Blog | Thursday, October 11, 2018

'It's okay Doc, I trust you'

When I'm working in a hospital setting as a physician, part of my everyday job duties involve going over consent forms with patients. I am of course a medical physician, rather than a surgeon, so generally don't have to go over them as often. But I do have to take consent regularly for certain interventions including blood transfusions and minor procedures. The process of getting consent is something everybody is probably familiar with from their own health care experiences, or if not, when a family member has needed it. It basically involves the doctor going over the risks and benefits of any treatment or procedure, and then the patient signing a form giving their informed consent. It's the cornerstone of patient-centered care and any decent health care delivery system. Patients must be told all the pros and cons, before allowing any intervention on their body.

I would say that well over 80% of the time I go over a consent form with any patient, this is what happens: I explain something which is usually medically necessary, give them the form to sign, and encourage them to just take a minute to read through the typically short one or two paragraphs that summarize everything, and any risks involved. The patient response as I hand them the pen is something along the lines of: “It's okay Doc, I trust you if it's what you're recommending … I'm okay signing it”. They then grab the pen from me and duly sign their names on the dotted line.

It's okay Doc, I trust you. Every time I hear those words, a tingle goes down my spine. It serves to remind me of the trust that's placed in us as doctors. I'm typically not someone who likes to show overt emotions in public (hey, I think it's a British thing), but sometimes in life-threatening situations when I've heard this said to me, it almost makes my eyes well up.

Think about it for a moment. People who were strangers to you a few hours before, are at this really low and dark point in their lives. They have lost control over their body, and you are giving them the chance to weigh up the risks and benefits of a decision that could even kill them (no medicine or foreign object put into your body, doesn't have risks, no matter how small). And their reaction after you've communicated the information to them, is to look into your eyes and say: “Hey, it's okay … give me the pen, I trust you!”

This is deeply humbling to me, reminds me of the unique physician-patient bond, and the privilege and honor of being placed on a pedestal like that. It's a responsibility that I'll never take lightly, and feel like every minute I should be earning that faith through my actions and the way I interact with my patients. How many other professions are people trusted that much?

The practice of medicine in this modern age, with all the problems we face in America, is really stripped bare during moments like that. I may have just seen a really annoying administrative or bureaucratic email half an hour before, heard about yet another medical practice regulatory roadblock, or seen the latest statistic online about physician burnout—but it's everyday occasions like this, which keep bringing me back to what's important and what our patients really want from us when they're sick. It's why I went to medical school, and why I want to keep doing my best to be a good doctor worthy of that level of trust.

Suneel Dhand is an internal medicine physician, author and speaker. He is the founder of DocSpeak Communications and co-founder at DocsDox. He blogs at his self-titled site, where this post first appeared.