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Discussion in 'General Issues and Discussion Forum' started by JaY, May 18, 2011.

  1. JaY

    JaY Active Member

    Members do not see these Ads. Sign Up.
    Should a podiatrist put cream on a patient's feet after general treatment?...

    Where do we draw the line between being a medical practitioner (not a beautician!) and achieving patient satisfaction?
  2. admin

    admin Administrator Staff Member

  3. ginger

    ginger Active Member

    Where appropriate I always put cream on a patients feet at the end of a treatment. Not a fancy massage but just a quick rub on of some good cream like Flexitol or Simply Feet. The patients all love it and I think it encourages them to carry on afterwards too, a few have asked what cream I used and have then bought some of the same cream and carried on the good work at home. I do work privately and totally understand why it's not done routinely in the NHS. I think it's a nice way to finish the treatment. I usually use it as a chance to give advice about emollient use too.
  4. Catfoot

    Catfoot Well-Known Member

    It all depends, as the OP says, as to whether we want to be seen as health-care professional or beauticians.
    I would only rub cream into a patient's feet if they either

    a) had a serious dry skin problem and/or
    b) could not reach their feet themselves.

    and not as a matter of course.

    This is the sort of activity that the unregulated sector tend to get involved with as they don't have the skill-base to do much else. If one is practicing serious Podiatry foot-rubs and massage don't come into it.

    Rubbing a bit of cream in doesn't necessarily increase patient satisfaction if your podiatry skills are lacking in the first place.


  5. ginger

    ginger Active Member

    I don't see how applying emollient means your Podiatry skills may be lacking? I doubt very much applying emollient at the end of a treatment (note "applying emollient", not "massage" or "foot rub" etc) would make anyone more like a 'beautician' than a healthcare professional. Patient feedback is that it does increase their satisfaction in the treatment. If someone came in for a biomechanics exam I wouldn't be applying emollient, only for appropriate patients. Offering my patients the best I can, my bad!
  6. DAVOhorn

    DAVOhorn Well-Known Member

    There you go my loverly, some nice cream that you should also do at home every day.:D

    Hope you feel comfy.

    You can get off the couch now..

    Yooooowwwwwwww i think i have broken something.:butcher:

    Did you slip on the floor?

    The bloody cream you smeared all over my feet has meant i slipped and fell.:boxing:

    DEEE Daaaa Deeee Daaaa

    dringg drinngg Hello

    This is mega bastards solicitors speaking our client fell and broke their wrist while at your clinic.:craig:

    I never applied cream to peoples feet in 20 years.

    Until i went to AUS in 2006 and it was expected.

    To do it once in a while has no clinical benefit. So why do it??

  7. David Smith

    David Smith Well-Known Member


    I always finish with a massage and mobs of the foot joints after every treatment. No one has ever slipped over but most people feel the extra comfort" feels like walking on air", if I've heard it once I heard it a hundred thousand times. I file the nails to shape and finish the skin to look smooth and healthy as possible. Satisfaction and a little extra more than expected go a long way in retaining and building the customer base and profit margins. High profit margins from increased sales of foot care product and because patients are happy to pay for the extra satisfaction and value they feel they are getting. When you recommend a cream that you regularly use in practice then the customer has more confidence in buying and using it regularly so skin condition is improved. The patient who applies cream regularly is also taking notice of their foot condition regularly and so will be more aware of any impending problems.

    There are so many advantages to that extra bit of care far and above just the occasional bit of cream on the feet. and I feel this adds much to my professional status and inserts into the pastoral /whole person / holistic/ loving care that we give in terms of being listeners, encouragers and contributors to the general well being of a person in our care.

    This is not the law of good practice just a way of dealing with people in our community - Maybe you like a more pragmatic and impersonal approach to your practice, well that is fine and obviously works for you. We all give excellent clinical care but that should be expected. However, I feel, If you and your practice like to be part of the local community then part of community is communication and communication is more than just words its about giving a little extra to show love and care for another soul, literally loving your neighbour.

    All that from a dolop of cream :cool:

    Regards Dave
  8. RobinP

    RobinP Well-Known Member

    If a practitioner is confident in their skills and feels no need to prove how different they are to a beautician, what is so bad about applying a little cream to a patient's feet and massaging it in, anecdotally, improving the whole patient experience?

