Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
Mountain View
Medical &
Surgical Associates,
Madras, Oregon
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I Love When That Happens!
One of the truly wonderful things about being a physician—specifically a podiatrist—is being able to successfully heal another person. How many physicians can say their patients walk in with pain and leave without it? How rewarding is hypertension management, for instance? Success is evidenced in most cases by a negative response—no MI or stroke. How rewarding is that compared to the satisfaction of a well-done surgical procedure or that wound that’s completely healed, saving a limb and prolonging a life?
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A week ago, a new patient presented to me with anterior ankle pain of 6 months duration. A charger lateral radiograph demonstrated anterior impingement from a tibial spur with minimal other arthritic changes. He asked me to surgically remove the spur.
My response was, “Let’s see if a heel lift in your shoes doesn’t take away your symptoms. If that doesn’t work and you want surgery, then we’ll talk about an arthroscopic procedure.”
One week later, the patient returned, dumbfounded, smiling, telling me no longer had any pain. “I was really skeptical,” he told my assistant, “that a little pad would make that much of a difference.”
I tried a standard treatment that most podiatrists know to employ. Nothing out of the ordinary. But with that simple treatment, I looked like the hero. I love it when that happens! I made him a pair of cork heel lifts and he’ll be back in a month for follow-up. If the pain returns, I told him, we can try an injection or he can have his surgery.
Some of my patients are employees of my hospital. One of them, a nutrition services worker whom I see almost daily, had presented to me about a year ago with such severe lateral ankle pain that she would sit in my exam chair cringing, closing her eyes as waves of pain rolled over her. An MRI showed partial peroneus brevis tearing and after some attempted nonsurgical care, I repaired her tendon. She resolved her issue without any complications. About 6 months later, she returned again with worsening heel pain that didn’t respond to nonsurgical care. Again, sitting in my office, we decided on surgery. One week after a partial plantar fasciotomy, she was a new woman again! Smiling, happy, and pain free. Whenever I see her in the hospital, I’m reminded how I managed to touch and improve another person’s life. I love it when that happens!
This is the nice part of podiatry. We can still enjoy our patients’ successes without worrying about insurance reimbursement, malpractice concerns, or paying the bills. The simple act of healing. We spend so much time agonizing over our difficult patients, critiquing our work, trying to improve for our patients and ourselves. But let’s take a moment to simply feel happy for the good work we do and the people we help. Congratulations to all you physicians – you have my and your patients’ respect. Best wishes.
Keep writing in with your thoughts and comments or visit eTalk on PRESENT Podiatry and start or get in on the discussion. We'll see you next week. Best wishes!
Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]
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