Before you pick up a single instrument, you need to know who is in the chair. A short health history at the first visit shows where to be careful and when it is wiser to send the client to a doctor first. It takes a few minutes, and you will use the answers at every visit after that.
Why the health history matters in podiatry
Many common conditions change how you work on the feet. Someone with diabetes may not feel a small cut, and a client on blood thinners can bleed longer than you expect. If there is a skin infection on the foot, you plan hygiene for the rest of the day around it.
You are not making a diagnosis here. You are writing down what the client already knows about their health and taking it into account. If something looks wrong and the client has no explanation for it, suggest that they see their doctor.
What to ask at the first visit
Use the same list and the same wording with every client, so a busy day does not make you skip something. These topics come up in most podiatry practices:
- Diabetes: sensation can be reduced and wounds heal more slowly, so take extra care with blades and with any small wound.
- Blood clotting problems or blood thinners: even a minor nick can take longer to stop bleeding.
- High or low blood pressure: some clients feel dizzy when they stand up after a long procedure.
- Heart disease and varicose veins: worth knowing before massage, pressure or long sessions with the legs raised.
- Infectious, viral and skin diseases: they affect hygiene and instrument handling, and sometimes the order of clients in your day.
- Oncology: skin and nails may be more fragile during treatment. Ask whether their doctor gave any advice about foot care.
- Epilepsy: the team should know in advance.
- Allergies and regular medicines: note anything the client mentions, especially reactions to antiseptics, gloves or creams.
Ask about shoe size and the shoes the client usually wears as well. That answer often explains corns, calluses and pressure points.
How to ask without making it awkward
Some clients find health questions too personal for a foot appointment. A short explanation usually settles it: "I ask everyone this, because some conditions change how I work with the skin and nails." Most people answer once they understand why you need to know.
- Ask before the procedure starts.
- Read the list out loud; a long form handed over to fill in silently gets skimmed.
- Accept "I don't know" as an answer and write it down as it is.
- Do not comment on the answers or give medical opinions about them.
If the client prefers not to answer a question, note that too, so you and your colleagues know the gap is there.
Keep it up to date
Health changes between visits. A client may start a new medicine or stop a treatment, or get a diagnosis they did not have last time. One question at the start of each visit covers it: "Has anything changed with your health since last time?"
When the answer is yes, update the record the same day. If you only remember it, the next specialist who sees the client will not know, and after a few busy weeks you may not either.
When to pause and refer
Sometimes what you see does not match the history, or the client describes something new and worrying. Signs of infection, a wound that is not healing, or a sudden change in the colour or temperature of the foot are good reasons to stop and suggest that the client sees a doctor before you continue. Write down what you saw and what you advised.
Where to keep the answers
The health history helps only if it is in front of you at the next visit. Keep it with the rest of the client's record, so anyone who opens the card sees it before they start work. A paper folder at reception is easy to miss.
In PodoCard, the client card has a Details section with 14 health checkboxes, including diabetes, blood clotting disorders, high and low blood pressure, varicose veins, oncology, epilepsy and infectious and skin diseases, plus fields for foot size and notes. Allergies, medicines and anything that does not fit a checkbox go into the notes.
So the routine is short: the full list at the first visit, then one question at the start of every visit after that.
