Are You Suggesting or Prescribing?

Think About Your Latest Patient Encounter…

Have you ever used these phrases?

• I would recommend…
• We can either treat it this way or treat it that way. It is your decision.
• It is my recommendation to…
• I would encourage you to consider…
• Would you like me to prescribe…?
• Here are all your options… What would you like to do?
• If you were my grandparent, this is what I would do…

Let’s Look At Some Examples

Podiatrist: “Mr. Jones, you have plantar fasciitis. I would recommend customer orthotics, or we could try an injection, or you could try stretching at home. I am not sure if your insurance will cover custom orthotics, but we can call and check on it. Mr. Jones do you know if you have met your deductible? If not, the hell injection will go against it. What would you like to do?

Cardiologist: “Mr. Jones you have a blockage in your heart I would recommend surgery, or you could try medication, or we could just try a diet change at home. I am not sure what your insurance coverage is for the medication but, we can call and find out. Mr. Jones have you met your deductible? If not, your surgery will go against it. What would you like to do?

Can you imagine a Cardiologist using that wording? How do you think that would make the patient feel?

Instead, a Cardiologist would use the following wording:

“Mr. Jones, you have a blockage in your heart, we are scheduling you for surgery on Friday. I am prescribing you medication to your local pharmacy. Here are diet changes that you will be making to prevent a future occurrence. Cindy will be in to discuss your surgical payment responsibility.”

A Better Way to Communicate with Patients

Instead of making recommendations, most physicians use strong wording and prescribe or tell the patient what they are doing. Use words like:

• We are…
• I am prescribing…
• This is the course of treatment…
• I will…
• You will…

How would that sound if the same wording was used in Podiatry?

Podiatrist: “Mr. Jones you have plantar fasciitis. We will be doing a heel injection today. I am prescribing you custom orthotics; we will be ordering them for you today. You will also be doing stretching exercises at home to prevent reoccurrence. I will be seeing you in two weeks for a follow-up and an additional injection. Cindy will be in to discuss your patient responsibility and go over the stretching exercises.”

You Are the Physician

Many podiatrists were trained to put the patient in charge and help guide the patient on deciding their course of treatment. As a consultant, I hear podiatrists use the initial example repeatedly. This is insane! You are the physician.

The patient has already researched their condition on the internet and looked at all their options. They are coming to you because they want you to tell them what to do. If they don’t want orthotics or an injection, they will tell you no.

When a physician makes suggestions and gives options it makes patients uneasy. They want a physician that knows what they are doing and how to treat a condition. They want a clear course of treatment. They do not want suggestions or recommendations.

This technique also applies to treating ulcers. Ulcers are life and limb-threatening and should be treated with the same urgency and care as a cardiac blockage. Follow strict wound care protocols. Don’t suggest that they go to the local CVS and buy wound care supplies off the shelf. Prescribe and dispense high-quality wound care supplies straight out of your office and know that your patients have and are using the correct wound care products. Don’t risk their life or limb by making suggestions and recommendations.

In Conclusion

Tell your patients what they need to do. It is good for business and good for patient care.