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Three Miami Podiatrists

The X-ray above shows my fractured pinky toe, which I got on an e-bike accident in Miami Beach. The medical doctor at the urgent care center took the X-ray and referred me to a podiatrist.

“Who was the podiatrist?” Asks Mr. Skeptical.

My eyes narrow in on him. “I don’t want to say yet.”

The podiatrist said she’d take her own X-rays to see if the fracture aligned correctly. She claimed that most fractures that go across the pinky-toe bone heal normally. But since my fracture is diagonal, it may not.

She advised manipulating my toe back into place. She saw my distressed face and added, “Don’t worry. You won’t feel a thing. You’ll get an anesthesia shot.”

I grimaced, remembering my shot two days earlier when I went to the urgent care center. It made me yell out in pain.

Mr. Skeptical remarks, “Awww did you cry?”

I swallow and force myself to ignore his comment.

The podiatrist continued, “I’m only trying to save you from surgery. You want to avoid surgery, right?”

“Yes, I do. And I think you’ll adjust it right back into place.”

The podiatrist left and returned with a big needle in her hand, which, unfortunately, I saw. I breathed slowly and deeply, bracing for the shot, but it hurt less than at the urgent care. Then, after waiting a while to ensure the anesthesia sunk in, the doctor came in to manipulate the pinky toe into place.

I said, “I don’t need to look, right?”

“Nope. No need to see it.” She grabbed my pinky toe and started manipulating it. Avoiding my foot, I saw the doctor’s face distorting as she wrestled with my most distant bodily appendage. However, the Novocain worked, for I didn’t feel a thing. Yet, thinking of someone distorting my pinky toe felt unnerving.

The doctor said, “Let’s get more X-rays.”

I stood up to get on the X-ray machine designed for the foot. I noticed my left pinky area was much more swollen. She shot two X-rays, then looked at the screen and said, “Nope.”

The comment wasn’t hopeful.

She approached me, grabbed my foot, and manipulated it again. This time, I saw everything. She took three more X-rays for a total of five.

My foot was still on the X-ray platform when it started to bleed again. Blood spilled. It was throbbing. I begin to feel nauseous. Her assistant helped me to a chair.

“Clean the blood.”

Feeling like passing out, I said, “Let me lay down.”

The podiatrist sternly said, “Just sit in the chair till you feel better. We don’t want you on the floor. Get some alcohol wipes for him to smell.”

After some time and smelling the alcohol wipes, I started to feel better.

“You’re such a wuss.” Says Mr. Skeptical.

I shrug my shoulders. “It’s not something I’m proud of.”

Later, my dad came to pick me up. He was surprised that the doctor recommended surgery. But the podiatrist showed with her hands how they appear displaced on the x-ray, like a sliced-in-half avocado.

I asked, “What if I just leave it alone?”

The doctor shrugged her shoulders. “Then it may not heal. The surgery is simple. We put a little pin in there to ensure the bone aligns properly. You don’t get full anesthesia. You’ll be knocked out but breathing on your own.”

My father asked, “Are you the doctor who does the surgery?”

“Yes, we perform it here in the office.”

On the drive home, I told my father I’d likely have the surgery. He casually said how she stands to earn a lot more money performing surgery. He suggested a second opinion, and I agreed.

It also felt weird that the other doctor at the urgent care mentioned this podiatrist. I knew from my past as a chiropractor that when you get referred to another specialist, it’s usually not because they’re better than anyone else; it’s simply someone they met. And if a doctor is out there meeting a lot of other doctors, creating a larger network to get referrals…

Mr. Skeptical comments, “It seems capitalistic. A doctor is supposed to be above that. They are supposed to live by the Hippocratic oath: first, do no harm.”

“As a chiropractor, I’d network with other doctors to get referrals, but this is more serious. It’s a surgical procedure, and I’ll have a metallic pin in me. It goes with what I’ve always said: “Love and money make the world go round.”

I went home and researched the need for pinky-toe surgery. It appears that, mostly, surgery isn’t needed.

A chiropractor friend referred me to a podiatrist. The next day, I sat in a specialized chair that brought my foot up so the podiatrist could view it. I told him I just wanted a second opinion.

But he asked, “Who was the podiatrist you saw?”

I tilted my head and looked the doctor straight in the eye. “I was a chiropractor for twenty-two years. People become friends with others in the profession. I just want an unbiased opinion.”

The doctor looked at me and smirked. “Yeah, okay.”

He looked at all the X-rays and said he didn’t think surgery was necessary. He also told me to get rid of the crutches.

Mr. Skeptical jumps in. “You must’ve been pissed?”

“Well, I had already booked an appointment to see another podiatrist the next day, so I decided to get a third opinion.”

“What did that doctor say?”

“The doctor there wanted new x-rays before even seeing me. However, I told the medical assistant no. I already had enough of them. The medical assistant gave in, and I got to see the podiatrist. She didn’t ask who had recommended surgery. But she still wanted me to get X-rays. I insisted that she was my third opinion and that the second podiatrist didn’t insist on x-rays. After looking at the previous x-rays taken, she also agreed surgery wasn’t necessary.”

“So, two out of three didn’t think surgery was needed?”

“Yep. The third podiatrist was very nice yet insisted, “It be a good idea to get new x-rays.”

She assumed I’d just agree to it, but I didn’t. I felt the X-rays were unnecessary. It was lunchtime, and she added, “Well, the x-ray team is out to lunch.”

On that note, I left.

“So, who was the first podiatrist who recommended surgery?” Asks Mr. Skeptical.

I sigh and decide. “I don’t want to say. No need to put bad karma out there.”

“But you said earlier that you’d tell.”

“I know, but I changed my mind. The main point is using common sense to control your healthcare.”

Mr. Skeptical gets animated, getting up and putting his hands in the air. “The public should know that there’s a podiatrist out there promoting unnecessary surgery.”

“Maybe the first podiatrist genuinely gave her honest opinion.”

“You believe that? After she’s incentivized to perform a surgical procedure?”

“I believe it’s unlikely, but it’s still possible. Besides, my foot is still healing. I must wear the medical boot for a few more weeks.”

“The podiatrist likely has a trip planned to Paris, and if she did your surgery, it covers the cost of flying first class.” Mr. Skeptical puts on a pouty face again. “You’re going to make a doctor fly coach, poor her?”

Mr. Skeptical’s sarcasm is through the roof today!

The main advice is this: always get a second opinion in health care, especially if it involves a surgical procedure.

Be assertive, and don’t give in. When getting a second opinion, be sure it’s unbiased. Don’t let the doctor know who gave the first opinion. Don’t let yourself be X-rayed more than you believe you need. Use common sense.

Be aware.

You can read more from Hermann at www.SubconsciousFat.com.

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