How to deliver an effective consent process

In an evidence-based healthcare landscape there is more and more pressure on the health practitioner to execute the consent process effectively and efficiently.

The problems arise in a time-poor consultative environment where there is pressure to complete every step including consent.

Hi, this Dr. Andrew Arnold, Chiropractor and Founder of the Million Dollar Wellness Intern program.

In this article I want to show you ways you can provide a thorough consent process without compromising patient-doctor communications or your treatment process.

1. Email the new patient intake form prior to the initial visit.
2. Include the consent form and
3. General evidence-based and clinical information relating to all the techniques you offer.
4. Include a short video introducing yourself and a ‘how to…’ Around the intake form and consent process.
5. Make sure it’s understandable. You don’t need to provide the full research paper rather, the key points with the reference.
6. Extend your consent process to include your fees and number of visits.

Emphasise safety and choice. It is critically important the client feels empowered right from the outset to participate in the treatment process.

If some of your treatment protocol is generally considered outside the scope of practice for your modality it is still reasonable however, you must include safety implications, any supportive information and alternatives to treatment.

The consent process is fundamentally about providing enough information considered reasonable by the board / association for the patient to make an informed choice around proceeding with your recommendations prior to any treatment commencing.

Provide as much general information prior to the consultation as possible and then highlight the key points at the time of the consultation.

Encourage the patient to ask questions. Let them know your role is to explain the examination process, working diagnosis and treatment plan in a way they can understand and that they will have opportunities at any time to stay ‘yes, no, stop or I need more information’. It is important the patient knows they will not be caught unaware.

The health practitioner must check in regularly thru-out the initial consultation until such times as enough rapport is established and less check in is necessary.

Get agreements. Once you have explained your treatment rationale including costs and number of visits, it is not unreasonable to ask for an agreement from the patient. This is founded on a visit by visit review process and an opportunity to change the plan at any time.

Consent is about defining the destination in collaboration with the patient. Only then can you work back to the start point and establish the action steps.

Use web-links if additional information is required along the way. The consent process is dynamic. It never stops being important. These may link to information on your practice website, social media page or a 3rd party link that supports your treatment rationale.

Finally, remain teachable. Encourage your patient to introduce their own information. Be open to something you may not have considered and always refer to another practitioner who has more expertise.

Consent is founded on relationship and rapport and this is founded on communication. Talk to your patients. Be honest. Ask questions. Get feedback. Are they on track, ahead of schedule or behind? Make it clear there are no guarantees however, you will do your best in accordance with your experience, clinical skill and the current evidence-based research available.

About the Author:

Dr. Andrew Arnold is a Chiropractor and Founder of the Million Dollar Wellness Intern program.

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