Practice Perfect - A PRESENT Podiatry eZine
Practice Perfect - PRESENT Podatry

Jarrod Shapiro, DPM
Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
Mountain View Medical &
Surgical Associates,
Madras, Oregon

 
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Free Advice

As physicians, we’re very used to dispensing advice.  It’s part of our jobs.  If you use a reflex hammer on a doctor’s mouth, you’ll elicit the well known advice reflex!  I’d argue that just as orthotics and surgery are tools to help us heal patients, advice is a fundamental tool in the doctor’s armamentarium.  If advice during a patient encounter is a necessary and important part of medicine, then what about giving advice to non-patients?  What about free advice?

When I was a resident, one of my attendings maintained a strict policy on this.  He never gave medical advice to those who weren’t his patients.  He would politely suggest the person schedule an appointment to see him and he’d be happy to discuss their issue further.


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I’m ambivalent on this subject; it’s possible to look at this from both sides. 

Reasons For

Those against free advice might make the argument that medicine is a knowledge-based business and patients are paying for our hard-earned knowledge.  By giving away that knowledge for free, we are short-changing ourselves. I don’t see WalMart giving out free TV’s simply because someone asked for it—you may argue.  You might also argue that without eliciting a person’s entire medical history (such as you would when seeing a new patient) you can’t adequately provide reasonable medical counseling.  One might also be justifiably cautious about dispensing free advice without any compensation in regard to the legal risk.  What if you give advice and the patient suffers some complication and tries to sue you?  I’m not sure if there’s legal ground here, but do you want to find out?  Is it worth it?

Reasons Against

On the other hand one might argue that this is a great practice building tool.  How often does a family member who has accompanied your patient ask for advice?  How about the scrub tech in the OR?  I’ve even heard of physicians giving injections to OR staff.    Those in favor of free advice may argue that a quick moment of simple advice may add a new patient to your practice.  Perhaps that family member or OR staffer appreciates your taking a moment to listen and decides to become a formal patient.  The 20 seconds you’ve lost may buy you new patients.

A while back I received a phone call from a patient of another physician.  She wanted a quick moment of my time, she asked, so I reluctantly took the call.  She’d had Austin bunionectomies and had the unfortunate complication of hallux varus (on both sides).   She’d been through an unsuccessful revisional surgery, was still in pain, and wanted to know her options.  I advised her to return to her doctor to give him a chance to rectify her issue (this is my standard policy in this situation — I never speak badly of another doctor and live by the golden rule: if it were my patient I’d like the chance to make this situation right).  About a month later the patient showed up in my office desiring to establish care by me.  She had returned to her doctor but wasn’t happy with his care.  The few minutes of time I took on the phone and some simple free advice landed me a new patient

For many busy, well-established physicians, this issue is a nonentity simply for the fact that they’re too busy to speak with non-patients.  However, for those building their practices, this is a significant issue.  For me, I’ll continue to provide basic advice, always after stating that the advice is limited by my not having full medical information about them AND always recommending they schedule an appointment with me to see them as a formal patient.  Personal contact often equals new patients. 

What are your thoughts?  Do you give free advice?  How important is this to the growth of your practice? 

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Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

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Diabetic Foot Infections: Antibiotic Therapies
Diabetic Foot Infections: Antibiotic Therapies
Amerigel
Diabetic Foot Infections: Antibiotic Therapies

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