In preparation for my move to Exeter I am slowly working through a long list of ideas to research and rethink so that when I start I can hit the ground running doing dentistry the way I want.
Those that read my content regularly will know that I spend a lot of time and energy trying to improve patient communication methods in a variety of ways. Whether that involves using technology to make photography more powerful and efficient or using standardised Oral Hygiene postcards so that delivering better OHI is quicker and easier.
Today I will be revisiting a document I use regularly for complex cases as I have reworked it recently and it has been a long time since I last discussed it so some people may not have seen it. I call it my "Treatment considerations" document.
When I posted this on the forums last year I thought people might not be that interested in it. How wrong was I! This sparked such a big response. Easily the biggest of any of my blog posts. In the first 24 hours alone over 500 people liked or commented on it. The debate was long and extensive so to take in all of it I would probably recommend heading over to D4D and requesting to join that forum (there is a link in the useful resources page) and searching for "rambles" which is how I labelled all my blog posts there.
There have been quite a few posts recently about people being sued and proper consent for different procedures. I too have been contemplating this topic and decided to try to standardise my consent process by creating some standard dental procedure consent forms.
Up till now the only signed consent I have been obtaining has been for photos. And in the last few months I have moved to doing that digitally by getting it signed directly on the iPad and then saving it as a PDF which I do via the adobe fill and sign app (here: https://appsto.re/gb/V_vO4.i). I really like this process because it means no printing, scanning and shredding and I also found that by wording the consent form carefully it actually made it easier to get formal photo consent because everything is laid out in order.
So I searched on google for dental consent forms and was surprised to find a pretty poor selection available with most being so text heavy that I just couldn't imagine them being useful. So I widened my search to medical consent forms and found a template style that seemed to make more sense to me. It is pretty much this:
1) Explanation of the procedure and its intended benefits.
2) Expected complications from this procedure that occur almost every time.
3) Common complications/risks.
4) Rare complications/risks.
5) A statement pointing out that this procedure doesn't work every time and therefore what might be needed in the future.
6) Alternative treatment options.
7) Pt to sign confirming they understand this procedure and have had time to ask questions and are happy to proceed.
Now I know this type of consent can't stop a pt making a formal complaint against you all the time but it might hopefully have some weight in that scenario. However for me I will be trialling it predominantly as a way to standardise my consent process so that I can ensure important points are not missed.
There are some procedures that I have not created forms for yet because I don't do them (eg implants) and I might end up doing things differently for some situations. For example I have heard in the past of people getting pts to sign a "consent to ignore professional advice" form when pts choose to not have a procedure that you strongly advise them to. I will have to think about that.
And obviously it is likely that over time my wording my need tweaking if pts routinely don't comprehend certain parts etc. I am very happy to take any comments about any of the wording if you think there are points that need adding or changing especially if you are a specialist in any of the fields.
I am very happy for you to use these if you think they will be useful to you. They can be downloaded from my google drive here:
Since the first time I posted this I have also created "information sheets" corresponding to each consent form which are basically the same form but simplified slightly which some its seem to prefer. They too can be found on my googledrive.
Dr Chris Harper