Just a quick look at my foot, please?
Recently, I was just grabbing a quick coffee during my lunch hour at the reception desk. Unfortunately, I neglected to put the closed sign up on the door and a person walked in. He proceeded to remove his shoes and socks and ask for advice on his foot problem. I suggested that he make an appointment but regardless he continued to ask advice. By the time he had left I had spent the best part of twenty minutes giving out advice – but then I thought – it was outside a formal appointment, I haven’t carried out a full assessment and so have no details on the person and yet I have given professional advice – all in my break!
In our day-to-day practice, it’s surprising how often we get asked about foot problems outside of allotted appointments (or about patient’s family members during appointments). Unsolicited informal requests for advice can also come through phone calls, drop in patients seeking on-the-spot advice or e-mails (with or without pictures attached). I remember receiving an e-mail from a potential patient. It contained a picture of a foot with an unusual foot rash. It stated if I knew what it was could he make an appointment, please? On-the-spot advice can go even further, for example, when out and about. Once people find out you’re a podiatrist, the foot questions can start coming at you, even down the pub or on a night out! This is something that is probably common to us all.
I looked online at published research about this phenomenon and came up with an interesting paper published in the United States in the journal “Paediatric Dermatology”. The paper describes these events as “shadow consultations” and “quick peeks” and the authors describe them as unsolicited, informal requests for clinical opinions on a patient, a history or from a digital photograph (1). Of course, dermatological problems are particularly vulnerable to this type of approach as they are visual in nature. The authors undertook an online survey of paediatric dermatologists to investigate their experiences. The survey in dermatology clinics showed about half of those surveyed had about 6 unsolicited consultations a week averaging about 6 minutes each with most having no record of the event being taken. Three quarters were unsure as to the legal or insurance implications of giving such advice. As the authors point out, these “shadow” consultations are not necessarily bad things as so often they can increase awareness and benefit patient education but nevertheless perhaps practices need a policy for this type of consultation.
So, can you take a quick survey about your experiences of these?
Consequently, I thought it would be good to capture the opinions of our colleague here in the UK. So, particularly for those in private practice, I am seeking your help to undertake a short online questionnaire to ask about your experiences with this phenomenon of “quick peeks” to collate a piece of work. It shouldn’t take more than five minutes to complete. All responses are treated as anonymous but if you wish to leave a contact e-mail address at the end of the survey, you will be entered into a free prize draw to win a £50 amazon voucher. The survey can be completed online by clicking the link below.
1. Khorsand K, Sidbury R. The shadow clinic: Emails, “curbsides,” and “quick peeks” in pediatric dermatology. Pediatr Dermatol. (E-publication ahead of print)