1. ODRP 726 Lecture 1 Consent Forms

2. Purpose: Informed patients are more likely to: Take responsibility for their own oral health Keep Appointments Pay Promptly Not become unduly upset at a negative outcome It is a legal requirement that all health professionals provide this information so patients can make informed decisions about their health!

3. Informed Consent Informed = to have information or knowledge Consent = to give assent or approval These go together. To have one without the other may lead to disaster…

4. What happens if your patient is not INFORMED? Your patient may be confused about treatment or payment and: Refuse to pay Cancel or not show up to appointments Be angry Seek legal action Give you a bad reputation

5. What happens if your patient is not INFORMED? Examples: Students take a LOOOOONG time doing procedures for the first time. Patients often get very upset at how long things take at a dental school. Informing patients at the outset can insure that the process goes more smoothly. A doctor had a patient trying to seek legal action because she was not aware that to “cap” all her front teeth required significant amount of tooth structure reduction. Clear explanations of the process go a long way to head of legal problems.

6. What happens if we do not get CONSENT from our patient? We have no legal record that our patient is aware of the information that we give them: The diagnosis/problems The treatment to be performed The cost of the treatment The ideal treatment plan for our patient

7. What happens if we do not get CONSENT from our patient? Examples: We hear all the time “I just went to another dentist and they said I didn’t have any cavities!” in patients with major amounts of decay. If a patient tried to challenge that dentist (whether or not that is what they really said), a legal informed consent signed by the patient would prove that the patient was informed. When patients have root canal treatment, it is imperative that a permanent filling or crown be placed as soon as possible. Many dentist end up paying for the patient’s extraction, implant and crown when a permanent restoration hasn’t been placed, because no consent was signed and nothing was noted in the patient record.

8. HIPPA (Notice of Privacy) Facts About Fillings

9. Notice of Privacy Practices or HIPPA Known as the HIPPA form A federal requirement that this information be given at mostmedical professional offices and hospitals. (Some types of medical facilities are exempt) Gives information on: Who will use or have access to patient information What patient information will be used for Patient rights regarding their information Written and distributed by Loma Linda University – the same form used University-wide Must only be signed ONCE Generic form on Canvas

10. Facts about Fillings Dental Board of California requires that this pamphlet be given to every new patient Began in 2004 This document provides information on the safety, advantages and disadvantages of most materials we use in dentistry Must only be given to a patient ONCE Pamphlet is on Canvas

11. HIPAA and Facts about Fillings Hard copies of pamphlets are located on the clinic row next to your coordinators (some students keep a stack in their clinic folder) Review the documents with your patients. Make sure they understand what they are signing! Do this at the beginning of the patient’s first appointment so they can be informed by the time you begin to discuss the treatment plan

12. Procedure …in axiUm Attachments tab Consent Forms (on the left side) Create a new Record (on the right side) Ellipses (…) Receipt of Notice of Privacy OR Receipt of Facts about Fillings (double click) Print the previewed document Have patient sign the signature pad when the signature box appears Document will print at your coordinator’s desk. Give it to your patient.

13. Consent for Treatment

14. Consent Forms vs. Consent Process The forms are important The process is MORE important

15. Treatment Information Forms Course document “Patient Diag & Tx Planning” is located on Canvas (Module 1) This includes all the patient information forms You are responsible for ALL the information included in these forms You should be able to relate this information to a patient

16. Consent for Treatment (Procedures) Your patient must sign a consent form ANY TIME a new procedure is added to the Treatment History Comp Oral Eval FMX or Pano Caries Susceptibility Testing When the Treatment Plan is complete and is presented to the patient The procedures must be approved by an instructor before the patient can sign

17. Informed consent document When your patient signs the “treatment plan” they will be given a document that contains several things: Their list of treatment procedures (properly sequenced) General information for all patients Specific information about each planned procedure

19. What information is in the “Dental Treatment Information?” printout? Each specific procedure recommended and how much each costs The total cost of the treatment plan recommended Recommended sequence of procedures This information is helpful for patients so they can determine how they are going to pay for treatment, and which treatment they want.

20. “Informed Consent and Treatment Confirmation” This is the actual form the patient signs

21. Procedure….Informed Consent In the Treatment Plan tab, print a rough draft of your treatment plan by clicking on Preview Report on the right. This way, you can discuss the treatment plan with your patient and PAF easily. When a treatment plan is finalized, in the Detailed Plan tab press the “Choose Option” button. This is where your PAF can approve a treatment plan. Once your PAF has approved it and you patient understands it, they can sign in the Patient Acceptance tab. This will print at your coordinator’s desk

23. What general information should a patient know? The Informed Consent also includes general information such as:  Patient’s Bill of Rights  Patient’s responsibilities  General Information – Emergency numbers, etc.  Common Risks Associated with Dental Treatment Procedures It is VERY important that a patient knows (an hopefully understands) that:  They are responsible for their oral health, not you!  Our cancellation policy  We are a school. We take a LONG time to get things done.  Our work is NOT free

24. What else is included in the Informed Consent Packet? Specific Information (written at a 5 th grade level) regarding each procedure is provided: Explanation of the proposed treatment procedure Benefits of receiving the treatment Alternative treatment options Potential risks (most common) – very important Potential consequences of NOT receiving treatment  This packet of information helps the patient understand their treatment plan and their options.  It’s not enough to just hand the information to the patient.  You must also discuss it with the patient and make sure all their questions are answered. Let’s look at “Crowns and Veneers”

26. Printout of document The document at your coordinator’s desk will include the Treatment Plan, Information about each procedure and General Patient information. You should give this to the patient, and then explain the document You MUST give the patient the opportunity to ask questions (at this or future appointments) This is also the time to discuss payment options. If you don’t, you will end up paying for it with your student loans!!! These may take discussion at several appointments This process takes time. Some patients want to know every detail. Plan accordingly…

27. Are you bored yet?? Even though this is not the most exciting subject. It is VERY important. So stay with me…

28. Oral Surgery Consent

29. Oral Surgery Consents Extractions:  This consent form is really an informative page like the ones that are printed with the Informed consent about extractions and is presented to the patient before any oral surgery appointment  The form describes the procedure, benefits, alternatives, risks and consequences of not doing treatment

30. Procedure Form found in the OMFS department If patient has already signed for the extraction in axiUm just review the form with them If the patient has not signed, make sure they sign by clicking on the red “stop sign” at the bottom of the EHR or next to the procedure code in the Tx History The patient takes this form home with them.

31. Bisphosphonate Consent Form

32. If your patient is taking or has taken bisphosphonate medication for osteoporosis, a consent regarding complications with dental surgery must be signed before any invasive dental surgery is done! These patients are at risk of severe osteonecrosis of the jaw after invasive dental surgery and need to be aware of this.

33. Procedure Attachment tab Consent Forms (on the left) Create a New Record (on the right) Click on the ellipses (…) Double click Bisphosphonate Consent Review the points listed in the consent Click OK Print the preview Have your patient sign at the signature box Collect the document at you coordinator’s desk and give to your patient

34. Paperwork As in any profession, the paperwork is the most boring part but it is very important not only for legal reasons but so that your patient is aware and understanding during your time together. Make sure that you have these discussions with your patient, and that they are well documented. You clinical experience here at the dental school, and when you are in practice will go much more pleasantly! Paperwork does not stop when you graduate! Trust me.

35. Questions???