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GYNECOLOGY: CONSENT and COMMUNICATION

A Gynecology examination is often fraught with angst, uncertainty, awkwardness and fear.

From many years of experience, the ingredients for a good Gynecology consultation include good communication, excellent nursing support, good examination technique and equipment and a solid consent process.

Together this creates a caring and safe experience, where you are heard and where you feel in control: this protects your autonomy and the ability for you to direct care.

 

A well-known ethicist, Carol Gilligan defines ethics of care as “an ethic grounded in voice and relationships, in the importance of everyone having a voice, being listened to carefully and heard with respect. An ethics of care directs our attention to the need for responsiveness in relationships (paying attention, listening, responding) “

 

At Meridia Medical, we take pride in the fact that our consent workflow and communication is rock solid, yet ever evolving. We have an extraordinary comprehensive consent process using dynamic annotation on a digital platform when explaining a procedure, to obtain your informed consent.

 

As you can imagine, everyone is different when it comes to being a patient, especially when seeing a Gynecologist. It depends on expectations, the relationship with the nurse and doctor, your previous Gynecology examination experience, mental health issues including anxiety, depression, borderline personalities, phobias to germs etc, and whether you have existing problems that cause pain during an examination. Unfortunately, some also have a background of abuse.

 

We have developed a safe environment for everyone, by creating a consent work flow and good communication, that is always being adapted and improved as times and information change, in order to provide you with an ethics of care approach that promotes and supports every patients’ autonomy (control and independence).

 

This is particularly important in our time of disenfranchised and diverse populations. I appreciate the fact that our waiting room is filled with women from all walks of life, from all corners of the globe, from refugees and uninsured women, to caregivers, entrepreneurs, artists, musicians, and other professionals. Everyone is welcome, respected and their dignity is maintained.

 

Our consent process is interactive, simple, yet comprehensive, allowing everyone to clearly understand what’s happening.

 

So how good are we: lets test it!

 

  • We had our ultrasound process reviewed by the head of Women’s Imaging at a nearby teaching hospital, and she told us she wished that they had a similar consent process for their pelvic ultrasounds.
  • We have independent Gynecology experts review our clinic. All have found the communications and consent process to be above the standard of care. (one said “exceptional”)
  • A communications expert Prof. Gail Siskind reviewed on site and wrote:
    • Gerber was professional at all times in his interactions. For each patient, he explained the procedure step-by-step. He used cognitive empathy to explore the patients’ experiences.
    • Gerber performed sensitive, personal examinations on vulnerable patients, which were consistently managed with detailed explanations of his approach, support and encouragement…..

 

We also undertook an anonymous patient survey, which was analysed independently to ensure legitimacy and accuracy. Just under 1800 patients participated.

Results: 

  • 99.8% said Dr Gerber adequately reviewed why they were having the consultation.
  • 99.7% said they were able to ask questions.
  • 99.8% said that the pelvic/vaginal examination was easier/more comfortable or similar compared to previous ones they have had elsewhere.
  • 99.3% said they were adequately informed what was going to happen before the examination or ultrasound.
  • 99.6% said the felt comfortable and that they and their privacy were respected during the examination.
  • 99.7% said an effort was made to make them comfortable during the examination.
  • 99.7% said there was opportunity/respectful atmosphere to allow them to freely stop the examination if they wanted to.
  • 96.5% said they were very satisfied or satisfied that their questions were addressed.

 

From a qualitative standpoint, the statistics summarized above do not capture the exceptionally positive handwritten comments that patients chose to include, including the following:

 

  • Nurses & Dr. Gerber are very professional, polite & sensitive to my needs through the examination.
  • Gerber was exceptional Very professional, kind doctor Staff was accommodating and kind.
  • Procedure done very smoothly It was a great experience!
  • I am happy with my experience at the clinic. I had no concerns regarding my procedure and was made to feel comfortable at all times. I would continue seeing Dr. Gerber for ongoing care and find him to be knowledgeable and caring.
  • Your team is awesome. I hate downtown with a passion but then feel so happy and respected after my appt.
  • Gerber is very personable, warm & helpful. Makes me feel comfortable.
  • This is the Best Dr.s office I have ever been to. Great Dr & staff
  • Gerber and his staff go above and beyond. I would highly recommend Dr. Gerber – he is knowledgeable and professional and warm. I am thankful to be your patient.
  • Communication was clear and made me feel safe and protected.
  • Felt comfortable and liked knowing each step before proceeding.
  • Everything was clearly explained and there was patience w/ questions.
  • Everyone was extremely kind, a great first experience! Excited to come again, kudos to all involved!
  • This is the most comfortable I’ve ever been made to feel about a transvaginal exam and I’ve had 50+ in my life.

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