Should We Give Away Our Expertise For Free?

We have all seen that look before. It is the look of excitement that people get when you first meet them and you are introduced as a podiatrist. The eyes widen, the mouth opens and the shoe starts slipping off.

   I enjoy seeing this look at the office since it is very fulfilling. There are times, however, that I do not enjoy it as much. For example, I do not enjoy being out for dinner at a nice restaurant and someone putting a foot on the table and asking me to “take a quick look.“ (Yes, this has actually happened to me.)

   Oftentimes, we are put in a situation in which someone would like a quick answer to “What is this?” or “Is this normal?” We all know there is normally not a short answer to these questions.

   So where do you draw the line?

   I always will tell people that they are welcome to come into the office so I can check out their problem in further detail. Alternately, I will say that it is difficult to fully diagnose the problem without clinical evaluation. The latter of the two has caused me some awkward situations in the past as some will say, “Go ahead, move it around. Check it out.”

   That is the point at which I think to myself about what a relief it is to be a podiatrist and not a urologist.

   With some seriousness, it is important to know how to respond to these requests in a professional and non-offending manner. I do not like to be vague with my answers but I like to be careful in what medical advice I give. While rare in these situations, medico-legal issues may also arise. For me, a light joke will often lift the mood while getting the point across. If that does not work, I like to drive the conversation to talking about the profession and our level of training.

   Certainly, we all like to help people with their lower extremity conditions. This is why we entered the field. That is also why there will be some controversy with this next point.

   We like to treat people but how often do we do it for free? We have a skill that is mostly knowledge based that took many years to obtain. Some have even accumulated incredible student debt in doing so.

   Since we do not mainly offer tangible items, some people may feel that it is not costing anything to give an opinion. However, it would be akin to meeting a car mechanic and asking him or her to just look under the hood “really quick” and diagnose the problem, or asking a lawyer to look over divorce papers and “see what you think.” Personally, I have never heard someone ask a mechanic or a lawyer those questions after being introduced to those types of professionals.

   In the medical arena, these questions seem rampant and it may be partly our own doing. We offer multiple opportunities to disperse our opinions, whether it is through “Meet and Greets,” lectures at community groups or health fairs. These types of events are important to educate the public on what all we do and dispel common myths. This especially holds true in the age of the Internet when there are an increasing number of potential patients who have already diagnosed themselves and are looking for validation of conditions they think they have.

   While I don’t think many are opposed to these meet and greets, we do create an environment of openness at all times, which can be a drawback.

   It is great for the profession to advance through education and information. That is why the balance between doing so in a formal versus non-formal setting is imperative. As a profession, we want to be respected and be taken seriously, but not come off as unapproachable and conceited. There is a fine line between the two, one that we constantly have to address.

   I would love to hear others’ thoughts on how they handle these situations or what the opinion is on non-formal treatment.

   Dr. Lawton is in private practice in Naples, Fla.

   Dr. McCord recently retired from practice at the Centralia Medical Center in Centralia, Wash.