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Wednesday, March 31, 2010

K.I.S.S. Principle of Medicine

K.I.S.S. Principle

The K.I.S.S. Principle is a Golden Rule of Foot. What does it mean?
K-----Keep
I------It
S-----Simple
S-----Stupid
How low-tech!! Definitely not for the 21st Century!!
When dealing with many lower extremity problems, the KISS principle should be the ground the patient and doctor stand upon. Of course, this implies the doctor or therapist knows simple, yet effective, solutions for every day problems that occur. Covering a bleeding, gapping, wound with a band aid, is a simple, yet probably not effective solution. So, the doctor and patient should attempt to work as a team (another Golden Rule of Foot), to develop a strategy based on simple progressing to complex treatments.
Who is stupid? Normally, it is the doctor or therapist, with their massive intensive medical training that make a mountain out of molehill. It is an error in medical training to learn the newest, most sophisticated, techniques, but be ill-trained in the simple techniques. Often, it is my patients, who calm my anxiety down, and let me know it is alright to start simple. I appreciate their help in this grounding.
But the patient can also be at fault for wanting a seemingly quick cure using the most high-tech solutions. It can take some trial and error to learn what works and what does not work in relieving symptoms. Patients can get impatient with this process. Doctors and therapists can over-react to this impatience by ordering unnecessary tests or doing unnecessary procedures.
Does this mean I am a simple doctor, limited to simple remedies? No way!! If you start simple, you must know what to do if that does not work. A good doctor/therapist should have a range of simple to more complicated treatment regimens to choose. It is quite an art deciding when to advance treatments. It is the art of medicine that most practitioners love.
Simple and Effective solutions do exist. Our society almost cries out the contrary. Better technology must mean better solutions. But it often does not. Most of my foot treatments are simple, some more effective than others. The more disabled the patient, the more my mind wants more technology to save us! The patient/doctor or patient/therapist relationship must evolve around a KISS principle, with ascending complexities based on the progress of the patient.

3 comments:

  1. Dear Dr. Blake: I cannot thank you enough for your K.I.S.S. approach in dealing with my doctor-made injury, and then using your skills as podiatrist, orthotic specialist, and perhaps most important - friend to help me heal. From one of your favorite patients: CSDavis (I know... all of your patients will be fighting to stay on the 'favorites' list!)

    ReplyDelete
  2. The friend part means the most. Dr Blake

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.