05/11/2013    Paul Kesselman, DPM

Smart Patient With Smart Phone (Bret Ribotsky, DPM)

Use of digital cameras by patients in the office
to take pictures of their x-rays and foot
condition prior to surgery is certainly nothing
new to most of us. Smart phones, however, have
certainly taken this issue to a new height and it
was only a matter of time before patients started
shopping for our very services, while sitting in
our very offices.

Excluding the use of digital cameras was easy by
maintaining a policy of excluding photos (while
in my office) or videos of their ingrown toenail
surgeries.

I have refused this process by informing patients
that my policy is to keep the foot in a sterile
field. The use of a blocking screen has also kept
the number of vaso-vagal reactions I have had to
deal with to a minimum.

This, of course, did preclude patients from
taking pre-and post-op photos prior to or after
leaving my office.

But on demand price checking while in your
office? A word chutzpah comes to mind.

You can have a policy of prohibiting the use of
cell phones in your office, but can you legally
keep patients from surfing the Internet (using
their own Internet connection) in your office?
And even if you could, ultimately the patient
will be able to price check your services and
products you dispense after the fact. That could
result in a flurry of complaints and leave your
reputation tarnished should patients think they
are being ripped off.

Comparative price checking is nothing new to
retailers, including shoe stores (recent story on
Pedorthic Newswire).

Many brick and mortar stores are disappearing
with many shoppers (myself including) using the
internet to price shop and ultimately purchase.
Who today does not?

Current legislation in Congress is to support
mandatory sales tax based on the shipping
address. There is wide support in the Senate and
resistance to this in the house.

The appropriate response and some talking points
to this patient may include some or all of the
following:

The Internet commodity may or may not be of
identical and/or professional quality to the DME
item dispensed by our office; Our office policy
requires patients sign a liability statement
releasing us from any harm resulting from a
device not purchased from our office.

Furthermore, some provisional treatment would be
required (which would meet the standard of care
until the patient received their internet
device). This may or may not be covered by the
patient's insurance; There would be
an "inspection fee" (likely not covered by
insurance) of the internet device.

This, to be sure - the device they purchased was
appropriate for both size and diagnosis (yet
again reminding them, you would not be
responsible for any harm caused to them by this
device due to breakage, malfunction, etc.).;
The price for the DME item does not include any
required professional fitting, adjustments or
warranty from the physician.

As. Dr. Ribotsky's comments reminds us, one does
need their pricing competitive, avoiding patients
from feeling they were ripped off. To keep
patients satisfied with your pricing points,
strategies to reduce our wholesale costs should
include:

Group and/or Internet purchasing of our own and
pressure (via boycott) of those companies who
sell identical (or similar) products
to lay consumers over the Internet.

Paul Kesselman, DPM, drkesselmandpm1@hotmail.com

There are no more messages in this thread.