Informed consent
Introduction : An implant treatment can be the subject of a collaboration between two or more practitioners, one performing the surgery, the other the prosthesis. We are often asked about the distribution of responsibilities in the event of legal proceedings.
It is important to know that the treatment plan is fundamental. It must be the subject of consultation between the two practitioners, after a thorough study of the patient’s case.
Once defined, it is the subject of a written document signed by the parties, patient and practitioners. It therefore becomes common to both practitioners. If the prosthetic treatment proposal does not suit the surgeon, he must establish a consultation with his fellow prosthetist and arrive at a common treatment plan. In the event of a profound disagreement, admittedly unlikely, elementary prudence requires that the implants be abandoned.
In the context of normal collaboration, the treatment plan was defined and approved by the various practitioners involved in the treatment. Study models were made as well as a diagnostic wax-up. A surgical guide was prepared from the diagnostic wax-up, therefore according to the prosthetic project. The surgeon is therefore able to place the implants in the most favorable situation that will have been determined for the final prosthetic realization.
Name:……………………………………………….….First name:…………………………………………………………..………
Date of birth:………………………….….Profession:……………………………….………..….……
Address:…………………………………………………………………………………………..Tel.:………………..……………
Patient Consent
I, the undersigned ………………………………………………………..certify that I have been informed by Doctor……………………………………………………………………………………………………………………
1-that surgical placement of implants is possible but that no guarantee of success can be assured in this type of treatment;
2-classic treatments by fixed prosthesis (bridge) or removable prosthesis which would be possible in my case;
3-the need for clinical and radiographic checks twice a year for three years following implantation, then once a year thereafter;
4-classic post-operative follow-ups and consequences of possible failure;
5-that in case of failure, the implant will be removed at no additional cost;
6-that treatment by implants is not included in the social security nomenclature, and that consequently no coverage is possible by health insurance funds.
Date:
Signature
(Preceded by the handwritten mention “read and approved”)
Some practical advice
It is important to remember a few essential principles in the context of professional civil liability .
The patient’s medical record must be meticulously kept. This record must chronologically trace the different sequences of care. This care must be described in a legible manner (i.e. so that the practitioner can reread it) and sufficiently precise. Pre- and post-operative prescriptions must be noted with the name of the prescribed specialty, its dosage and the duration of treatment.
The reference labels of the implants placed must be stuck in the medical file.
The fundamental documents signed by the patient must be scrupulously kept in the file:
_ Health check;
_ Treatment plan – quote;
_ Informed consent.
These are essential elements in the event of legal disputes. Radiographic and imaging documents are archived and radiologists’ reports are retained.
In the event that the patient wishes to recover his x-rays (the images belong to him), it is possible, if desired, to have certain images duplicated or to photograph them. In any case, it is necessary to keep a copy of the reports and have the patient sign a summary document of the images provided.
If during treatment the treatment plan is modified (for example, a tooth that was thought to be kept must be extracted or an additional implant must be placed), it is imperative to make an addendum to the initial treatment plan-estimate or to redo a new document canceling and replacing the first one. It is essential that there is conformity between the treatment plan-estimate accepted and signed by the patient and the final therapeutic realization.
If you have a problem with a patient, it is often helpful to seek advice from another practitioner who, being less involved, can give sound advice to avoid the conflict escalating.
Informed consent
Bibliography:
-Patrick MISSIKA, Anne BANHAMOU, Isabelle KLEININGER Access the jpio collection implantology
Informed consent
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