A Case Report From the Anesthesia Incident Reporting System. ASA Monitor 2017;81(8):50-51.
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© 2019 American Society of Anesthesiologists
Resident physicians have an important role in informed consent but should be supervised, formally evaluated, deliberately coached and only perform independently when they have been “signed off” on this skill to the extent possible. Grey areas should be acknowledged. This is already practiced in many programs. The same would be true in non-teaching practice settings in which non-physicians obtain signatures on consent forms, even if the physician discusses risk with the patients.
Standardized patients would seem to be an ideal vehicle for this education.10 Such resources are time-consuming and expensive but can be shared with trainees in virtually all specialties.
Our job is ridiculously complex, and attention to a constructive approach to informed consent can slip through the cracks, even for experienced and otherwise competent anesthesiologists.
It is at least a strong possibility that the informed consent process, and the resulting gain or loss in rapport, can have a concrete effect on the safety of subsequent care.
Postoperative telephone follow-up of outpatients by non-physician staff members is important and useful, but if things did not go perfectly there is no substitute for the physician doing this personally. Such follow up, besides having the obvious benefits on patient satisfaction, subsequent litigation and ethical care, can inform safety. In this case, the anesthesia team would have missed a critical learning opportunity had this not been done.
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