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Forms That Are Not Forms


A form is a form is a form.

Not exactly. It's semantic, or maybe more.

Last week a friend who reads my blog gave me a "form" she dislikes. I had to correct her: It was an agreement, not a form. When a patient confuses the two I worry less than when a medical care provider does the same. Providers regularly complain about "signing forms." I believe much of the time they sign something else entirely.

In my opinion a form consists of a lot of blanks for the primary purpose of collecting information. Your signature at the bottom just means you attest to the accuracy of the information you provide. If, on the other hand, you see more than a brief sentence or two, more than likely you have signed an agreement or contract.

By lumping all of what they call "forms" together providers often minimize the difference -- and the consequence of signing. I have observed an apparent tendency for providers to "just sign" whatever someone puts in front of them without considering the consequences, and sometimes without even reading the "fine print." They may neglect to consider the source of the agreement, often a third party payer or the patient's employer. By signing agreements or assessments they may in effect provide services to a third party, negatively affecting the relationship with the patient and raising ethical concerns. Forensic examiners should properly perform many assessments, freeing the provider from duties to anyone but the patient, but someone must pay for them.

Reflexively signing agreements and contracts, dismissing them as just more forms, plays into the tendency of payers, employers, government agencies, and others, to exploit providers, getting them to provide services for free by holding the patient hostage. Providers naturally want to please their patients and save them -- or help them get -- money.

If treating providers cannot avoid such entanglements they should at least read and understand all of what they involve and the implications for their relationship with the patient.