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Say Anything | Oct 2020

Say Anything: CRST Readers Comment on Whether Their Informed Consent has Changed in the COVID-19 Era

How has your informed consent changed in the COVID-19 era? What language do you include when providing important pre- and postoperative safety considerations? Do you ask patients to acknowledge that they assume the risk of contracting the SARs-CoV-2 virus?

Denise M. Visco, MD, MBA<br>President and Medical Director, Eyes of York, Pennsylvania

Denise M. Visco, MD, MBA
President and Medical Director, Eyes of York, Pennsylvania

"When we reopened on May 4 in the midst of the coronavirus pandemic, we considered the necessity of a legal waiver for seeing patients and performing surgeries. Although we knew we were going above and beyond following CDC guidelines, we consulted our attorney, who was adamant about using a waiver. In fact, he drafted a strong one that says in no uncertain terms that we are not liable, as we all know how ubiquitous this virus is becoming (see Sample Patient Waiver for Treatment Care During COVID-19 Pandemic). Patients will sign the waiver one time to consent to treatment at the clinic and/or ambulatory surgery center. On subsequent visits, patients are asked COVID-19 screening questions, and their temperature is taken and recorded with their answers in the medical chart. Documentation of the COVID-19 processes and precautions during patient care is also entered into the chart with every examination. We employ the waiver for all patients. Anyone who is not comfortable accepting and signing the waiver is offered the option to postpone their care until after the pandemic is over or to seek care with another provider."

Vance Thompson, MD, FACS<br>Founder, Vance Thompson Vision, Sioux Falls, South Dakota

Vance Thompson, MD, FACS
Founder, Vance Thompson Vision, Sioux Falls, South Dakota

"We haven’t changed our informed consent.”

O. Bennett Walton IV, MD, MBA<br>Private practice, Slade & Baker Vision, Houston

O. Bennett Walton IV, MD, MBA
Private practice, Slade & Baker Vision, Houston

"We have added a new informed consent document for all surgery patients to ensure we communicate as clearly as possible.

The wording is comprehensive and specifically includes acknowledgment of the option to defer the treatment or procedure until later. In general, patients have been understanding. We have strict policies in place in the clinic, and although some patients become frustrated by the mask and limited visitor requirements, most feel better protected. To us, it’s an important way to earn patient trust: They see the extra effort and thought that go into taking the best care of them possible.”

Anat Galor, MD, MSPH<br>Staff Physician, Surgical Services, Miami Veterans Affairs Medical Center, Miami

Anat Galor, MD, MSPH
Staff Physician, Surgical Services, Miami Veterans Affairs Medical Center, Miami

"We test all individuals for COVID-19 48 hours before surgery and cancel or postpone surgery if they test positive. Additionally, all individuals seen in the clinic are required to wear a mask at all times, and companions/significant others are not allowed to accompany patients to appointments unless medically indicated—for example, a blind patient who needs help navigating.

We have not changed our consent forms regarding surgery.”

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