Hello Colleagues,
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From time to time I am called upon by various agencies to report on the status of a patient in connection with fitness to work, insurance claims, post-operative recovery issues etc.
Once in a while I find a patient I believe is faking symptoms. When investigations are normal and clinical tests reveal little. When the only evidence is vague, and confined to a subjective complaint from the patient who says there is "foot pain"; "it hurts all the time" etc. Or when there are some findings but the connection with the alleged pain is all but tenuous.
I will be interested to know if as a profession there are 'pearls of wisdom', e.g. clinical assessment tests etc. that can be deployed as evidence to the suspicion of a malingering patient, with a known or hidden agenda.
For example, I have spoken to a back specialist who has devised tests that can expose the faker from the genuine. Can the Podiatrists / Podiatric Surgeon devise similar tests to help with this? And, if necessary, is such evidence robust enough to withstand the legal test?
What is it that makes me hesitant about condemning a patient outright? Simply because I have to accept there are patients with foot pain who cannot be easily diagnosed. There is a small cohort of patient with such foot pain, who has no other motive (that we know of) other than to return to a pain free foot.
I have previously considered posting this enquiry - but it is an open forum and internet savvy patients harbouring any such plans could easily also learn from this exchange. And perhaps this is more suited to a PM reponse.
What are your experiences of this type of work? And have you found a good strategy to deal with this type of patient and enquiry?
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Hallux valgus angle as main predictor for correction of hallux valgus
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