Have you ever played Buzzword BINGO?
It was one of my favourite distractions in my previous incarnation as a volunteer development worker with VSO, sitting through interminable meetings- generally with government organisations- where everybody gets to make excellent points using buzzwords such as sustainable development and in Uganda and people-to-people. Not to say that these words don’t have great meaning, they once did before being picked up and used by every Tom, Dick, and Chikondi to make a point whether they knew what they were talking about or not.
And unsurprisingly, medicine is a great breeding ground for similar fun.
So, informed consent.
Meaning, before a patient is prescribed a drug or undergoes surgery, the doctor has thoroughly explained why that person needs this drug or procedure right now, what are the side effects and risks (all of them), what the alternatives are for that patient at this time, and what is likely to happen with and without the proposed treatment.
Colorectal surgeons, in my experience, are sufficiently anal to believe totally in informed consent. Some other surgeons do sit down and have a long and honest discussion with a patient. Emergent situations are meant to be the only exception, but the reality is, well, they’re not.
Sending the medical student to get a signature on a piece of paper after a discussion of infection and bleeding rates, of common complications and dangerous complications, does not make for informed consent. It can get particularly hairy if there has been a change in plans due to late scan results and the student is not clear which surgery the patient is even going to have because the resident doesn’t know and there are references to three different types of surgery. Makes for a very confusing pre-op clinic.
Similarly, most of the patients I have seen who have a list of medications as long as your arm have no clue why they are taking any of them.
Which is just as well, in some ways, because if most people knew what an NNT was, they’d never trust any doctor ever again.