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.

Orthotic Fraud? Pls help...

Discussion in 'Biomechanics, Sports and Foot orthoses' started by CdaPod, Feb 26, 2010.

  1. CdaPod

    CdaPod Member

    Members do not see these Ads. Sign Up.
    Hello All!
    I have been a long time reader but this is my first time posting because I have a serious question that I need all your help with. Pls answer freely and if this question has been discussed before, I apologize.

    I practice in Canada and I am a podiatrist (DPM) trained in US. I have a nice small practice. I get referrals from MDs and walk-ins.

    Recently a "orthotic store" has opened up down the street from me. These are not health professionals, they are not orthotists or pedorthists. They are not doctors. They have a store which to the best of my knowledge foam casts patients for orthotics. I cannot say for certain if fraud occurs, i.e. are they giving shoes instead of orthotics.

    Suddenly my patient visits at my office started increasing after the store opened. I got all these walk-in patients requesting to be seen by me, a podiatrist and they would all fill out my office forms stating that they have foot pain in the heel or arch or wherever and they would like to see me.

    Sometimes the entire family of 4 comes (the entire family coming for a foot exam happens a lot with this group of people). My numbers in addition to my regular practice are now 50 patients a week who just want a foot exam and script for orthotics. I tell them what is wrong and all they want is a prescription for orthotics. I recommend something else like physiotherapy or cortisone injection or surgery or even do nothing but no, all these patients want are a prescription for orthotics. Sometimes their problems are mild and sometimes they are severe, but whatever the problem (bunion, hammertoes, tendonitis) all they want is a script.

    So far I have obliged and these people then take my script and I think they go to this store and get orthotics. In fact I know all these 50 people a week come from this store. Maybe they dont get orthotics and this is some scam.

    By seeing these walk-in patients and giving them a prescription, am I committing orthotic fraud?
    Pls help. I dont know what to do. Should I screen these patients out and no longer see them?
  2. Lab Guy

    Lab Guy Well-Known Member

    Not sure what the laws are in Canada but it sounds like the store requires a prescription from a licensed Podiatrist to fabricate the orthotics. Perhaps they fabricate their own custom orthotics or custom fit pre fab orthotics. Most of these outfits sell pre fabs but at inflated prices (ie, Good Feet Store)

    You invested a lot of money and time for your degree and to get your office going. Why would you even consider writing out a prescription for orthotics to folks that do not want to be your patients?

    I have had patients come in with prescriptions from their physcial therapist for orthotics and always turned them down. I usually managed to gain their trust in my knowledge (and through foot manipulation) and they were casted by me.

    Look at this challenge as an opportunity. The store is doing the advertising and these people are coming to you for orthotic prescriptions, people you would otherwise not even see. Sell not the orthotics but your self. Show them what you know, show them how they can be better helped by your expertise. Find out what they would be paying for the store's orthotics and perhaps meet their price or give them a special discount.
    People are not stupid. They should be able to discern what is truly of value and what is not if you give them a chance. You will be turning lemons into lemonade. Good luck.

    Lab Guy
  3. Ai_Luong

    Ai_Luong Member

    Hi CdaPod,
    I am a new grad (2008) chiropodist practicing in Toronto. That store seems very fishy. The store probably gives out shoes (and other stuff) instead of the orthotics. But I agree with Lab Guy. You should see this as an opportunity to educate these patients.
    I dont think you commit any fraud so long as you can justify your prescription. This is the orthotic guideline from COCOO.
    "Prescription of a Functional Orthotic should include:
    · A thorough biomechanical examination with appropriate measurements taken and recorded
    · A stance and gait analysis
    · Non weight-bearing plaster of paris
    casts, non weight-bearing STS slipper
    casts or equivalent, or threedimensional,
    non-weight-bearing scanning of the feet."

    You should have a fee schedule for custom-made orthotics as a package (including biomechanic exam and gait analysis) and the biomechanic exam and gait analysis alone. So if they want just a prescription, explain to them that you have to do a thorough biomechanic examination and gait analysis. They will be charged separately for this service.

    Hope this helps.

  4. Boots n all

    Boots n all Well-Known Member

    Cant see what your concern is, so you do a script and not everyone comes back to your store, improve your marketing and really find out what they are offering up the road, then send them a box of chocolates for the 50 extra/new clients they send you every week.:drinks

    Charge each of these clients for the consult $65 X 50 new/extra clients = $3250 extra per week;)
  5. joejared

    joejared Active Member

    On the surface, there's not enough information. As they're bringing business your way, perhaps it would be in your interest to visit this "store" and see for yourself. One of my customers actually has a retail outlet and manufactures orthotics for podiatrists. Usually, the practitioner choses the lab, and not the other way around.
  6. David Smith

    David Smith Well-Known Member

    My sentiments exactly, I'd kill (almost) for an extra 50 customers at £50 each per week. Tell me the name of these shops so I can move closer to one.

    LoL Dave
  7. CdaPod

    CdaPod Member

    Hi all,
    Thank you for all of your great responses.

    Yes whilst it would be great to get 50 new patients every week, I feel that something fishy is indeed occurring at that store and so I reduced my amount of patients accepted from that location.

    I have started a new orthotic learning campaign to educate potential patients.

    Lastly I reviewed the link that Ai_Luong posted to make sure I was not doing anything illegal and thank goodness I am not.

    Overall there is a reduction in business, but now I get a good night's rest.

    Thanks again
  8. Bellmont

    Bellmont Member

    We have these stores in the Prairies. You could make sure that your Rx stated "Orthotics made from a STJ Neutral Cast" The pt then goes to the shop, some may come back some don't. Quite frankly I look forward to these "Orthotic Co's' coming, sometimes they cause more problems, then they will come to you to have the problem sorted out. Some insurance are now asking for a copy of all the paperwork including the Lab invoice (Cost blacked out). We have no problem at all.

Share This Page