Most medical practitioners are aware of the legal requirement for “informed consent”. That is, the legal requirement to inform patients of all material risks involved in a medical procedure. “Informed consent” is therefore a clinical and legal requirement.
However, there are suggestions that informed consent also now requires full disclosure of the financial implications of medical treatment to patients. It is suggested that all patients should now be fully aware of the financial implications of medical treatment, including the decision not to proceed, to defer or cancel proposed treatment or to seek alternative treatment. There is clearly a differential between seeking treatment as a private and public patient, depending on whether the consumer can afford private health cover.
At this stage, there would appear to be no legal basis for requiring “informed financial consent”. However, there are a number of professional and ethical reasons why full financial information should be disclosed to patients.
The RACS Code of Conduct for all surgeons requires:
“A surgeon will:
1. when charging a fee for professional services:
a) ensure that it is reasonable and does not exploit a patient’s need
b) provide information about fees when obtaining consent to treatment
c) disclose to patients any relevant interest in or of a third party
5. be honest in financial and commercial matters
It is a breach of this Code to:
1. take financial advantage of a patient"
The Medical Board of Australia “Good Medical Practice: A Code of Conduct for Doctors in Australia” (March 2014) requires:
- Ensuring that your patients are informed about your fees and charges (clause 3.5.3)
- Not exploiting patients’ vulnerability or lack of medical knowledge when providing or recommending treatment or services (clause 8.12.1)
- Being transparent in financial and commercial matters relating to your work” (clause 8.12.5)
Accordingly, the Medical Board of Australia regards most health professionals as having a professional duty (if not a legal obligation) to inform patients of financial implications of treatment (including no treatment or alternative treatment).
It is also clear that a misunderstanding or misrepresentation of costs can lead to complaints to relevant health complaints bodies, whether the Health Services Commissioner, Health Complaints Commissioner, Medical Boards etc. For example, complaints to the Health Commissioners/Health Ombudsman in the various states and territories in relation to costs or information regarding costs have averaged 5-8% of all complaints. Complaints about costs and information regarding costs have constituted approximately 30% of complaints to the Private Health Insurance Ombudsman.
Medical professionals have an interest in ensuring that their costs are clear and transparent. There is obviously some reticence on the part of some professionals to discuss costs. However, in this “modern world”, consumers are aware of rights, want to understand all cost implications, and certainly wish to know how much they will be out of pocket.
General experience has also shown that a large reason for consumers and patients seeking to make complaints against health professionals has been a lack of knowledge or information or lack of communication. Information and communication regarding costs is part of this message. Good communication in relation to the costs and expenses likely to be incurred by the patient may avoid expensive and time consuming complaints