Informed consent
(These are actual questions asked by physicians at risk management seminars. The answers are general guidelines only and are not intended to be a comprehensive treatment of very complex subjects.)

"Is it all right to have a nurse or assistant get the informed consent form signed, or does the doctor have to do it personally?"

The doctor must obtain informed consent. It is the physician's responsibility to inform the patient of the risks, benefits, and alternatives of the proposed treatment or procedure, and guide the patient through the decision-making process. Once that has been done, the task of actually obtaining a signature on a form can be delegated. Remember: informed consent is a process, not a signature.

"Is it illegal to have a patient sign a consent for treatment form after services are rendered?"

It would depend on your state's law, but from a risk management standpoint, you should be more concerned about a release of liability and making sure the situation doesn't arise in the first place. The concept of consent is proactive. A person can only consent to something before it happens. After it happens, the person can perhaps sign a release of liability, but cannot consent to it retroactively. We suggest you check with a health law attorney in your state, and set up a system of checks and balances to make sure the situation is prevented in the first place.

"I know you need informed consent for hospital procedures, but does the same hold true for procedures done in the office? The patient even requested the procedure; does that make any difference?"

Laws regarding informed consent vary from state to state. Some states require that you always obtain consent for specific procedures. From a risk management standpoint, you should make sure you explain to the patient the risks associated with your treatment or procedure. Some physicians use a special form developed for "office procedures;" others simply document the conversation in the medical record. The point is to make sure the patient understands what could happen and consents with that knowledge; and that you have documented that fact.

Latest Question / Informed Consent / Liability / Recordkeeping / Confidentiality / Managed Care
Got a question? Submit it to MedRisk®.
Let us know if we can use your question with your name; otherwise, confidentiality rules.