Just after a few opinions here, i am experiencing more and more practitioners sending foam boxes out to patients requesting them to cast them selves. Is this just me or is this extremely obsurd?
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Should patient be allowed to self cast
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No! totally obsurd
71.0% -
not really.....
6.5% -
does it make a difference
19.4% -
yes it saves time and is accurate enough
3.2% -
best idea since sliced bread!
0 vote(s)0.0%
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Treatment of the Distal Fibular for Lateral Ankle Sprains
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Clown shoes gather popluarity among ultrarunners
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Is it any more absurd than a person buying some prefabricated devices from a chemist shop or e-bay? Is it any more absurd than a practitioner with poor reliability in their casting methods taking the cast? Is it any more absurd than a practitioner with limited skills and knowledge base taking the cast? etc etc. What if the patient in question was me?
The cast is only one element in the puzzle, you need a diagnosis and be able to prescribe the device too, or do you?
Some very preliminary data I'll be presenting next week in Manchester seems to indicate why "meat-pies" might be efficacious in a proportion of the population. -
isn't the aim to get the best you can all the time or as close to perfect as possible as basically isnt the general rule garbage in = garbage out?
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To reiterate the cast is only one link in the chain. As you know, regardless of the scanned data you receive, you can make the finished orthosis look anyway you want it to. This being the case, do you need a foot model at all? In certain circumstance you probably do, but not in all. Hence prefabricated and library systems are efficacious in some individuals. In others, you are going to need a cast.
If the patient can reproduce the same position I would aim to produce, what's the issue? Lets say I wanted a cast of the foot in relaxed weightbearing. I reckon the patient could achieve that with fairly basic instruction. Lets say I wanted a cast in MASS position, I doubt the patient could achieve that. -
The destination is important, the journey to get there, less so. -
I was thinking the same thing just the other day with regard to 'customized' devices Simon. Are others of the opinion that there is a subset of say "heel pain" patients who would benefit from a step up from prefabs but not a fully custom device initially, a mid-range device from a library that is more cost effective and could be casted semi weight-bearing in foam?
Many of the prefabs that I have encountered seem no better suited to this purpose than the insoles that come stock in shoes. -
Let's imagine for a moment though that if rather than describing the neutral suspension cast, Root, Weed and Orion had described weightbearing casting standing in a foam box 30 or 40 years ago. We wouldn't even be having this discussion. Patients would be casting themselves left, right and centre. So why were Root and colleagues
right and why is standing in a foam box wrong? Riddle me that and stay fashionable y'all. -
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Got a question then to those that have voted does it make a difference.
Do you charge for a casting consultation ?
If so do you charge more than the cost of materials ?
If so what are you charging for ? your time, your expertise ?
Then you are charging for something that the patient believes make a difference is that ethical ?
Just asking ? -
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Nope - foam boxes 90% of the time. But I use modified prefabs far more than bespoke these days
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I charge for casting.
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Still just asking lawyer for the Devil and all -
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and if you really busy do you ever get a patient to self cast ? -
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Ok cool.
Ive make my own as you know and did a review of the process and spend much much more time over the casting and foot position during casting and have noted a great improvement in results. maybe a placebo podiatrist effect - Robert ?
the argument with standing that the same device can be created from whatever cast or even no cast with CAD I agree with , but personally Ive found spending more time etc during the casting process has worked well for me
I charge for Casting
PS has anyone tried the patient casting v´s pod casting trial. I guess foam box would be the only way to achieve this PoP would be a disaster. -
"F**K OFF - We're the People's Front of Judea"
Favourite movie ever
I do charge for casting if I don't do it within the initial consultation. So for example, I tell someone what is wrong and what they need to solve the problem - ie orthoses. I give them the costs and if they decide that they want to have a think about it and not decide on the day, that is fine. However, if they decide to proceed with treatment and need casting, I will book them a slot and they will pay for that slot
I work on the same basis as Ian. Pt pays for the slot of time - more or less irrespective of what i do in that time. If I just need a foam box, it will only take me 2 mins and I generally just squeeze them in and don't charge.
RP -
peoples front!
Whatever happened to the popular peoples front?
He's over there
Bag of otters noses, make that two.
Thanks Reg. -
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Thanks for the quick reply Mike :)
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A meat-pie is basically a "neutral" foot orthosis with a 4 degree post.
You know on prescription forms where there is a tick box which says "labs discretion"? Yeah. You could replace that with a box that says: "meat-pie"
<
Treatment of the Distal Fibular for Lateral Ankle Sprains
|
Clown shoes gather popluarity among ultrarunners
>
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