|
Follow this link for correct image display instructions. Consent and Education |
|||||||||||||||||||||||||||||||
|
|
|
||||||||||||||||||||||||||||||
|
In fact, I once had a patient ask me on his third visit what was wrong with him. I relate this to a break in
communication between myself and my patient; i.e. my fault. Granted, some of our patients just can not be educated for any number of reasons,
but the vast majority are intelligent enough to supply their consent. Isn´t the consent process simply educating our patients? When we consent a patient for surgery, we´re educating them in regards to what will be done to them, the risks of surgery vs. the benefits, potential complications, as well as what to expect postoperatively. It´s not just a letter that lets you do surgery. And is this not the same for non surgical care? Take bunions, for example. You´re seeing a new patient complaining of a painful bunion. After obtaining a history, physical, and radiographs, you ´ll discuss the etiology, non surgical, and surgical options. Depending on your philosophy, you´ll lean toward surgery vs non surgical methods. I´ll typically tell my patients that shoe changes, anti-inflammatories, and orthotics may keep them comfortable for a while, but in order to "fix the bunion" they need surgery. Have I not just consented them for their care to come? • Risks – continued pain and deformity; • Benefits – temporary relief from pain; • Complications – possible continued pain that will require surgery. • Consent equals education. So, how do YOU educate your patients? Clearly, some of this comes with experience. I had an attending who could say more in 10 words than I could in 10 minutes. More experienced folks than I have recommended having a standard "lecture" to give for different issues. Consider writing it down, editing it, and memorizing it. Keep it clear and without medical jargon. Remember, your patients have not gone through college, med school, residency, and possibly fellowship to learn all this stuff. Try explaining first ray kinetics to your patients, I dare you!! When I´m trying to convince someone to undergo a more "aggressive" treatment (say, an amputation) I´ll use statistics. I´ll tell them, for example, that patients who undergo a BKA have a 50% 3 year life expectancy. This makes a partial foot amputation a bit more palatable. Patients also want to know what success rates and complication rates are for different procedures. I´d recommend reviewing the literature and writing down these statistics. Look up meta-analyses and RCTs if possible. Consider using written literature. The APMA and ACFAS have educational materials available. If you´re so inclined, you might write your own. Keep pictures handy to show people. The foot is a complex structure; your patient may have difficulty visualizing what you´re talking about. I´d caution you on use of the Internet. Medical information is hit and miss, good and bad. Review the web yourself and offer your patients recommendations for websites with reliable information. Again, I´d refer you the APMA and ACFAS. What other methods of education have you found successful? Models? Videos? Do you have a technique that would benefit all of us? Write in and educate us. Consent us for improved patient care! Talk to me!  Jarrod Shapiro, DPM PRESENT New Docs Editor [email protected] |
|||||||||||||||||||||||||||||||
|
GRAND SPONSOR
This program is supported by an
|
|||||||||||||||||||||||||||||||
