How Informed Are Your Patients?

by Richard Quinn •

Key Points

  1. The process of informed consent protects the physician from liability and allows patients to understand all risks and benefits of their decision.
  2. Multimedia tools for patient education can be useful for otolaryngologists in clinical practice.
  3. A good way to ensure that a patient’s consent is truly informed is to build a relationship with that patient.

When a Patient Declines Consent

The process of obtaining informed consent is a double-edged sword for Leigh Sowerby, MD, and not because of litigation after obtaining said consent. “For me, the more frustrating thing is somebody who, after hearing the risks and benefits of surgery, decides that they don’t want surgery,” he said.

Take sinonasal surgery. “We’ll say there’s a risk we could injure your orbit and cause you to have decreased vision. And occasionally a patient will hear that and say, ‘Oh, I don’t want the surgery. There’s no way.’” He added, “To me, the most frustrating aspect of the informed consent process [is] when you know how much benefit a patient could potentially have from a procedure, but we have to respect their decision [to decline].”

Dr. Sowerby said that informed consent is more than getting patients to sign documentation allowing a procedure. It’s the process of making a patient understand why she’s signing. If a patient doesn’t sign, Dr. Sowerby sees it as his job to make his argument even stronger. “You just need to get to know that patient longer,” he added. “It means continuing on medical therapy, and seeing the patient back in three months, and seeing them back in another three months after that to develop a relationship, which then develops trust, which then ultimately allows the patient to let you help them.”