Podiometric Referral Patterns

[Feli]

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...Getting an x-ray simply to placate the patient isn't necessarily good medicine but it could keep them in your practice long enough for you to fix their problem rather than driving them to another provider to finish what you started, which is just reality of private practice in the USA where people feel entitled to Presidential level care. ...

Yep, people think they need everything... and we should give it to them if it's reasonable. I tend to do it if reasonable or tell them insurance won't allow or it's dangerous if it's not reasonable (abx for no infection, surgery for ****oo, DME they clearly don't need, etc)

Personally, I'm in a hospital. For fasciitis, bunion, etc, I will look at the XR if it was ordered by ER or PCP, but if it wasn't, I just have them do it after they leave and we'll discuss it next f/u visit. I might inject hallux rigidus or PF, or I might drain a ganglion or gout joint without XR since I know what it is and don't want to waste the time of having them go and come back. They still go to XR after their new pt visit if they didn't have one done already by the referring doc, though. To not do XR as a specialist is short sighted on many levels (billing, medical-legal, satisfies the pt, missing some zebra, boards, etc). I have no problem if a cash pt or a pt who doesn't want the time/hassle refuses my XR, labs, MRI, Rx, or whatever... but I don't ever refuse it for them.