Level
We are calling hospitals nationwide to present a hard copy of any consent form NEXT to the black electric signature pad and asking for INFORMED CONSENT FORMS (surgery permission) to be only given on paper.
Cincinnati Children's had this out for their patients to read so they would know what they were signing when they checked in for an appointment. We encourage this practice and are asking for hospitals across the nation to follow suit. Patients shouldn't have to ask to read what they are signing their names to.
If enough people start demanding to read what they are being asked to sign, hospitals will eventually get with the program and follow Cincinnati Children's lead. It's more ethical, more transparent and our country will have far less 'Never Events.' (link in blue)
Cincinnati Children's had this out for their patients to read so they would know what they were signing when they checked in for an appointment. We encourage this practice and are asking for hospitals across the nation to follow suit. Patients shouldn't have to ask to read what they are signing their names to.
If enough people start demanding to read what they are being asked to sign, hospitals will eventually get with the program and follow Cincinnati Children's lead. It's more ethical, more transparent and our country will have far less 'Never Events.' (link in blue)
