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Everything Was Fully Explained



All of us have to go for medical procedures whether it's an annual physical, an eye exam or something more serious and/or invasive. Often, what we're confronted with is an office iPad, a clipboard of forms and ballpoint pens that everyone who's come into the office before they ran out of ink has used. Talk about infection control? Forget it and bring your own pen to the appointment.


Try to forget that the rug needs cleaning or that the receptionist has all the enthusiasm of someone at the returned merchandise counter in the local department store. She's probably had a rough time of it and it's only 10 AM. The day isn't a sunny one and wet umbrellas are being shook all over the place. Where to put them? No umbrella container, so it's going to be your soggy companion for this entire visit. How long will it be before I see the doctor?

"You're the second patient of the day," she responds without lifting her head. Now you have some idea why people are giving this office less than stellar ratings. Wouldn't this woman be better placed somewhere else, perhaps at the post office on the night shift? Yeah, but that's a problem, too.

Carefully, you print out all the information you were asked to provide via their online forms yet once again and try to keep your composure. Perhaps they want access immediately or they think something might have changed. There must be a reason for all of this duplication. Who knows. You are the patient and you comply.

Plodding along, you skip the part on the iPad that wants to take your photo, move to the credit card swiping, which you won't do either and pray for the final page. It comes none too soon as you are told to proceed into the inner sanctum. You've been sitting in the waiting area now for a half-hour past your appointment time.

A quick review of your chart reveals that you need a minor procedure on your thyroid. A paper is pushed across the desk as you are told when and where it will be and who will do it. The print is a "huge" 8 pt. type and reading glasses don't help much, especially when you know the physician is breathing down your neck to get this thing signed.


No time to get a thorough read, you sign and once again it is in the physician's possession. Now you are shown back to the waiting room, given a card and you're off.

Wait, was there something you missed in all that verbiage? You never got a copy and you failed to think you might need one. After all, what would you need to know that you weren't told? Therein lies the rub.

Did you read much of it at all? Probably not. There's one part that almost all patients skip over and most physicians fail to note that portion, too. It's the part where in very general terms you have been told about the risks of the treatment and that it was explained to you. Know what boilerplate is? Well, that's it and some forms even contain sentences that indicate you agree to be videotaped and have your procedure observed or used for educational purposes and even tissue samples may be taken and used for unknown purposes. Do you want that?


I was once given several VHS tapes (yes, that long ago) of several people who had a specific neurologic condition for which there was a test to see how it progressed. The people were identified by name, the town and state in which they lived and the tape was distributed around the country. It could have been distributed around the world for all I knew.

I found the tape helpful, but I didn't think it should have provided so much personal information. The information added nothing to the teaching or diagnostic aspects of the disorder. Why hadn't it been cut out when the clinician stated who this person was and where they lived? It was just one of the problems I found with this training tape.

How many times have you received a confirmation of test results that also included that line that you were "taught how to do...and the risks and benefits were explained to the patient (you)..." and you know they didn't explain much of anything. What did you do? I will bet you did nothing and just felt that since the test turned out ok and you didn't have anything to worry about, you let that "explanation" part go as so much of nothing.

TV commercials for various medications and medical procedures now have a person quickly running through risks (the one that gets me every time is "on rare occasions death has resulted") and there may be a quick flash on the bottom of the screen about warnings. Is that sufficient? Okay, the physician who is going to administer the mediation or perform the procedure should fill in the blanks, but do they? Again, you'll be given a consent form (usually only for procedures) and you're off to the races.

I heard a physician tell a patient, "It's been around for a long time and they'll send a nurse to your home to show you how to use it. Over 10,000 patients have used it." Who is the nurse employed by? Where were the 10,000 patients located and was it a third-world country?


Risks? Well, you might get a major bone fracture or a really upsetting jaw problem from another med and you can't take this med for longer than two years. Why? No research on it beyond two years. So, it's been out for 10 years, 10,000 patients have taken it but after two years the nurse disappears and you have nothing? Looking down the road is something your doc can't do.

Advice? Next time you are asked to sign a consent form, ask for a copy after you sign it and remember that you have the right to ask questions later (before the procedure) and then change your mind. You did not sign a contract for anything and you cannot be held liable for backing out of the deal.

#consentforms #medicalprocedures #fullyinformedconsent #medicine #medications #universalprecautions

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PO Box 761, Tenafly, NJ 07670

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DR. PATRICIA A. FARRELL