Foot pain - common pitfalls 

• Failure to diagnose: Foot pain can be caused by a variety of conditions, some of which are serious and require prompt treatment. If a primary care practitioner fails to diagnose the underlying cause of a patient's foot pain, the patient may suffer further injury or even permanent disability.

• Inappropriate treatment: Even if a primary care practitioner correctly diagnoses the cause of a patient's foot pain, the treatment they provide may be inappropriate. This could lead to further injury or complications. For example, if a patient has a nerve injury in their foot, surgery may not be the best course of treatment.

• Failure to obtain informed consent: Before any treatment is performed, a primary care practitioner must obtain the patient's informed consent. This means that the patient must be fully informed of the risks and benefits of the treatment, as well as any alternative treatments that may be available. If a primary care practitioner fails to obtain informed consent, the patient may have a legal claim if they suffer any complications from the treatment.

• Failure to document: All interactions with patients, including the history of the present illness, the physical examination findings, the diagnosis, and the treatment plan, should be carefully documented in the patient's medical record. This documentation is essential in the event of a legal claim, as it provides a record of the care that was provided.

• Failure to refer: If a primary care practitioner is not able to provide the necessary care for a patient's foot pain, they should refer the patient to a specialist. Failure to refer a patient who needs specialized care could result in further injury or complications.

Failure to diagnose:

• A 55-year-old woman presents to her primary care practitioner with a complaint of pain in her right foot. The pain has been getting worse over the past few months and is now making it difficult for her to walk. The primary care practitioner examines the woman's foot and does not find any obvious signs of injury or deformity. The practitioner diagnoses the woman with plantar fasciitis and prescribes some pain medication and physical therapy. The woman's pain does not improve with the treatment and she eventually sees a specialist who diagnoses her with a stress fracture in her foot.

Inappropriate treatment:

• A 25-year-old man presents to his primary care practitioner with a complaint of pain in his left foot. The pain has been getting worse over the past few weeks and is now making it difficult for him to walk. The primary care practitioner examines the man's foot and diagnoses him with a bunion. The practitioner prescribes a bunion pad and some pain medication. The man's pain does not improve with the treatment and he eventually sees a specialist who diagnoses him with a nerve injury in his foot. The specialist tells the man that surgery is the only way to correct the nerve injury.

Failure to obtain informed consent:

• A 70-year-old woman presents to her primary care practitioner with a complaint of pain in her right foot. The primary care practitioner diagnoses the woman with plantar fasciitis and recommends surgery to remove the plantar fascia. The woman agrees to the surgery, but she is not told about the risks and benefits of the procedure. The woman suffers complications from the surgery and is unable to walk for several months. The woman files a lawsuit against the primary care practitioner for failure to obtain informed consent.

Failure to document:

• A 35-year-old woman presents to her primary care practitioner with a complaint of pain in her right foot. The primary care practitioner examines the woman's foot and diagnoses her with a stress fracture. The practitioner prescribes some pain medication and tells the woman to rest her foot. The woman returns to the primary care practitioner a few weeks later with the same complaint. The primary care practitioner does not document the woman's previous visit or the fact that he prescribed pain medication. The woman eventually sees a specialist who diagnoses her with a more serious condition. The woman files a lawsuit against the primary care practitioner for failure to document her care.

Failure to refer:

• A 12-year-old boy presents to his primary care practitioner with a complaint of pain in his right foot. The primary care practitioner examines the boy's foot and diagnoses him with a sprained ankle. The practitioner prescribes some pain medication and rest. The boy's pain does not improve with the treatment and he continues to have difficulty walking. The boy's parents take him to see a specialist who diagnoses him with a stress fracture. The specialist tells the boy that he needs to wear a cast for several weeks. The boy's parents are upset that the primary care practitioner did not refer the boy to a specialist sooner.