ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Sunday, February 23, 1997 TAG: 9702210029
SECTION: BUSINESS PAGE: 1 EDITION: METRO
COLUMN: health care
SOURCE: SANDRA BROWN KELLY
You're at the doctor's office waiting to be seen, but first you need to sign a statement that authorizes the physician to treat you and that warns there are no guarantees you'll get better.
But isn't just being at the doctor's enough to imply that you want to be treated?
It ought to be, says Dr. Richard Grayson, whose office now asks for the patient "consent" signature because a liability insurance company suggested it.
"You're not at the doctor's to clean the floors or to give him advice on taxes," he says.
Grayson, a member of Roanoke Ear, Nose and Throat Clinic Inc., says he's not embarrassed by the patient consent form, nor does he think it suggests anything about the doctor-patient relationship, but he hates like heck the reason it exists.
It's there because an insurance company thinks it will add one more layer of protection just in case a patient decides to sue the doctor.
The statement is just another piece of "evidence," says Briggs Andrews, general counsel with Carilion Health System. Carilion owns Carilion Health Plans, which asked doctors' offices it works with to add the language to patient forms. Carilion Health asked for the consent statement at the recommendation of Doctors Reciprocal Insurance.
Helen Woodfall, director of assigned risk with Doctors Insurance in Richmond, says her company doesn't write the forms, but it recommends them to its doctor clients and has for many, many years. She couldn't understand why every office didn't have one.
Now more of them do. Right at the bottom of the patient information form, just after the consent for HIV blood testing, below the Medicare Lifetime Signature line and the private insurance authorization agreement, is health care's newest twist at the local doctor's office, the "Consent to Medical Care" statement.
The statement says that by signing, you give the doctors the go-ahead to diagnose, examine and treat you, using whatever tests they see fit. It goes on to explain that by signing, you also say you are aware that:
"The practice of medicine is not an exact science" and "no guarantees have been made as the result of any procedure, treatment or examination."
It's silly to even be discussing such a statement, Grayson agrees. "It's unfortunate to have to spend any time on the issue," says the physician who has 27 years' experience.
"But some people have unrealistic expectations," Grayson concedes. He can see why it's good business for an insurance company to want to "enhance" the patient's awareness that the doctor can't always cure you or even make you better.
Signing the statement doesn't bind the patient to anything, Grayson says. The patient can refuse a test or a shot or any treatment recommended, and patients often do, he says.
"No matter what they sign, the patients can always say no," Grayson says.
What does signing the statement mean?
According to Roanoke attorney John Jessee, who specializes in defending medical malpractice cases, signing the statement doesn't mean much of anything.
Having the signed statement is no protection if a doctor is negligent, Jessee says.
"From a legal standpoint, I wouldn't put a whole lot of support in this kind of form," Briggs Andrews also says. But, being a lawyer, he says he would never recommend against a consent form.
Statements like the new consent form do put the patient and doctor on opposite sides and hints that neither can really trust the other, however.
That's the sadness of health care today. That's the reality.
It's a lousy situation, Grayson says.
"There's no handshake anymore," he says.
LENGTH: Medium: 74 linesby CNB