The Advocate Update Report --  November 2003
by Dr. Matthew McCoy, Chair – WCA Chiropractic Advocacy Council

Terms of Acceptance and Informed Consent

A recent article in the November 2003 British Medical Journal titled Making consent patient centered http://bmj.bmjjournals.com/cgi/reprint/327/7424/1159 serves as a reminder of the importance of you and your patient agreeing upon the objectives of your care and is worthwhile reading.

Hopefully you are using a Terms of Acceptance with your patient prior to initiating care and hopefully you are taking the time to review this form with your patient rather than just including it in the number of other forms they must wade through in order to see you.

As the BMJ article points out, not enough attention is being paid to the patient’s objectives and by taking the opportunity to review your Terms of Acceptance you can insure that the new patient knows whether or not their objective is the same as yours. If it is not, this gives you the perfect opportunity to address any disparity and also serves as an excellent way to give a pre- Report of Findings.

This practice also adds to the validity of the consent you are seeking since the patient has received appropriate information about the objectives of care. Since this amounts to sharing of information it becomes much more patient centered and allows the patient to participate in a shared decision about undergoing care.      

These types of discussions with patients should also inevitably lead to discussing goals of care. This is a good thing since, as pointed out in the BMJ article; involvement of patients in setting goals is fundamental to the concept of patient centeredness.

As always, I look forward to your feedback, comments and suggestions.

Dr. Matthew McCoy advocate@worldchiropracticalliance.com

Chairman – WCA Council on Chiropractic Advocacy