    I provide a nice little bag with instructions, a shoe horn and some other marketing bits when I provide orthotics. Are they necessary to my treatment plan and the effectiveness of the devices - no. Do my patients like this added extra - of course. Am I doing it because my skill base is not good enough and I feel I have to do extra to make up for poor orthotic prescriptions - no(at least I hope not)

    My 2p

  9. David Smith

    David Smith Well-Known Member

    Nice touch

  10. RobinP

    RobinP Well-Known Member

    I haven't given anyone one of them yet.

    Still, if we are talking about improving the patient experience...........;)

  11. markjohconley

    markjohconley Well-Known Member

    At your practice, so far, and may it continue, but it certainly has occurred.

    I too have never applied any form of emollient to anyone's feet, but I certainly recommend they do!

    Don't need to rub in cream to do this

    That's not justified nor 'called for', not nice

    aaarhh, I'm going to be sick! Again, one doesn't need to apply cream to communicate or listen or show compassion....

  12. Deborah Ferguson

    Deborah Ferguson Active Member

    Hi All
    I have acquired two new patients this week who were unhappy because their `regulated podiatrist ` didn't apply cream after their treatments.
    It is such a small thing to do to for a patient, especially the elderly I personally don't have a problem and I don't feel any less professional by rubbing in cream at the end of a treatment.


  13. susiesue

    susiesue Member

    i apply cream, the old dears (and younger ones) love it.
    a few months ago-during the very cold weather i was about to apply the cream so rolled up the ladies trouser legs, and the long johns, to inspect the legs and apply cream i saw a suspicious pigmented mole with a halo around it. i expressed my concern without worrying her to death to see her GP.

    a few weeks later the ladies daughter came in and asked to see me, her mother had been to the gp who sent to see a dermatologist asap. who confirmed early malignant melanoma.

    i will continue to use a bit of cream its a useful tool in spotting things out of the ordinary. and i doubt that my professionalism is called onto question.
  14. markjohconley

    markjohconley Well-Known Member

    If I had lost a patient because they were ‘unhappy’ with my podiatric skills then I would be concerned, if for reasons for lack of applying ‘creams’ then good riddance.On another subject, I always offer to remove and replace hosiery and footwear. Its saves time and reduces the chances of the patients injuring themselves.
    In Australia podiatrists jurisdiction? ends proximally at the knee so it is our responsibility? to assess ‘up to the knee’ when possible.I have observed and brought to the patients attention MANY suspect lesions and all without having to apply ‘creams’, AMAZING isn’t it, Mark
  15. Tkemp

    Tkemp Active Member

    "snap" Mark! me too. Sent lots of cleints to Dermatologists for suspicious looking moles, etc.

    I dont apply cream for a couple of reasons:
    because I work public health for those who cannot afford private, and started having clients who could go private attending because it was cheaper. I stopped the practise and those who wanted the nice touch could go private and pay more for the privilege - and they did. My client list has not dropped and I am seeing people who need the care, not those who just want their feet looking nice
    Plus its stopped the male clients who came in just wanting a foot massage! THEY can take their business else where.
    If you want to apply cream its a personal choice, but I originally trained as a Beautician and when re-qualified as a Podiatrist found its necessary to keep the lines seperate, else clients just think you are a glorified Beautician who also does corns but doesnt paint their nails.

    Ok...... let the retorts fly! :)
  16. markjohconley

    markjohconley Well-Known Member

    I think i've mentioned it in an earlier thread, but I LOVE you Tkemp, mark
  17. Tkemp

    Tkemp Active Member

    I am feeling the love Mark! ... I thank you

  18. cornmerchant

    cornmerchant Well-Known Member

    Well Mark,I love both you and Tkemp.

    I agree with both of your comments, I do not like Davids style of preaching as if his way is right and the rest of us need to think again!

    I never apply cream, for all the reasons mentioned, plus you never know if the patient is going to be sensitive to a cream you may use.

    I have a great communication with my patients and I always look at the lower leg as I am treating the feet to check for suspect lesions .In fact, many patients now ask me to check out something on the leg before they go and see the doctor or the nurse .

    In my opinion, it does not raise the profile of the profession, if anything it blurs the margin towards
    Pedicure even more. But, it is personal choice and there is no right and wrong way.

