What have I been doing?

I have been blaming the air for my shortness of breath.  And I have been blaming the allergy season for my tears during the film showings on these two days.   The truth is that I have been having more visceral reactions toward the patient safety stories.   It gets emotional easily when I think that my family could have been the one affected by similar events.

Obtaining informed consents occupies a relatively minor part of a resident’s day.  After viewing Michael’s story, I have to ask whether it should be the case.   The moment when an informed consent is being obtained, usually is a critical time in a patient’s stay: it means a likely diagnosis was suggested and it means a possible treatment has been proposed.

It should be a time of many questions: how was the diagnosis obtained?  what else could have caused this?  how certain is the diagnosis?  what is the standard treatment for this?  is there something else that can be done?  what happens if I don’t undergo the test or treatment?  what are the complications?  what are the expected side effects?  how is it going to change my life? etc, etc.

I have not been doing good informed consents.  Did I encourage or stimulate them to ask enough questions?  Did I answer their questions fully in ways they can comprehend?  Did I offer accurate information to them?  Did I let them know the alternatives?  Was I trained adequately for informed consent?  Am I helping my juniors to do better?  What exactly have I been doing for my patients?