- Understand the name of the surgeon listed as the surgeon on the surgical informed consent DOES NOT mean that surgeon has to legally lay one finger on you.
- If your surgeon asks you to sign an electronic signature pad for your written informed consent, we suggest you say, "I'd rather read and sign a paper copy instead." They have to give it to you.
-We are calling on ALL HOSPITALS, public and private, to stop the use of electronic signature pads for the informed consent process. The electronic method cannot ensure that the form was directly presented in front of the signer. The use of a physical piece of paper is the only way to ensure the patient saw the form.
-READ the entire informed consent form YOURSELF, after your surgeon goes over it. Your surgeon will not go over every aspect of that form because there are LOADS of important information in it. There will be specific clauses you need to pay attention to, especially regarding overlapping or concurrent surgeries, as well as other health care providers. These are not the kind of contracts you sign when you buy a car or a house. This is one form and your life. Remember, every hospital writes their own informed consent and from there, every surgical division will revise it to suit their own needs. This means no two informed consents will be alike unless you're having the identical surgery with the identical surgeon and the form hasn't been modified (which can be at anytime and without any notice).
*The following information is going to be overwhelming. As soon as we can, we'll have it condensed into a checklist for printing. You'll be able to bring it to your pre-op appointment and/or the day of your procedure. The checklist will be made under the tab, "Printables." Look for the form, "Informed Surgical Checklist."
-On the day you sign the informed consent, ask your surgeon what part(s) of your procedure he/she will be performing, if any. Remember, the surgeon's name listed on the informed consent DOES NOT MEAN THAT IS YOUR SURGEON. Even if you scheduled the surgery yourself, asking for that specific surgeon, it does not guarantee that surgeon. The name on top simply represents the attending surgeon in charge of the fellow and residents at the time of your surgery. The language in the fine print will flat out say you understand that residents and fellows may be performing your procedure. We believe the current form is deceptive, making it UNINFORMED CONSENT. Until the law changes, requiring that the names of the surgeons and their respective roles be listed, it will continue to be an UNINFORMED CONSENT.
-On the day you sign the informed consent, ask your surgeon what part(s) of your procedure that a resident or a fellow will be performing. If you're in pre-op at this time and your surgery just minutes or hours away, request that the names of the surgeons and their roles be written in on the margins of the paper (there is currently no place for this). Your surgeon should state at this time if he/she will not be performing any parts of the procedure, because they've just told you what their residents or fellows will be doing. If your surgeon isn't going to performing any part of your surgery, ask if he/she will be present during the CRITICAL part of your surgery.
If it not the same day as your surgery, your surgeon truly may not know the names of the other surgeons. Tell your surgeon that you would like the names and roles to be added to the informed consent form on the day of the surgery and that you would like to make initials by those names on that day, prior to surgery.
Then follow up! On the day of your surgery, put your initials next to those names, identifying that you understand. Hospitals and surgeons may grumble over this new level of accountability but too bad. It's not informed consent if you don't know WHO is doing what to your body or what they'll be doing.
-On the day you sign the informed consent ask if your surgeon is not performing any part of your surgery (which we know sounds funny but happens every day due to current federal laws that allow this), ask if your surgeon will be present during the critical part of your surgery.
-We believe ALL hospitals should be required to upload operative and anesthesia reports to patient portals for ease of access and even if they're not required, that they stand up to show their transparency by making it their hospital policy. I don't know a hospital in our country that has taken that step yet. Regardless, hospitals are required by law to provide your records within 30 days of your record request (link here). We suggest two weeks after your surgery, request your records to cross check for accountability because this is a critical time - either there will be enough push from the public to make change or their won't. If you want to be part of the change then you have to be part of the solution.
-Realize hospitals and surgeons aren't perfect and most often do follow the laws and "interpretive guidelines," that CMS has set. Hospitals and surgeons save lives, in ALL hospital settings...residents, fellows and attendings. Do NOT attack or be critical of teaching hospitals because of our story. If you do, you've missed our purpose. Our purpose is to educate you and the general public about how things work and why they'll continue to work until The Quality Safety and Oversight Group of Hospitals at The Centers for Medicare and Medicaid Services change things.
- Stop believing in teaching hospitals. They are amazing places, do amazing things, have amazing people and are on the cutting edge of medicine. Just learn what questions you need to ask prior to having a surgery at one.
- Use an electronic pad to sign an informed consent prior to surgery. Request for the paper form only and read EVERY word after the surgeon goes over it. If you're very concerned, ask for them to take it to the copy machine to make a copy then and there. A witness has to be there to sign it as well. Sometimes this is the surgeon, another doctor or nurse. Make sure they sign this in front of you.
-DO NOT ASSUME the name of the surgeon listed on the top of the informed consent will be performing surgery on you...even if it's the surgeon YOU asked to be scheduled with. The surgeon's name listed on top is deceptive. It's LEGAL purpose is only to name the attending surgeon in charge of the residents and fellows on his/her team and in charge at the time of your surgery. There are currently no legal requirements to delineate names and roles of surgeons involved in your procedure. The attending may truly be involved in your surgery, but then again may not be. Legally, the attending must only be present during the CRITICAL part of your surgery...the attending not necessarily the one to perform it.
-Don't sit there and do nothing. You can be part of making addendums to the current "Interpretive Guidelines" set forth by a division of our federal government called The Center of Medicare and Medicaid's Center for Clinical Standards and Quality.