An open letter to Dr. McCloskey--…read more
During my visit last week for a ruptured anterior tibial tendon, you told me--under no uncertain terms--that I would need surgery to repair the damage, and that I could not put any pressure on my foot at all because the "tendon was hanging on by a thread"--insisting that I leave your office without driving, which might further damage my foot, and that I use crutches going forward so as to prevent further injury.
Putting aside the fact that you had several days prior to my appointment to read the MRI report and warn me ahead of time NOT TO DRIVE to your office rather than waiting until I got there...per your orders, I called my neighbors to pick me up; ordered an Iwalk and a scooter--which cost close to $400; and waited for you to schedule surgery. I invested significant funds in mobility devices and hobbled around for a week--risking a fall (especially in the shower) and putting pressure on other joints. I also had friend in town, and had to cancel almost all of our plans and fun adventures. I also let our CEO know that I would need to take time off work for surgery.
However, my husband and I were concerned by your claim that "you didn't know what you would do, exactly, when you got in there"... so yesterday, I went to the orthopedic surgeon who handles almost all of the foot and ankle injuries for the NFL, to get a second opinion. Imagine my shock when they read my MRI and explained that a) surgery NEVER works on the anterior tibial tendon, especially when it's a chronic injury--and instead, always makes it worse; b) that it could not possibly be "hanging by a thread" because that tendon ruptures all at once, not slowly over time; and c) that I needed to rest for a month with an orthotic in my boot, and if this conservative treatment does not work, I will need plasma replacement therapy, not surgery.
I understand that anterior tibial tendon tears are relatively unusual and that this is perhaps the first one you have seen. However, as a professional, you ought to recognize and acknowledge when a problem is beyond your expertise and recommend patients see someone who can properly assess and treat their problems, rather than terrifying them with false notions that they might further injure their foot when that is simply not possible--or worse, performing a painful and totally unnecessary procedure that would not resolve the issue in the first place. If I had trusted your assessment, I would have had surgery, missed a significant amount of work, and weakened the rest of my body...and after all of this sacrifice and discomfort, I would still be in pain. There are plenty of clinics, like the UC Health Steadman Hawkins clinic where I went yesterday, who specialize in and see many of these kinds of injuries, and it would behoove you to recommend that patients see these experts when they have issues that are outside of your scope of knowledge and experience.
In retrospect, I find the entire way you. handled my situation unacceptable--from waiting until I was in the office to tell me I could not drive (even though that was wrong)--to not recommending an orthopedic surgeon. Not everyone has the wherewithal, vocabulary, or insight to seek second opinions on their own. Moreover, it is your ethical and moral responsibility to do no harm, and above all else, to give your patients the highest level of care, even if that means referring them elsewhere. At the very least, I would hope you would consult your colleagues.
After going to podiatrists for sports injuries for years and receiving NO HELP whatsoever from any of them, I have learned the hard way that I need to visit orthopedic surgeons instead.
Please treat future patients with more care and respect--and be honest about what you can reasonably do. I am lucky to have lost only $400 and a week of my life, rather than months to unnecessary pain and restrictions.
Thank you,
