Patient consent to observation. Responses to requests for written consent in an academic family practice unit

To examine patient rates of consent to observation and response to being asked for written consent.

Patients were asked to provide written consent for a supervising physician to observe a resident performing a physical examination, or for both direct observation and videotaping of the visit. After the visit, all patients were interviewed, and patients who had given written consent completed a questionnaire.

The family practice unit at a teaching hospital affiliated with the University of Toronto.

A representative sample of new and returning patients.

Patient consent to observation or videotaping.

Most patients (92.2%) agreed to be observed. Of those asked only for consent to observe, 97.3% agreed. Of those asked for consent to observe and videotape, 85.2% agreed. When specifically asked, 22% of patients who agreed to observation expressed concerns.

We must devise clear policies and procedures for obtaining patient consent that are both sensitive to patients' concerns and administratively effective.