As a podiatrist, you understand just how much communication with your patient is of utmost importance. Not only this, but it’s crucial to have a thorough understanding of your obligations regarding effective communication. 

Effective communication professional obligations

The Podiatry Board of Australia’s Code of Conduct (Code) sets out a podiatrist’s professional obligations with regards to engaging in and maintaining effective communication with patients and other treating practitioners. 

These obligations aim to promote good communication between a podiatrist and their patient to ensure a patient is fully informed and understands all aspects of treatment.  

To get a deeper understanding of what this means, let’s examine a clinical scenario. 

Clinical scenario for context 

John attends an initial consultation with a podiatrist, Olivia. He presents with stabbing heel pain which started when he began to train for a half marathon. John tells Olivia that he has never seen a podiatrist before and initially consulted his general practitioner who prescribed him anti-inflammatories, yet they were ineffective. John asks if Olivia would mind sending a letter to his general practitioner after this consultation. Olivia brushes off this comment and responds along the lines of, ‘GPs are useless at dealing with heel related aches and pains.’ 

Olivia conducts an assessment and diagnoses John with plantar fasciitis. During the assessment, John explains to Olivia in addition to his half marathon training, he also stands all day in his casual role at a supermarket. Olivia says, ‘You’ll need to ease up on that, it’s the cause of the plantar fasciitis’. Olivia prescribes anti-inflammatory medication and provides John with some home-based exercises and stretches.  

John completes the recommended exercises and stretches daily. He also cuts down his shifts at the supermarket as a result of Olivia’s comment to ‘ease up’. John does not fulfil the anti-inflammatory prescription as these did not ease the pain last time. 

In a fortnight, John returns for another consultation with Olivia and reports his heel pain is, ‘Similar, if not a bit worse’. He advises that he completed the exercises and stretches daily and has been continuing with his running training. 

Olivia responds, ‘You’ve been running? I told you to ease up.’ Olivia advises John to stop running for the next month and continue with the prescribed exercises and stretches. 

After this consultation, John sees his general practitioner who says he never heard from Olivia. John is annoyed at Olivia’s treatment, in particular that she failed to contact his general practitioner and the instruction to ‘ease up’ was not clear, which meant he reduced his hours of work. He makes a complaint against Olivia. 

Learnings and safeguards 

What can we learn from this? Well, the scenario of Olivia and John reveals a number of common communication errors.  

 

Breach of communication obligations

Olivia breached her communication obligations by:

 

  • Not discussing with John exactly how his general practitioner planned to manage his condition or any medications he had been prescribed.
  • Olivia’s comment regarding general practitioners reflects a breach of her communication obligations as she has shown a lack of respect for John’s views and preferences to have his general practitioner also involved in the treatment of his plantar fasciitis.

 

Miscommunication

Olivia’s comment about ‘easing up’ on his running caused some miscommunication. Notably, Olivia has not been aware of John’s health literacy, that is, John’s ability to understand the information provided by Olivia, noting that John has not attended a podiatrist previously. Olivia should have been especially cautious to confirm that John understood what she said.

Where to from here 

Podiatrists have a responsibility to ensure that all communication with patients is effective and clear. Breaches of communication obligations can lead to distrust and a breakdown in the treating relationship between a podiatrist and their patient, as seen in Olivia and John’s situation.  

So, how can we better safeguard against such outcomes? Here are some examples on an individual level, many of which you no doubt do already:

  1. Make ongoing enquiries into how the patient is managing their condition 
  2. Employ clear and straightforward language when speaking with patients 
  3. Request that a patient confirms what a podiatrist has said
  4. Understand a patient’s health literacy and adapt your communication style accordingly
  5. Spend time reflecting on your own communication style and undertake mentoring if you wish to troubleshoot any particular areas

 

When it comes to safeguards on a practice-wide level, here are some suggestions to consider:

  1. Consider communication training for all new staff to better understand different communication styles and professional obligations. 
  2. Organise regular staff meetings to discuss effective communication and how to best communicate with a variety of patients and health practitioners. 
  3. Develop and implement communication policies and procedures, including ones that focus on effective communication with other health practitioners, and also effective patient communication in regards to understanding their full health history.  

What to do if miscommunication happens

If you are involved in a miscommunication, or you are unsure how best to discuss a particular health concern with a patient, then seek assistance from the APodA, senior colleagues or trusted peers. 

 

If the miscommunication leads to a complaint or claim, please contact your insurer immediately. 

Disclaimer
Barry.Nilsson. Lawyers communications are intended to provide commentary and general information. They should not be relied upon as legal advice. Formal legal advice should be sought in particular transactions or on matters of interest arising from this communication. BMS Risk Solutions Pty Ltd (BMS) AFSL 461594 ABN 45 161 187 980 is the official and exclusive insurance broker for the APodA member insurance program. 
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