Biomechanics V Surgery

Simon, Bob and Others:

I have expanded on your sub-discussion on the biomechanics of subtalar joint arthroereisis procedure in the thread: Biomechanical Treatment Post-op HyproCure. Maybe we can carry on this good discussion on the subtalar joint arthroereisis in that thread?

 

Thanks for a positive, clinically relevant example Eric.
Perhaps I'm being a bit over sensitive today, but it's refreshing to see an internet post that reflects a positive story about foot surgery. In my experience, there is far too much 'surgery-bashing' going on around the world. I suppose this reflects the example I gave earlier about happy patients remaining silent, while those with poor results shout about it - it's rare to see a surgeon praising their local biomechanics specialist and it's rare to see the biomechanics guys praising the surgeon (as before - probably because they only see each other's complications). :drinks

 

Bob:

I think Eric's posting offers an example of how surgery can do things that foot orthoses or other conservative therapeutic measures never could do. Many podiatrists, such as many here on Podiatry Arena, who have not experienced the very positive and gratifying patient results that can be achieved by well-planned and well-executed foot surgery, may have a rather negative opinion of foot surgery/foot surgeons. However, here in the USA, since most podiatrists are more surgically-oriented, many of them don't seem to know how to best perform conservative care therapies to help their patients avoid surgery. Since one podiatrist can't possibly know everything about every aspect of podiatric practice, the wisest and most ethical podiatrists soon realize their limitations and will readily refer selected patients to other talented podiatrists or specialists that can give their patient the best treatment results.

Good discussion!

 

I'll bump this one back up.

Kevin is no doubt right that many Podiatrists focus on surgery because of the possibility to earn more money and have a higher status. Some of this is historic and cultural. The need to learn about surgical technique, post-op recovery, complications etc no doubt removes some headspace that would be used for biomechanics. This is unfortunately very short-sighted because of all the reasons that have been mentioned in this thread.

However to take this further, perhaps many of us or even the profession-at-large are guilty of under-selling the worth of conservative treatment and specifically foot orthoses. This lack of perceived "value" has lead to low fees or inadequate insurance coverage/re-imbursement. The low fees in turn have lead to the pursuit of other avenues by Podiatrist to earn a reasonable living.

Given the benefits of foot orthotic therapy and the impact they can have on pain and disability they should be chargeable for far higher amounts than the average Podiatris does. For comparison see what an Orthodontist would charge you or the lifetime fees paid by Chiropractic patients.

I dont have an answer though!