Was the surgeon a satisfactory informant? How to minimize room for claims.

Patient demand and expectations for plastic surgery have significantly increased over recent decades, leading to an increasing trend in claims. This—arguably, the result of a progressive lack of communication between surgeons and patients—becomes apparent in inadequate informed consent , as previously highlighted by Patel et al. 1 Surgeons have the moral and legal obligation to adequately clarify for their patients everything concerning such operations and cannot perform any procedure without written patient consent. In fact, this aspect of the process allows patients to take active part in their own health care. 2 Well-informed patients generally have good compliance and few anxieties and malpractice claims to raise. Despite this, the everyday clinical process may offer a different scenario: the legal formula of informed consent often becomes a mere act of hurriedly signing a form. As a result, the surgeon deprives patients of information they deserve. Nevertheless, patients usually tend to sign the consent form to accelerate the process. Such lack of information opens the door to possible future malpractice claims. The success of informed consent is based not only on the surgeon providing adequate information but also on the patient thoroughly understanding the procedure and process. A standard informed consent does not indicate evidence of effective communication and thorough understanding on the patient's part at the time of signing; a signed informed consent does not prove the patient has fully understood its content. This is such a risky deficiency that the surgeon may be prosecuted even if information has been properly disseminated, due to a patient's later denial of either sufficient comprehension (" If I had understood, I would have never undergone the procedure! ") or time (" I did not have time enough to read the consent form carefully. "). This scenario is why we felt the need for a consent document that includes the patient's self-assessment of his or her understanding. The proposal is to insert the question , " How do you evaluate both the written and oral information provided? " and have patients fill in their answer in the space provided next to the question. Only positive comments such as " good, " " very good, " and " excellent " will indicate understanding and readiness for surgery. Additionally, the patient will be provided sufficient time to assess his or her level of understanding and awareness of the operative risks. Thus, no future complaints predi-cated on misunderstanding …