Clinical Articles
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The Receptionist
My first experience in a hospital with a secretary who acted as my ‘phone receptionist was dire. She was efficient but had the personality of … well, we don’t want to go there. Still, Paul Harris is quoted as saying, ‘Personality has power to uplift, power to depress, power to curse, and power to bless’ – my first secretary failed the first part of the quote. Who was Paul Harris – he was a humanitarian and an American lawyer.
Thoughts on the Hammer Toe
When the foot flattens or heightens, the muscles’ position and tendons change, exerting a different pull. This concept has been in vogue since the sixties emanating from US podiatry education and scholastic theory.
The International Podiatry Market
Blogging as an article is great and, when pitched at 1800-2500 words (this article is 1500 words), creates a solid basis of advice. Regarding the countries that contribute the most written material in English, the USA is at the top of the publication tree, with Australia developing a strong base from such a small professional population. Is there evidence for this statement? Well, I never write or produce material if better material exists. At CFP, I like to share material, more often from the USA or Australia.
Treating Corns on Feet
In Part 1 – The corn is part of the keratin layer and does not penetrate the basement membrane because the area would bleed if it did. There are other reasons the dermis is penetrated, not least due to penetrating splinters. However, in some cases, infections and changes arise where blood vessels become invested between the dermis and epidermis, as seen in wart infections (a virus). These have been erroneously called vascular corns or neuro-vascular corns.
Where does patient blockage lie?
The same recruitment issues exist in the NHS and the private sector. On top of this, the fabric of healthcare is under greater strain because people have been neglecting their feet a lot more than they did before, and problems have built up over those two years where they weren’t doing things. So people having foot health checks every four to six months haven’t had them for two years, and small problems became big problems, and therefore needed more treatment.
At the same time, people are more health aware, more fitness aware, and more on their feet, so it’s a combination of more patients wanting podiatry with less availability. So we have a trio of factors: funding essentially, patients failing to check their feet, so the problems have built up during the Covid period, and lastly, better health awareness is actually drawing them out of the public arena now.
Should you befriend patients?
It is likely that podiatrists or others reading this article, feel it is essential to bond, and create a sense of trust through light-hearted banter. Perhaps we think we are better liked and can outclass an old practitioner who hardly breaks a smile. It would be unusual for any self-respective clinician to be unaware of the subject of body language but the non-verbal cues are essential. A smile never hurts, but it is listening that is vital.
Obstinate Corns over Tendons
We must always reflect upon any problems, our decision, the effectiveness of the treatment and whether we could have done anything differently. Patient counselling is always essential and the rationale for conservative treatment should be emphasised along with the patient’s preferences. All intractable lesions can be helped by podiatry, but the EDJ damage and underlying deeper tissues may not respond or may take longer than a patient is willing to persevere. This should be clearly documented, and a follow-up summary should be shared with the patient and GP to include recommendations.
Rehabilitation Injury and Podiatry
We all have barriers, which is probably one of the most common reasons that everyone’s journey is different. It may be that someone is very time-poor; they may not have access to a gym. There may be other health conditions that need to be considered, such as financial barriers or fears and beliefs from reading something on the Internet; these will have to be managed and overcome before embarking on a rehabilitation journey.
Research Papers Made Simple
Here are some of the questions worth addressing –
Ask yourself what you need from a paper. Do you need data – numbers, do you need methods, do you need outcomes showing the effectiveness of a method? How up-to-date should the paper be? Is there a limited number of papers on the subject you want to read, or are there dozens of papers? What does the study tell us? What is the outcome? What have I learned and is the paper a good paper? Is there a better paper and can I use this reliably?