Reformed Consent

Dr. Lieberman offered some excellent insight from his years of practice experience in his reformed consent article. In that post, he discussed the difficult task of avoiding litigation during his jurisprudence discussion. The 300% rule he cited should be inscribed in the podiatric code of ethics. I would respectfully recommend watching the movie Patch Adams and adopting the mindset of Robin Williams! It is required "reading" for all physicians who wish to succeed in the 21st century.

Like Dr. Lieberman, I have also been fortunate in avoiding litigation through my 20 years in private practice. For me, the keys have been the establishment of excellent, open and honest communication with my patients. Additionally, I formulated a practice mindset and adopted a mission statement that ensures that every patient understands they will be treated as if they are a family member. Every attempt is made to exceed patient expectations at each encounter, whether it involves a physician encounter, or staff encounter. Office policies are created which are as patient friendly as possible. Excellent customer service ensures the patient feels as though they are the most important item on your office's agenda that day, which goes a long way in avoiding lawsuits and creating active patient referral sources. Physicians must make every effort to establish solid professional relationships with each patient they encounter. They must engage in active listening skills which impart feelings of empathy towards their patient's concerns. One must also take steps to allow patients to actively participate in the medical decision making process when possible, since the old passive/active physician model is archaic and but a vague memory from the past. When one doesn't feel they have connected with their patient, that's the time when red flags should be raised and one should become leery of potential, future, litigious behavior. Closely monitor the verbal and non-verbal communications exhibited by those patients whom you feel disconnected from.

It's generally not about the bad result, it's about the poor doctor-patient connection. Empathetic connections create feelings of trust, which is the key emotion one looks to elicit when one provides services to the public. Once you've lost it, beware and avoid feeling pressured, or coerced into providing ongoing healthcare to an individual whom you no longer trust, or whom you feel no longer trusts you. There are tactful ways of ending professional relationships and discharging patients to colleagues. Beware however, for one must have solid documentation to explain the rationale why one opts to terminate a given doctor-patient relationship, but understand that you have that empowerment. When it is all said and done, you are the doctor; it is your practice; your livelihood and professional reputation are at stake, so you must ALWAYS take control over EVERY situation that you encounter. Always take the high road and that's The Mullen Angle!

Respectfully submitted,

Barry Mullen, DPM