  19. Lizzy1so

    Lizzy1so Active Member

    In my private practice I apply cream when the skin appears anhydrotic, I find its a really good way to feel if i have missed any small HDs or calluses its also a good way of showing patients how to apply cream themselves. Some clients request no cream, others love, some are not bothered. No one has ever fallen over as I blot afterwards. I understand why others dont do it, but its a little extra and often leads to a discussion about footwear as well
  20. DAVOhorn

    DAVOhorn Well-Known Member

    This is interesting so far.

    it is nice

    The pts love it

    Some pts love it too much and are a bit creepy

    Enables me to check the quality of my work

    It shows i am compassionate

    Pts expect it

    I came from the other side of DUTY OF CARE

    Anyone remember their falls prevention lectures.

    Also infection control whereby keeping floors clean, ie a little bit of cream from up to 18 pts per day will be a reasonable amount of cream in a very specific and small area adjacent to the chair.

  21. shimmer

    shimmer Active Member

    I usually apply cream and gently give a quick massage. It isnt just about making the patient's feet feel nice, although alot comment that it does, it allows me to make sure there isnt any callus or seed corns I've missed or problems with joints. Why is it so bad to send your patient off walking on air as alot seem say they are. It is supposed to be a caring profession.
  22. Lizzy1so

    Lizzy1so Active Member

    I use a disposable water resistent backed paper mat for all my clients so i am not worried about infection from cream build up, which sounds pretty horrid, has anyone experienced a cream slick in their clinic!I think there was also a thread last year about whether to put paper down or not which resulted in very similar types of comments from the fors and againsts. Whatever, i'm sure we could all pick apart each others practices until the end of time, so for now i will continue to cream.
  23. David Smith

    David Smith Well-Known Member

    Sounds like a good idea but I've never come across this paper before, where do you get it from. I don't have a cream slick since I wash the floor with a disinfecting cleaner between patients.

    Cheers Dave
  24. Lizzy1so

    Lizzy1so Active Member

    I buy mine from canonbury, it has pictures of feet on it, I buy in a box of 1000, probably not perfect but i still use them even when not using cream, as some patients dont like putting their feet on the floor no matter how clean it is:)
  25. David Smith

    David Smith Well-Known Member


    Kind of confusing this post since you answered it like you were replying on behalf of, and offended by my comments to, David like they were directed at you.

    Regards Dave
  26. David Smith

    David Smith Well-Known Member

    OK cheers, yes some don't your right.

  27. David Smith

    David Smith Well-Known Member

    More good points, the for argument is gaining ground I feel :D

  28. David Smith

    David Smith Well-Known Member

    OOerr! sorry to be preaching CornMerchant, but you don't have to do what I say you know. When I use you and your it is instead of using one or one's since they sound a bit formal especially to the American ear but as you can see earlier I have changed to the more impersonal form so you will not feel you are being criticised directly.

    Regards Dave
  29. garytc

    garytc Member

    [As a male practioner I find that to provide a massage with cream ok to do if the client request it, but I worry if the treatment could be misinterpreted in these law suite times
  30. Rebecca Lomas

    Rebecca Lomas Member

    I work in the private sector and I do apply cream most times to my patients feet as I have the time and resources to do it, though in an NHS setting this is more difficult to justify I think. I find it a good 'finishing' tool, and I do not consider that it makes it more of a beauty treatment, I can feel for any bony or soft tissue problems at the same time, and for the people that cant reach or are unable to do it, it is much appreciated.
  31. Rebecca Lomas

    Rebecca Lomas Member

    I agree me too
  32. markjohconley

    markjohconley Well-Known Member

    Rebecca, you've won me over. What 'bony or soft tissue problems' have you 'fe(lt)' ?
  33. Catfoot

    Catfoot Well-Known Member

    Rebecca, I am also curious :
    What soft tissue/ bony problems have you discovered during this creaming activity that were not revealed by your initial examination of the foot? And what would you do when you found anything amiss, as this is effectively the end of the treatment?
    Was this something that you were taught when you trained ? - as this is something new to me.

    Curious cat
  34. markjohconley

    markjohconley Well-Known Member

    I am definitely losing it .... I applied moisturiser to the heels of a patient this morning .... first time in 25 years ....
  35. markjohconley

    markjohconley Well-Known Member

    I should register on Facebook, most of my posts would be more appropriate there methinks ...

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