Home' Clinical Aesthetics : CA issue - 3 Contents BUSINESS
Dr Flynn regularly presents around the
country on the topic of the importance
of informed consent, something he is
“It is by no means enough to have a
patient just fill out a standard consent
form,” he says. “Proper documentation and
counselling of patients is important in any
“It must be preceded by disclosure
of sufficient information. Consent can
be challenged on the grounds that
adequate information was not revealed
to enable the client to take a proper and
“It cannot be a patient’s signature
on a dotted line obtained routinely by a
“ When you are talking about side effects
such as, say, bruising, redness or swelling,
it is not enough to just leave it at that,
according to Dr Flynn.
“ You need to go deeper, to explain very
clearly - or even present photog raphic
examples - to show `what this means is ...’, so
the patient isn’t under any misconception as
to how side effects can manifest.
“It could mean explaining that bruising,
swelling or redness could be mild or severe
and last from a few hours or days to a week
or more, and why these sy mptoms occur.
“So if a patient comes back to you upset
that side effects have been more severe or
lasted longer than they imagined, you then
have the opportunity to say: `Remember, we
talked about that ...’.”
In the unfortunate event, for instance,
a patient is burned and develops blisters
or scars after laser, IPL or a peel, or suffers
hypo - or hyperpigmentation despite all due
care, if you have not explicitly explained
in advance that these are risks of the
treatment, your footing will be very shaky.
Informed consent also means explaining
to a patient that they may just not achieve
the result they desire.
As a practitioner, you well know
that some people are “responders” to
treatments, and others simply aren’t. It
all comes down to individual physiology
and factors like age, skin type and texture,
weight and body shape (for fat loss and
An all- encompassing consent to the
effect “I authorise so-and-so to carry out any
procedure in the course of my treatment”
is not valid. It should be specific for a
If, for instance, consent is taken for
microder mabrasion, it’s not valid for any
other procedure, such as an acid peel.
Additional consent will have to be obtained.
DON’T STICK YOUR HEAD IN THE SAND
As unpleasant, even intimidating as it is to have a patient on the warpath unhappy with
their results, as unreasonable as you might think they are (or indeed are) being, don’t
ignore them and hope it will go away.
The longer you postpone dealing with a bad situation, the worse it can get – and even
provoke legal action that could have been avoided.
Maintaining as good relationship with clients as possible often works better than the
best informed consent in these situations!
Invite them into your office and sit them down for a discussion, so you can assess the
situation close up. Offer niceties like coffee or tea and be as conv ivial as possible.
Hear them out, making notes and asking pertinent questions. Try to avoid being
defensive or responding to inflammatory accusations - unless of course it becomes so
intolerable or risky that it would be best you politely asked them to leave.
Take photos of the patient to record the issue that they are unhappy about. To this
end, it is best that you have taken photos before treatment so you have a reference point.
Without admitting culpability, offer remedial suggestions – unless you truly believe
their complaints are fabricated or without foundation.
Document your notes and photos and call your insurance provider and/or legal
advisor re further steps.
Legible notes must be kept primarily
to assist the patient when receiving
treatment. But, secondly, should there
be any future litigation against your
practice the notes will form the basis of
Notes are a reflection of the
quality of care given so get into the
habit of wr iting comprehensive and
• Always date and sign your notes,
whether wr itten or on computer. Don’t
change them. If you realise later that
they are factually inaccurate, add an
• Any correction must be clearly shown
as an alteration, complete with the
date the amendment was made, and
• Document decisions made, any
discussions, information given,
relevant history, clinical findings,
patient prog ress, investigations,
results, consent and referrals.
• Medical records can contain a wide
range of material, such as handwritten
notes, computerised records,
correspondence between health
professionals, lab reports, imaging
records, photog raphs, v ideo and
other recordings and printouts from
• Do not write offensive or gratuitous
comments – eg. racist, sexist or ageist
remarks. Only include things that are
relevant to the health record.
CLINICAL AESTHETICS | 25
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