by Melissa Lockwood

A recent residency graduate from Florida, just entering private practice, asked me this interesting question last week.  How do we, as podiatrists, know when to consult another health care professional and more importantly, who to consult,  in a private practice setting?  Medicine has, for decades, been focusing on specialists and our unique skill sets, so it begs the question: how soon to consult if we don’t know the answer?  My advice is as soon as possible.  If something doesn’t look like a horse or behave like a horse, it is probably a zebra!  Referrals and consults to other specialists (or even back to a patient’s primary care physician) is a great communication AND marketing tool.  It’s easy in residency – you are all either on service with the other specialty or you can call them within the hospital setting.  In private practice, it can take time to figure out the WHO, WHAT, WHERE, and WHEN of consulting with other health care professionals. 

One easy way to figure out the WHO is to ask your current patients who they see!  If you notice someone with a scar from an angioplasty or bypass, ask who their vascular doctor was and did they like him/her.  You can glean a lot of info to hone your marketing and referral networking efforts by asking your patients.  The WHAT can sometimes be difficult.  Patient with non-specific pain who describes it both as tingly, achy, burning, and in multiple joints.  Rheumatology?  Neurology?  Physical medicine and rehab?  Start with some basic lab work to rule out specific conditions?  Order the EMG yourself?  Here is a key place to get out and ask your colleagues WHAT they do and how quickly they can see your patients (WHERE and WHEN).  The key point to remember – it’s OK to not know all the answers.  Start building your referral network now (especially if you plan on practicing in the same area after residency) and know it’s NEVER too soon to get another opinion!