Attitudes, Beliefs, and Practices of Aesthetic Plastic Surgeons Regarding Informed Consent
Accepted Manuscript
Chelsea O Hagopian, Teresa B Ades, Thomas M Hagopian, Erik M Wolfswinkel, W Grant Stevens
Aesthetic Surgery Journal, 30 July 2019
Abstract
Background
Best practice for informed consent in aesthetic plastic surgery is a process of shared decision-making (SDM), yet evidence strongly suggests this is not commonly reflected in practice nor is it supported by traditional informed consent documents (ICD). Falsely held beliefs by clinicians about SDM may contribute to its lack of adoption.
Objective
To understand the baseline attitudes, beliefs, and practices of informed consent among board-certified plastic surgeons with a primarily aesthetics practice.
Methods
A 15-question online survey was emailed to active members of the American Society for Aesthetic Plastic Society (ASAPS). Items included: demographics, Likert scales, free-text, acceptability, and one question seeking consensus on general information all patients must understand before any surgery.
Results
This survey appreciated a 13% response rate with a 52% completion rate across 10 countries and 31 U.S. states. 69% are very-extremely confident that ICD contain evidence-based information. 63% are not at all-not so confident in ICD effectiveness of prompting patients to teach-back essential information. 51% believe surgical ICD should be reviewed annually. 86% report assistance with patient education during informed consent. “ASAPS members” should be a source of evidence for content (free-text). 63% were somewhat-very satisfied with the survey and 84% will probably-definitely yes participate in future surveys.
Conclusions
Findings echo concerns in the literature that ICD are focused on disclosure not patient understanding. There is notable concern regarding information overload and retention, but less regarding the quality and completeness of information. Current culture suggests key clinician stakeholders are amenable to change.