If it ain't broke, don't fix it.

This is one of the lessons I learned when I was younger, I have always kept this in mind when assessing patients.

I have sometimes told my patients, they do not need orthotics, as there was not enough data to recommend them. I have seen many orthotics dispensed by practitioners, when the patient would have benefited from other modalities. Some of the other choices could be shoes, physiotherapy to review up the kinetic chain or they need of other medical services. I try to build my reputation by sticking to this concept. Do not fix what is not broken. People with pes planus feet with no pain can adapt quite well. So I am always cautious when I help a patient make there decision. A few caveats are high risk diabetic patients, they should have good shoes and orthotics. There are also patients who I have seen indicate they are pain free. Its only to find after a discussion, they have pain but are just coping with it. Reputations are built on results, If people are getting orthotic who do not need them, no results.