Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Needing advice please.

Discussion in 'General Issues and Discussion Forum' started by JAYNES, Feb 5, 2011.


    JAYNES Active Member

    Members do not see these Ads. Sign Up.
    Hi all, looking for some advice on a situation that occured the other day.
    I sent a patient for a ultrasound scan for a suspected plantar fibroma to his medial arch.

    On returning with his results he was very distressed as the sonographer told him it was very serious and he should go to his doctor not the Podiatrist as they are not specialists.

    His G.P and Physio referred him to the Podiatrist.
    In your opinion do you think i should contact the radiologist and inform him of what happened or just leave it?


    JAYNES Active Member

    Sorry forgot to tell you it was diagnosed as a fibroma.
  3. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    If this happened to me, I would lodge a formal complaint in writing to the radiology practice in question.

    That is completely unacceptable behaviour, even aside from the fact that a plantar fibroma could hardly be called a serious condition!

    Don't take that crap, or else send your referrals elsewhere.

  4. Catfoot

    Catfoot Well-Known Member

    My take on this is a bit different.
    Personally, I would not get involved with this.
    You weren't there so you didn't hear what was actually said. It's possible that the patient misunderstood.
    Unless you have proof that the other person acted unprofesssionally don't start playing "Chinese whispers".*
    I would make a note of the incident on the patient's records and then if it happens again you have evidence to back up a formal complaint.



    * http://www.mwls.co.uk/icebreakers/chinese.pl
  5. Tree Harris

    Tree Harris Active Member

    Hi Jaynes,

    Reassurance should be the primary focus to ensure the patient understands the diagnosis and future treatment plans as required.
    And I would approach the radiologist to determine their understanding of our role in foot care. It could be a misunderstanding or may well have been related ot a previous bad experience.

    But look at it positively as an opportunity to market Podiatry. Nail cutters we are not.
  6. I agree with LL don't take this crap, but I would do it slighty differently.

    Write the letter to said sonographer and head of radiography department, but I would ask for a face to face meeting and apology.

    A letter will get read and put to one side.

    Good luck - but stand up for yourself
  7. Being the tactful and diplomatic soul I am, I'd try to educate. Firstly I'd call the radiographer rather than write, too easy to misinterpret a letter. Ring him up and make a joke of the fact that the go referred him straight back to you! Talk about tx options for fibromas and what you can offer bs the gp. Emphasise that if it's beyond you that you can refer on, but that the conservative methods (which should always be tried first) lie with you. Invite him to shadow you for a day or two so he can get to know what you do.

    Nothing will be gained by seeing who can piss highest up the wall. However he's made a tit of himself and if you take the oppertunity to be the "bigger guy" you might forge a useful and lucrative future working relationship.
  8. cornmerchant

    cornmerchant Well-Known Member


    How very professional Robert, but come on -we are in the real world!

    Jaynes,I believe you are in the UK, therefore actually tracking down the radiographer who alledgedly made the comments could be time consuming-not impossibe of course since we all have to put our name to any treatent carried out. Having found said radiographer, do you really think he is going to take the time out to shadow a podiatrist??????You may be lucky to get him to speak to you on the phone but be prepared to have got the wrong end of the stick.
    As Catfoot says, everything has been hearsay and as we all know comments can get distorted. He may have a competely different story.

    Ok so lots of other allied health professional do not know exactly what we do, but the GP and the physio referred to you so at least 2 out of 3 practitioners got it right. The patient got the correct diagnosis, and that is the main concern.

    Incidentally Robert-out of interest what would be the choice of conservative treatment for the fibroma? I ask because I do not recall having to actually do one.


    JAYNES Active Member

    Thankyou all for your help, i did reassure the patient and have outline a treatment plan for him.
    I think i will talk to the radiologist by telephone.

    Thank you again.
  10. W J Liggins

    W J Liggins Well-Known Member

    Hi Jaynes

    I have a slightly different take on this. The report will state who the sonographer was. It used to be that this was restricted to a Radiologist but changing roles may mean that it was a Radiographer. Whatever the case, I would (firmly) arrange a face to face meeting and repeat the patient's allegations - I am prepared to bet that you have received a 'spin' version of what was actually said. Even if it was accurate, by keeping it informal, you are bound to get some sort of apology, and as Rob has said, an opportunity to educate. If not, then that is the time to think of formalising the situation by putting it in writing to the Head of Department. Let your Head of Department know also, but not until the situation is formalised.

    All the best, and let us know how it goes

  11. Does professional not work in the real world? ;)
  12. cornmerchant

    cornmerchant Well-Known Member

    Sorry Robert,

    Poor use of words, of course it is professional in the real world but it is not unprofessional to let it go.
    In my experience you could spend a lot of time banging your head against a brick wall. I am far to busy to take the time out for a one off incident that has not damaged the patient.

    And what is the conservative treatment you referred to?

  13. Plantar fibromas tend to occur in the plantar fascia and most of the ones I've seen have been caused by either duputryns or ledderhose disease. In the first instance reducing the tension in the plantar fascia and deflecting pressure away from the fibroma can often acheive considerable reduction in pain. If we work on the basis that the fibromas are triggered by tensile trauma it is also reasonable to suspect that we might reduce future risk.

    Always worth a crack before someone goes under the knife.
  14. cornmerchant

    cornmerchant Well-Known Member

    Thanks for that Robert.

    I have seen several patients with plantar fibromas but they have all been asymptomatic, hence no treatment required.

  15. They often are. If there is a known predisposition (as in duputryns) I think a good case can be made for minimising plantar fascial tension / reducing risk of injury even in the absence of symptoms. But as always that is a matter of both opinion and circumstance.

    Tricky to treat, but very satisfying.
  16. footdrcb

    footdrcb Active Member

    Referrals should go elsewhere, Let it go.

Share This Page