As we all know, the reason for visit reported by patients at the time of appointment scheduling often presents differently in person. For this reason, I always encourage staff to pay close attention when evaluating patients and look beyond the NLDOCAT. By doing so better information is provided to doctors prior to entering the treatment room, allowing more efficient diagnosis and treatment, as well as potentially life changing care. What do I mean, here let me explain. . .

When a patient presents for a seemingly straight forward issue such as an ingrown toenail, make sure to have the evaluating staff member include in his/her line up of questions, “Do you ever suffer from knee, hip or back pain?” Although unrelated to the most pressing issue, you will be amazed at how many of your patients could benefit from a biomechanical exam and medical grade AND custom orthotics. As a Podiatrist, it is your job to educate patients and show them what more you can do to help. If you are still reading please refer to the link below for my recent article titled “Mary Poppins Probably Needed Orthotics.”

For those frustrated by decreasing reimbursement (yes, I know that’s all of you) please use this philosophy daily (especially for the “Ground Hog Patients” who present every 9 weeks). Like patients, it is also important to educate your team regarding your scope of practice (which should include more thorough dermatological exams and treatments). Train your staff to have all patients roll up their pant legs above the ankle and make note of new or unusual lumps, bumps and discolorations for you to include in your exam (please remind staff that they are not physicians and are not diagnosing, nor should they be alarming patients with observations/findings). Team members are the eyes and ears of the practice and can be tremendously valuable in improving the quality of patient care, but only if you teach them.

When you return from the holiday weekend, try it and see how many E/Ms (evaluation and management services, not “office visits”) you can justifiably bill as part of existing patient encounters, as well as the countless biopsies that may have previously been overlooked, potentially saving patients’ lives.