Tuesday, September 30, 2014

Dr. Orthochick: Consent

Me: Do we have consent for [patient]'s surgery?
Nurse: No, the family wanted to talk to Dr. Ortho. They had a lot of questions and they wanted to talk to a doctor.
Me: Well, maybe i can answer them so we can get consent tonight and we don't have to worry about it tomorrow.


Me: Hi, I'm Dr. Orthochick from orthopedic surgery, I'm one of the residents working with Dr. 0rtho. I heard you had some questions about the surgery?
Patient: Yes, what time is it going to be at?
Me: Tomorrow afternoon. Anything else?
Patient: No, that's it.
Me: OK, can I get your signature on a consent form for the surgery?
Patient That's fine.

4 years of undergrad, 4 years of med school, a year and a half of residency, and I'm qualified to tell people when their surgery is going to be. I really question the value of this degree on a regular basis.

Also, I always like to get consent myself so I can answer patients' questions, although I've noticed they only ask two questions:

1. What time will the surgery be at?
2. How long is it going to take?

And those are the two things i can't answer. What time it'll go at depends on when the surgeon is free and how many other things are going on in the OR at that time, as well as how many other traumas we have to do and who's the most injured. Plus, to quote Dr. Monday, "a chance to go early is a chance to go on time." Surgeons are not known for being punctual. Especially if your surgery is scheduled for after the surgeon finishes at clinic. Then you're really screwed. As for how long it takes, I don't like to tell people that because if I say it takes an hour and it takes longer, people really start to flip out. So I just say we won't know until we get in there and see. Which people seem to accept, even though if you think about it, it doesn't make that much sense. There's really not all that much we can get from looking at the bone vs. looking at an x-ray. So yes, I'm anal about getting consent myself, but in the grand scheme of things, I don't think it really helps the patient, since I can't answer the only two things they ever want to know.


  1. Don't your cases get booked for a certain block of time? Or are these just waitlist cases?

    Do people really flip out if the OR takes a bit longer than initially planned? The clear solution there is more Versed before induction...

    1. Yes they do flip out. Usually because they are NPO.

    2. Wait, are we talking about the duration of the OR? Would still go with more Versed.

  2. You forgot, "When can I eat."

  3. And "When can I drive?"

    And in my specialty, "When can I have sex?"