Today’s medical systems move faster, operate at greater scale, and handle a wider volume and variety of ailments than ever before. Doctors have access to vast repositories of medical information and data, all of which are intended to produce better patient outcomes. But in one critical way, this modern dynamic is failing patients: as doctors handle a higher volume of patients, they know less about them and can fall short in providing the detailed insight needed to ensure informed consent.
Goodbye, country doctor
A doctor’s relationship with a patient is the foundation of good medicine, and until recently a local doctor was a valued and largely consistent part of family life. In physician-owned practices the doctors knew their patients on an individual basis; they understood them as people, rather than simply as ailments and treatments.
Today, 3 in 4 doctors are employed by hospitals, health systems, or corporate entities, and they have a less direct relationship with their patients. They’re working longer hours—including on average 16 hours per week performing administrative tasks—leading to increased rates of burnout. That leaves them feeling less able to build rapport with their patients.
What is informed consent?
Simply put, informed consent means that a patient fully understands the risks and benefits of a course of treatment and makes an informed decision to consent to the regimen.
Providing that information to the patient in a way that is clearly understood is part of a doctor’s duty of care. Doctors are obligated to disclose all possible risks before treatment begins, and to share any new information that becomes available as the treatment progresses.
It’s a process, not a piece of paper
Unfortunately, in the mechanical, care-at-scale model employed in many health systems today, the administrative approach to informed consent is more about checking a box than developing the doctor-patient relationship. As a result, patients often sign informed consent agreements without fully understanding the risks, one of the reasons why 70 percent of Americans feel the health care system is failing them.
It only matters when it matters
Most of the time, patients who consent to a medical procedure or process without being fully informed have no problems. Their treatment does what it’s supposed to. Their health improves. And no one ever cares whether the doctor lived up to their duty of care.
But when something goes wrong, the velocity of modern medicine, the volume of patients, the long workdays and physician burnout do matter. And that’s why both doctors and health administrators need to remember that informed consent can’t happen without proper information—and doctors need the time to know their patients, so they can know the information they’re delivering is understood.
