Dear Liz,
I would explain the other treatment options open to this patient. Some nails
are so distorted that simple chiropody is not enough, although we all try
conservative treatment in the first place. Explain that you could remove a
large wedge under LA, back to and impossibly including the matrix so that it
will take up to 6 months to become a problem again; or that he could have a
permanent solution with a PNA with matrix obliteration.
Some patients do elect to have a more conservative treatment every five weeks.
Clearly lay out your fees for each scenario and let him choose which way to
go.
Giving free treatments only reinforce the patients opinion that you may not
have done it properly in the first place; and if its taken five weeks for him
to get back to you that's unlikely.
So long as you are firm, polite and professional most patients gain respect
for you, just remember the service you provide is valuable and you need to be
recompensed accordingly to run a modern practise.
Don't be intimated, and good luck.
Diane Nicholl.
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