The importance of providing patients with adequate additional information prior to the consenting process for a surgical procedure has long been established. This information is intended to provide sufficient detail to allow the patient to make an informed decision about the proposed surgical intervention. indeed, the general Medical Council states this in Good Medical Practice: patients must be given sufficient information, in a way that they can understand, in order to enable them to exercise their right to make informed decisions about their care.

No abstract

The authors gathered information about the consultative practice of nephrology in a community environment and used this information to speculate about improvements that could be made in the training of nephrologists in academic medical centers, based on their knowledge of such training. Data were gathered on the specialty affiliations of the physicians who requested 211 consecutive consultations, on the clinical problems encountered, and on the most likely diagnosis for each problem. In some instances the referral patterns, patient mixes, and clinical diagnoses observed in the community-based practice differed significantly from those often emphasized in training programs in academic medical centers. Such differences may be unintentionally reinforced, because the clinical literature in which new findings are reported and validated largely arises from university-type clinical practices. Specific examples of the differences observed and some suggestions for change are given. Although additional research is needed to confirm the findings of this study, and although these findings may not be applicable to other settings or other internal medicine subspecialties, these findings raise questions about the appropriateness of completely university-based training in preparing physicians for practice in a community setting. The authors suggest that cooperation between community hospitals and established university programs could bring about the best opportunities for clinical training.