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A rant about podiatrists - what's going with those folks??

Posted by Steve G on 8/29/03 at 00:52 (128338)

I just have to rant for a few minutes. I just read and responded to a note on the 'Ask the Doctors' section. Before I start ranting, I want to preface all this by saying that both of the podiatrists I have had (including our very own Dr. Davis) have been consummate professionals - caring, informative, supportive of my own efforts to gain knowledge and guide my treatment. However, I have to wonder if the other pods out there are all trained in the same manner or just become incompetent and cavalier with the passage of time. After presenting with PF, this poor woman was given shots, ice, and a golf ball. When this did not seem to help, he taped her foot a few times. When she went back he told her that they had come down to surgery as her only option. She did not even mention ESWT in her note. I don't even get the impression she knows what a night splint is. Even with her limited knowledge, she wonders if the push to surgery is 'too hasty'. She needs to run and of his office like it was on fire. And if I every encountered such a doctor, I would have to be thrown out of his office. And this is not the first time I have seen this sort of thing. About a year ago I responded to a post by a woman that had, as a treatment protocol, some stretching and 12 shots. What on earth was her pod thinking!! If the poor woman did not rupture her fascia it was a miracle. I am truly at a loss to understand this sort of thing. Do the kidney specialists over here at Harborview have vastly different treatments for diabetic kidney damage depending on where they went to school or whether it is Thursday as oppose to Monday? I don't think so. So why do I read about these cases where people are getting treatment that even I, with my limited understanding, know is both incompetent and harmful??

There - end of rant, it's time for bed.

Re: A rant about podiatrists - what's going with those folks??

Sharon W on 8/29/03 at 12:52 (128364)


I could go on similar 'rants' about just about any kind of doctor. I'm sure there are wonderful and terrible doctors of every type. (See my comments in response to your post on the Doctors' page, about a certain neurologist...) And yes I certainly DO understand the need to rant and rave and let off a bit of steam about it now and then, just to get it off your chest; it can really be MADDENING to hear over and over about some of the inconscionable things that happen to patients!!

That is the #1 reason why I believe it is imperative for us, as patients, to educate OURSELVES as much as we can; otherwise, we might not even realize that the doctor we've been sent to isn't doing everything to help us that could be done, and/or hasn't done all the tests that SHOULD have been done to make sure his/her diagnosis was accurate in the first place. Much of the health care in the U.S. these days is rushed and/or shoddy, and (unfortunately) that means it is up to us, the patients, to make sure our doctors do everything for us that can and should be done.

Ignore what it says in magazines and guidelines; don't depend on your doctor to remind you when your next check-up or your next blood tests for cholesterol, diabetes, etc. are due. WE, the patients, need to keep track of things like that -- or else we some of us may end up being among those unfortunate people for whom the problem ISN'T caught in the early stages...


Re: A rant about podiatrists - what's going with those folks??

BrianG on 8/29/03 at 16:16 (128398)

It may be a systemic problem, Steve. Have you ever checked out the message boards that are connected wth the Pod's colleges? I have read some really disturbing posts, most are all money related. The new graduates seem to be more focused on making that 1st million, than setting up a good, honest business, and letting time reward them with a quality office that has many repeat patients. It would seem that the instructors may be failing the new students in many areas. One area I notice that could be addressed right now is 'compassion', among others.


Re: A rant about podiatrists - what's going with those folks??

Ed Davis,DPM on 8/29/03 at 16:51 (128403)


It is a systemic problem, although it may be one that gets worse before it gets better. The important thing that many don't realize is that the doctor's role as a patient advocate has been badly eroded via the development of managed care.

Managed care in WA State had been focused around PHO's or physician-hospital organizations. In order to treat large groups of insured, doctors needed the blessing of the organization. The hospitals led such organizations. Those who are the 'big producers' at hospitals (ie. do a lot of surgery) curried favor with the hospitals that run the PHO's. Now follow the money and figure the rest out....

Re: A rant about podiatrists - what's going with those folks??

marie on 8/31/03 at 20:46 (128472)

It seems to me that when the health insurance industry changed from one main health insurance company to HMO, PPO, and fifty million different plans, physicians have become so limited by what they can and cannot do as dictated by the insurance company. I wonder how we as a country have allowed insurance companies to destroy what was a great medical system? Doctor's are only as good as your insurance allows.


Re: Wait a minute

lara on 9/01/03 at 11:19 (128495)

I've felt the same way you have when I notice my doctor answer a simple question with a defensive answer. However, I have to remind myself that
great health care is not free. I do not intend to denigrate the entire profession (filled primarily with good, honest people, including my husband's best friend and many who participate on this board) but doctors are vulnerable to the same temptations as the rest of us, and some resist temptation better than others. Before HMOs, etc, patients were referred to needless tests & surgeries and the reality is we ALL paid for it through medical costs, unemployment, etc. THis doesn't seem as egregious as a patient that doesn't get the necessary test or surgery, but I believe white collar crime (bilking the system) can be as damaging to society and individuals as violent crimes (failure top treat properly).

I'm not arguing that HMOs are the answer. Providing high quality medical care to everyone is a complicated problem. The reason we got 'here' is because of problems with the 'old system'. The new system has its own set of problems, possibly worse problems, which need to be explored and solutions found so that we can give the best health care to the most number of people.

Re: No easy answers

BrianG on 9/02/03 at 08:21 (128536)

I wish our elected officials would put as much energy into health care, as they do for foreign affairs. How can we spend what we do elsewhere, when our own own country's health care needs fixing ??? Sorry, but I don't pretend to have the answers.


Re: Wait a minute

Ed Davis,DPM on 9/02/03 at 11:46 (128559)


HMOs by no means provided a solution to problems found in the 'old' system but often exaccerbated such problems. There still has not been a good solution to the liability crisis.

The most efficient means to make an industry work has always been allowing the free market to function. That means that those who consume a service are the purchasers of the service. The purchaser must be a well informed consumer of services, having sufficient information to make intelligent choices. Shifting treatment choices from the doctor to the insurance company (as in managed care) can only make things worse.
Only a system that places the choices in the hands of the consumer who is also the purchaser of services can be efficient and fair.