#613 When is a web-cam second opinion just as good as in person doctor visit? - DOC

#613 When is a web-cam second opinion just as good as in person doctor visit?

When is a webcam second opinion just as good as an in person doctor’s visit for runners? Well, that’s what we’re talking about today on the Doc on the Run podcast.



Everybody has become familiar with things like Zoom calls and webcam visits, and it’s pretty normal now to get on a call with somebody and connect if it’s really difficult to meet them in person. And when you have an injury like a stress fracture or Achilles tendonitis, or even worse, you have something like an ankle sprain or a fracture and a doctor’s telling you you need surgery, well, you may really want to get a second opinion.

There are a couple of times when webcam second opinion visits can be almost as good as an in person visit, if not just as good. The first thing is you have to realize that a web camera visit is not me seeing you in person.

So if I see you in person, obviously I can read your body language a little bit better. I can take the inserts out of your shoes and actually look at those myself and analyze them a little bit better. I can push around on your foot. I can manipulate the structure that you think is injured. I can push on and pull on it in ways that may be meaningful to me that you can’t do yourself and communicate to me directly. But aside from that, there are lots of benefits to the webcam calls that do make them almost as valuable as in person visits and these are the situations.

Let’s say you’ve had a chronic wound. So you’ve had a chronic injury that’s not getting better. You’re not making any headway. You were improving a little bit and then you plateaued. Well when you’ve had a chronic wound, and the reason that can be hugely beneficial to have a webcam visit is you have lots of information. You’ve had the injury a long time. You’ve done lots of things. You’ve failed lots of things, and your options are running out.

You already know at that point for sure what the injury is and so when you have a chronic injury that’s not getting better, that can be a really great time to get a webcam second opinion visit because you can then take what you have learned and what has failed, and then make decisions to change direction and start trying something different.

Second situation is when you’ve already had imaging. So if you have had an MRI or CT scan or an x-ray or something that confirms conclusively what your injury is, at that point you know what the injury is. You know you’re just not getting better. And at that point, you don’t really need me to push on your foot and move it around to try to see. Is it peroneal tendonitis? Is it peroneus brevis? Is it peroneus longus? You already know what that is. And then we’re just trying to figure out strategies so that you can change direction and actually start healing faster while maintaining your running fitness so you can get back to running.

If you’re stagnated, I mean, we talked about this a little bit. But anytime you get stagnant, even if you’re trying to return to running and you start running and then you hit a wall where you’re having a little bit of discomfort that makes you feel like you’re getting the injury again, that’s a great time to get a webcam second opinion visit because you already know what the injury is and we have all this history to compare it to what’s been happening before.

Next time is when pain starts creeping in. Let’s say you’ve been doing well. You had a fracture, you used a boot, you stopped using the boot, you’ve been walking around without trouble. You start running. You’ve been running, but now the pain’s starting to creep in as you’re ramping up your mileage. Well, that’s a great time to take the information that you’ve used while you’ve actually been running and figure out what you need to do next.

Then the last thing is to figure out whether or not you need to commit to surgery or rule out surgery is an option for you. Now, nobody should have surgery without a second opinion unless it’s an absolute emergency. So if your appendix bursts and you’re going to die, well, you probably should just go to the operating room. But most of what we’re talking about with runners, these are injuries where it’s not truly an emergency. In fact, the doctor may say, “You need surgery and we’ll do it next Wednesday” or something. And so if you have time, you should definitely get a second opinion to make sure that it’s really necessary because surgery’s not always necessary. And in some cases, when you have the surgery, it creates different risks for you as a runner that may make it more difficult for you to run later.

One more thing is when you need to start running. So this was one that really trips up runners all the time. I get comments all the time on the YouTube channel and on other forms where people will say, “You know what? My doctor just doesn’t care at all about my marathon training.” Well, the fact is is most doctors don’t care about your marathon training. But I’ve done lots of marathons and Ironman triathlons, and I understand why it’s important to you because I like doing it too.

If you are trying to figure out when you can start running, how to do it safely, how to make sure you don’t get in a re-injury, then get a second opinion and that’s one of those things that really works well over webcam, because you already have healed from the injury and you’re trying to figure out how do you maintain your running fitness? How do you get back to running safely without causing another injury? That’s really easy to do over webcam.

So, whether you see somebody in person, whether you do a webcam visit, there are different benefits to each. But if you really are looking for speed and the information you need to get back to running, webcam visits can be a great option. If you found this useful, please like it, please share it and I’ll see you in the next training.