"You're some foot specialist!..." -please, I need advice Anonymous.

A lady came in for treatment of B/4/5 painful H/M. Whilst I was enucleating the soft corns, she asked if I was removing the "roots." I responded that there were no "roots" and the cause was her high end fashion dress shoes. By wearing shoes with a larger/rounder toe box her H/Ms would probably not recur. She responded that she probably owned moe shoes than Carrie Bardshaw and could not throw out her collection of shoes -as they were for work and going out. She then asked if something else could be done to prevent the H/Ms. I responded that silicone IDWs could help -she had tried them and they didn't. I then responded that her next visit should be to a podiatrist for minor bone surgery. She asked whether podiatrists are fully covered by OHIP. I said, "no, there will be a fee... the consultation and x-rays will probably be about $60 or more anf then there will be a fee for the actual foot surgery and that fee depends on what type of surgical procedure is done." She responded, "FORGET THAT. MY EXTENDED HEALTH PLAN WON'T COVER YOUR $40 FEE. MY PEDICURIST DOES WHAT YOU DO, SHE ALSO TRIMS, BUFFS AND APPLIES NAIL POLISH FOR $30 AND HER SESSION TAKES 45 MINUTES! SO, I'LL CONTINUE WITH HER!!!" Trying to be helpful, I suggested that she see he physcian for a referral to an othopaedic surgeon for surgery. She asked if the othopaedic surgeon was fully covered by OHIP. I said yes but I didn't know if there were any extra charges. She said, "that there better not be!" After I completed the treatment and she paid my fee, she said that it was too bad that I wasn't a real foot specialist because there were at least 10 co-workers with similar (and other) foot problems and she would've told them to see me for treatment instead she'll save them all $40/treatment by telling them to continue with their current pedicurists (if they're using them) and if they want to have a permanent solution then they should be referred to an othropaedic surgeon. As she left she said indignantly, "You're some foot specialist! You charge more than a pedicurist and do less for your clients." BTW, you'll probably find her at David's or Holt's buying 2 or 3 pairs of shoes this weekend.

So Anonymous just how do handle patients like this? After all as you pointed out in your post, "This legisltion specifically states that we provide comprehensive treatment ot the foot. That is why we are foot specialists (we do not directly treat knees and backs and shoulders, strictly the foot and ankle complex. ie. Foot Specialists." But this lady and many like her, are going to see an orthopaedic surgeon, who is a general musculo-skeletal surgeon, who surgically treats knees, backs, hands, shoulders -oh and sometimes feet. The lady will not be going to Ontario's own foot specialists, you or me anymore and I'm sure there are many, many people like her in Ontario! It certainly illustrates why people are waiting to see an orthpaedic surgeon 2+ years. Why pay to see a chiropodist/podiatrist and find out that the orthopaedic surgeon is the specialist who can really help. (I also know that not everyone waiting for the othropaedic surgeon is waiting for foot surgery.)

40 patients in one day! Impressive and they're all happy paying you -even more impressive!!!! I usually spend 30 minutes performing a treatment, how in the world do you manage 40 patients in one day? It would take me at least 20 hours to see 40 patients.

BTW, negative spin = reality in Ontario's chiropody realm. Whereas, your chiropody practise situation seems positively fictional.