In the most previous post on this forum I spoke about over the counter supports, and how they may be incorporated into your practice. There may be valid reasons for utilizing them, the truth is, however, when strictly speaking of clinical effectiveness, they rarely will be equal to a custom made foot orthotic. So, when a patient is hesitant to move forward with your biomechanical treatment plan, how do you communicate with them, and try to lead them into making the best decisions for themselves?
Salesmanship is a trait that never came naturally for me, in fact, I have generally thought of most salesmen as being somewhat sociopathic in order to be successful. Some will say or do anything, truthful or not, in order to make a sale and will often convince the customer to decide against their own self interest. However, in our chosen field of lower extremity biomechanics, (and medicine in general) the provider should have answers at their fingertips to the questions that the patients may or may not even know to ask. We should be able to articulate, in terms that the patient can understand, the reasons we are recommending a biomechanics based treatment plan including the use of custom functional foot orthotics. The challenge we face is translating our knowledge base into language that effectively convinces our patient to make the right decision for the right reasons.
I will share some things that worked well for me over the years but might not necessarily be effective for someone else. It is important to have some brief “scripts” in mind when discussing your treatment plan with your patients, but it is important to truly believe in what you are saying, otherwise you just become a salesman. I would often relate to patients my own experience, being “blessed” with bad feet myself. I could often empathize with their description of their symptoms, “been there, done that”. I could honestly tell them I am an orthotic success story, practicing what I preach from both the doctors and the patient’s point of view.
Skepticism is a common reaction when presenting the prospect of making a device to put in your shoes that is going to decrease pain and improve function, especially when simpler and less expensive options are readily available. A simple presentation on what pronation and supination is, how the feet and legs have to both support the body and propel the body in an efficient manner. Explaining how compensation mechanisms occur that cause the symptoms the patient is experiencing can be quite challenging. It is up to each of us to present that information quickly and in a form that is being understood by the patient. Visual aids are helpful. Nevertheless, you should have command of your subject matter and have confidence that you have the patient’s best interest in your mind. They will know that you do.
