Orthoses – managing expectations

It may surprise you to know that complaints about orthoses are a common source of podiatry claims to Guild Insurance. 

Common allegations include:

  1. The orthoses caused the client to suffer a new injury, such as a hip or lower back problem.
  2. The orthoses exacerbated the client’s existing or underlying condition.
  3. The orthoses failed to resolve the client’s presenting problem.

Any claim against you, whether substantiated or not, can be distressing.  Your good reputation may be damaged leading to undue criticism from other healthcare providers and reduced client referrals.  Furthermore, complaints to agencies such as AHPRA may take many months to resolve resulting in a prolonged period of uncertainty.

Managing client expectations through effective communication is central to avoiding claims against you.  Key issues to discuss with clients include, but are not limited to:

  • Discuss the range of options available to treat the individual’s condition. Take the time to discuss the pros and cons of each option, including costs and risks.Ensure the client understands the difference in expectations between pre-formed and custom-made orthoses.
  • Make sure the client understands what outcomes he or she can realistically expect to achieve with the orthoses. Remember, what is obvious to you may be completely foreign to the client.However, don’t just ask them if they understand, as in many cases they’ll say yes even if they don’t.It’s better to ask the client to tell you what they’ve understood from the discussion.
  • Where suitable, use visual aids such as diagrams and models to help explain the information.
  • Allow clients adequate opportunity to ask questions and weigh-up their options, including the financial implications of their choice.Give them time to make their decision, they shouldn’t be expected to decide at the appointment where they were given the information.They may wish to think about it for a few days.
  • Provide clear instructions about how the orthoses are to be used, including choice of footwear and any prescribed exercises or stretches.Carefully explain the implications of not following your instructions.
  • Remember to discuss the expected life span of the orthoses and any instructions for ongoing care.
  • Emphasise the importance of attending all follow-up appointments and contacting you immediately if they have any concerns.Remember to outline the early warning signs of any complications and urge the client to contact you as soon as any issues arise.
  • Where possible, provide clients with written information for them to take away and read in their own time.Sometimes people are not able to absorb everything they’re told during an appointment.However, written information should only be used to re-enforce what was discussed, not as a replacement for the conversation.

Finally, remember to clearly document your discussion and the outcomes in the client’s clinical notes.  Good clinical notes are invaluable in the event of a complaint against you.

Orthoses - Managing Expectations

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