GHOST SURGERY
PREVENTION
*Most important page on our site*
PREVENTION
*Most important page on our site*
. Consent for Treatment and Billing
- No one ever reads it. We hope that starts to change. -This will usually be the first form your sign and you'll almost always use a black electronic pad to sign it. -At a teaching hospital, it almost always gives permission for any staff member (including medical students) to treat you. This typically isn't a problem because you're awake and aware of your care. -It will usually say something to the effect of the hospital cannot guarantee any outcomes of the treatment they give. This doesn't mean they aren't liable for medical malpractice, negligence, or adhering to the standard of care. There is no form a hospital can ever make you sign that will allow you from taking action if something preventable does happen. Read our section about 'Reporting a Problem' if something does go wrong. - Hospitals have different names for this form. Some have one form for consent and another form for billing. Most hospitals have combined the two. You'll typically sign this form on an electric key pad and when you're checking in with a man or woman sitting behind a computer. Ask to see and read a paper copy prior to signing the pad. Hospitals need to be conditioned to stop asking for a signature without providing the contract that goes with it. |
********The Informed Consent*******
THE MOST IMPORTANT FORM YOU MAY EVER SIGN. - No one ever reads it. We hope that starts to change. - You'll sign this during your pre-op appointment or right before your surgery. -There are actually two parts to this process. Verbal Informed Consent- this is a discussion between you and the attending (note...not necessarily your surgeon even if you think it is) where the attending is legally obligated to give you all necessary information which could influence your thoughtful decision about whether or not to move forward with surgery. Written Informed Consent- this is where you will be asked to sign acknowledging that you understand the risks and benefits, that residents are allowed to perform significant portions of your procedure and that your attending is only required to be PRESENT during the critical part of your surgery - For the written informed consent, the name of the surgeon you hand-picked is nearly always what is on top. That surgeon MAY be performing part or all of your surgery, but maybe not. He/She legally only has to be present during the CRITICAL PART of your surgery and doesn't even have to be the one who performs it. - Because the name of the surgeon you chose is written on top, it's deceptive. Everyone thinks that's who they're giving surgical permission to. That name on top isn't necessarily the name of your surgeon at all. Federal law requires it to be the name of the attending in charge, meaning...the doctor in charge of ALL current surgeries taking place on the floor during his/her shift. - Current federal law doesn't require the name of your surgeon(s) on that form at all, only the attending in charge, even if he/she never touches you. - Legally, the attending is only required to be present (for billing purposes) for the critical part of your surgery. The attending gets to decide what that critical part is and because the critical parts aren't mandate by anyone for each specific surgery, an unethical attending can make the critical part whatever he/she wants it to be. The attending could make the decision based on when he/she has to be in the next surgical room or by the time of day if their shift it almost up. We're not implying most surgeons do this, but currently, the law allows it. - Surgeons will always go over the form with you, as they're trained to do. It's part of their job to inform you of the risks and benefits as well as other treatment options. They must use words that people who aren't doctors can understand. But this mandate that they must go over the form with you is actually what has made this form the most deceptive and least transparent. In our history, every single surgeon skipped going over the clauses that mention them performing overlapping surgeries, not being present for an entire surgery and most importantly, that a resident or fellow may perform significant portions of the surgery without the attending's presence. -Each hospital can write their own informed consent using "Interpretive Guidelines" from The Center of Medicare and Medicaid. From the hospital's template, each division of medicine will edit it to make it applicable for their type of medicine. So, don't think once you've read one informed consent that you'll never need to read another one. Quite the contrary. Each is different and each may explicitly allow a resident to perform the surgical task you went to the trained attending for. -There are a few acceptable conditions for a hospital to bypass a signature on this form. Two examples....the patient is in emergent condition and unable to sign or the surgeon finds an unknown condition during surgery, he/she can address it if it won't jeopardize the patient. This is known as implied consent. - Across the nation, no matter the hospital, there is only one name for this, Informed Consent. We suggest you NEVER, EVER, EVER, sign an electric keypad. Let the doctor go over it and then actually read it. Look for the clauses that talk about "Other Healthcare Providers" or "Overlapping Surgeries." |