Read this if you are a medical director, practice/hospital administrator, compliance officer, risk manager, or clinical quality director.
Early in my first year as a surgical resident, while taking my first night call, I was assigned a simple task: See the patients scheduled for surgery the next day and “get them to sign the consent.” At the time, elective patients were routinely admitted the night before surgery.
I remember telling my senior resident that I wasn’t yet prepared to have a meaningful conversation about risks, benefits, or alternatives. The response was immediate: “Don’t worry—the surgeon already went through everything in the office. The hospital just needs the form signed.”
That moment stayed with me. While common back in the day, it reflects a mindset that still surfaces today: Consent as documentation rather than consent as understanding.
—Alan Weintraub
Whether on paper or via electronic means, patients are asked to sign an ever-increasing number of forms—procedural consents, treatment permissions, privacy notices—often written in dense, legalistic language and presented during stressful or time-pressured moments. While these documents serve important regulatory and legal purposes, they do not, by themselves, ensure informed consent. Just as many of us scroll through an app’s conditions of use before downloading and checking the box to agree without reading, many patients sign a consent without fully understanding what they are agreeing to or feeling comfortable enough to ask questions.
In an environment of increasing comfort with ‘check the box’ agreements, consent can become a transactional exercise—an administrative checkpoint focused on signatures rather than comprehension. The emphasis shifts to ensuring paperwork is completed, rather than ensuring patients understand what is being proposed, what alternatives exist, what risks matter most to them, and whether they genuinely agree.
Informed consent: More than a form
The Joint Commission has been clear that informed consent is not simply a form, but a process of communication—one that ensures patients receive information in a manner they can understand, are informed of material risks, benefits, and alternatives, and are given the opportunity to participate meaningfully in decisions about their care. View the Joint Commission statement.
When consent is reduced to a throughput-driven task, organizations increase the risk of patient dissatisfaction, quality complaints, and adverse events linked to misunderstanding. Conversely, consent processes that emphasize clarity, dialogue, and comprehension support patient rights, safety, and trust.
Strategies for a patient-centered consent process
The challenge for healthcare leaders is balancing legitimate regulatory, legal, and accreditation requirements with patient-centered care that respects autonomy and promotes understanding. Consent should be a process done with patients, not one done to them. Informed consent is not about forms—it is about conversation.
For hospital leaders, the question is not whether consent forms are signed, but whether consent is truly informed. A few practical strategies for designing more meaningful, patient-centered consent processes include:
- Clear, accessible educational materials that focus on what patients need to know—not everything an organization wants to disclose. Materials should be written at an appropriate reading level, avoid medical jargon, and use analogies or visuals, where helpful. These support compliance with regulatory and accreditation requirements, including those pertaining to accessibility and non-discrimination.
- Streamlined consent forms that reinforce, rather than replace, clinician/patient conversations. Well-designed documents can meet regulatory and legal standards while supporting—not substituting for—discussion.
- Processes that allow time for questions, especially when risks, outcomes, or alternatives are significant. Allowing space for dialogue reduces the likelihood of surprise, dissatisfaction, and quality-of-care complaints, and may also reduce malpractice exposure.
None of this is easy in busy clinical environments. Time pressures, staffing constraints, and throughput demands are real. Even small changes, however, in how consent is framed and operationalized can make a meaningful difference.
Ultimately, consent is not a piece of paper. It is a moment of trust. When we treat it as such, we move closer to the experience patients deserve—and the care we aspire to deliver.
BerryDunn can help
Our healthcare compliance team can help. We incorporate deep, hands-on knowledge with industry best practices to help your organization manage compliance and revenue integrity risks. Learn more about BerryDunn’s healthcare compliance consulting team and services.
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