Informed Consent - The Importance of Obtaining Consent When Establishing a Patient Relationship

Consent is the voluntary permission granted from a patient from a medical professional to allow the permission to touch, examine, and perform medical services. If a medical provider were to touch or examine a patient without consent, they could be liable for battery. However, if a patient consents to a procedure, the physician CANNOT be held liable unless they fail to meet the accepted standard of care while performing the procedure.

Informed consent is when the patient agrees to a proposed plan of care, AFTER the advantages and risks of the treatment, treatment alternatives, potential outcomes, and the risks that may occur if treatment is refused, have been explained to and understood by the patient. Patients have the right to be told information that a "reasonable" person in the patient's situation would want to know. This is referred to as the "Reasonable Person Standard".

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The process is much more than a patient simply signing a form. It is based on effective communication from a provider to a patient to explain complicated treatment plans in terms that a patient can understand. Informed consent allows the patient to understand the treatment and alternatives and allow them to make an informed decision regarding their care. The patient should sign a form acknowledging that they were informed about the aspects of the treatment and it's alternatives as well as the treatments benefits and limits.

The explanation of a treatment or procedure alone does not constitute consent, as the patient must UNDERSTAND the explanation. After explaining the treatment plan and alternatives and the patient grants consent, the provider should ask the patient to summarize what they have been told to ensure that they truly understand. If possible, a family member or other responsible adult should be present and witness the process.

Within the physician/patient relationship, obtaining the informed consent of a patient is critical, as it is what holds the relationship together.

Because the practice of medicine is an evolving art and science, it is difficult to fully inform a patient about ALL the aspects of a treatment and all that can possibly go wrong. However, the provider must make a reasonable effort to do so, so that the patient can still make an informed decision.

A patient's consent applies ONLY to the procedure that was explained to them and which they agreed to. For example, if a physician is performing surgery on a patient's lung, and when doing so notices another condition that requires medical attention, if the surgeon were to correct the condition, they would still be liable for battery.

Medical providers are protected by law in emergency situations, in which a patient is not able to understand treatment information or provide consent.

Minors, the mentally incompetent, and those who do not understand English are deemed incapable of providing an informed consent.

Implied Consent

A medical provider should obtain written consent for treatment, regardless of its complexity, whenever possible. However, there are situations in which they can assume consent from a patient, such as when patients indicate by their behavior that they are accepting treatment or a procedure to be performed. This is referred to as "implied consent". For example, if a patient schedules an appointment for a physical examination, it is implied that they consent the physician to touch them during the exam.

Exceptions to Consent

Exceptions are dependent on state law

* A physician does not have to inform a patient of risks that are commonly known

* In emergency situations, a provider can assume that informed consent would be granted if the emergency did not exist. However, the provider does NOT have the right to assume consent if the patient has refused consent in the past

* If a patient asks a physician NOT to disclose the risks of a treatment or procedure, the physician can respect the request and not disclose the risks

Refusal to Grant Consent

Competent adults, who are conscious and of sound mind, have a right to refuse any medical treatment or procedure. Regardless of the patient's reasons, the refusal must be respected by medical providers, or they could be liable for battery.

If a patient refuses treatment, a provider should discuss alternatives and possibly encourage the patient to seek a second opinion. If the patient still refuses, a signed refusal to treat form should obtained from the patient and kept within their medical record. The document should state that the patient was informed of the possible consequences of refusing treatment.

Informed Consent - The Importance of Obtaining Consent When Establishing a Patient Relationship

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What the Patient Protection and Affordable Care Act Means for the Future of Mental Health Care

The Patient Protection and Affordable Care Act was passed in March of this past year, and aims to improve all aspects of our country's health services. One aspect that will be much-improved is the area of mental health care.

Insufficient coverage and a lack of programs that educate the public on mental illness have plagued the United States for quite some time. With the passage of the new law, a number of new provisions aim to change the public's perception of mental illnesses and offer programs and other initiatives to help those who need mental health care. A few of those provisions include:

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Improvements to Medicaid (including the expansion of eligibility) that will allow more people to experience the benefits of mental health services Several new options for people with disabilities Improve coordination and communication between primary care and mental health services Much more...

Essentially, what this means is that, over time, individuals with mental illnesses will have access to health insurance that covers mental illness and substance abuse services, giving people unprecedented help and cooperation from the government. Other services include prevention programs, new insurance plans for long-term community care, and more.

The Patient Protection and Affordable Care Act also aims to improve health services in the workplace. It specifies that starting in 2014, employers can offer bigger incentives for employees' positive lifestyle practices or participation in health promotion programs. The PPACA also creates a grant program to assist small businesses to provide comprehensive workplace wellness programs. Grants will be awarded to eligible employers to provide their employees with access to new workplace wellness initiatives.

The grants will be awarded beginning in 2011 with 0 million appropriated for a five-year period. The PPACA spells out that a comprehensive workplace wellness program must be made available to all employees and include health awareness initiatives(including health education, preventive screenings, and health risk assessments) as well as supportive environment efforts (including workplace policies to encourage healthy lifestyles, healthy eating, increased physical activity, and improved mental health).

The improved workplace atmosphere when it comes to mental illness awareness is particularly important, as knowledge about mental health is notoriously absent from workplace programs. It has been studied that employees are eager to become more understanding of mental illnesses and ways to treat them, and the Patient Protection and Affordable Care Act aims to accomplish that.

Mental health services will be experiencing a major renovation with the government's commitment to overall health care reform. Those with mental illnesses will find it easier to seek help and others will find much more information on mental illnesses to create a better understanding of how these health services operate. By creating a more cohesive health care system for mental illnesses, our society will not only become more fluid in its operations, but more knowledgeable and, therefore, better for it.

What the Patient Protection and Affordable Care Act Means for the Future of Mental Health Care

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What You Can Do As a Medical Provider to Improve Patient Satisfaction

It has been widely believed and accepted that if you provide quality patient care, your patient satisfaction rates will be high. We now know that this is not always the case. Research has shown that there is a large disparity between perceived hospital and physician quality of care and patient satisfaction across the nation. Research has also shown that patient satisfaction in many states is actually opposite what one would expect when providing quality patient care.

A survey performed by CareChex, has shown that while many hospitals and physicians across the nation ranked high in quality of care, they adversely ranked low in patient satisfaction. Florida, for example, ranked 8th in the nation for quality of care and 49th in the nation for patient satisfaction. How does this happen? It is believed that practices and facilities are spending their extra resources acquiring state of the art technology to provide high quality care to their patients. What they are lacking in many cases, is delivering exceptional care to each and every patient who enters the building. While the aesthetic appearance and technology a facility offers is important, so too is the way the patient is treated while receiving care.

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What does this mean for medical practices and facilities across the nation? Administrators must be proactive in gathering feedback from their patients. Patient surveys must become a common part of the practice. The medical industry at large has become highly competitive and as such, if your patients are not happy, they will go elsewhere. Gathering feedback alone is not enough, you must also implement any needed changes. If you take the time to ask your patients about their experience and then do nothing to fix any problems that may be present, you are telling them that their opinion truly does not matter. This is worse than not asking their opinion at all.

By taking a proactive approach to measuring patient satisfaction and then implementing needed changes, medical practices will bridge the gap between patient satisfaction and quality of care. The practices that deliver not only quality care, but exceptional service are the ones who will prosper the most!

What You Can Do As a Medical Provider to Improve Patient Satisfaction

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