Running through Golden Gate Park, Kendra almost fell when she stepped in a pot-hole. She thought she heard a crack and limped back to the car. She went to the Emergency Room, but the doctor said it wa just a foot sprain. Five days later she was sitting in my office saying that she seemed certain that her foot was broken.

I looked at her Xrays and she was right. Her foot was broken. The pain on the top of her foot was coming from a subtle foot fracture called a Lisfranc's injury. An injury to the top of the foot that doesn't typically heal on its own. She was simply not going to get better without surgery.

This story sounds far-fetched by is frighteningly commonplace. One study, that won an award from the American College of Foot and Ankle Surgeons, on foot fracture patterns showed that Primary Care Physicians and Emergency Room Physicians missed 98.4% of all of the findings on X-Rays that would suggest this type of fracture. Another ground-breaking study in 2004 from the University of Utah School of Medicine showed that subtle frequently misdiagnosed ankle fractures are actually 10 times more common than previously thought.

The problem is that many patients with foot pain or injury seek treatment from whichever doctor will see them the quickest. Often this is their Primary Care physician who is willing to work them in to a busy schedule just because they are already familiar with the person. Another likely place to go is the Emergency Room.

This doesn't mean that an orthopedic surgeon is a better doctor than a primary care doc or E.R. doc. It just means means you get more expertise with a specialist. If you have chest pain or a stroke, there's no question... your nearest Emergency Department is the very best place to be. But with a sprained ankle or suspected broken foot, you need to see someone who looks at broken foot bones all the time.

Even if you have seen a foot and ankle expert, but you are really improving, you can still seek a second opnion. There is a reason they say a doctor is practicing medicine." It is an art and a science. If you are not improving and your foot still hurts, your doctor will probably pick someone else for you to go see. A fresh pair of medical eyes may help see something that's been overlooked.

There is a saying in medicine that the eyes see what the mind knows." This means that someone with trauma experience is looking for the interesting, but less common injury patterns. A podiatrist without trauma or reconstructive foot surgery training, may not recognize all of the subtle changes that would suggest a rare fracture. That's why you should always get a second opinion if you are not happy with the pace of your recovery.

If you do get a second opinion and your doctors are in agreement, then you can probably rest assured that you will get better and just continue to see your original doctor. It is often worth the cost of a second opinion for peace of mind and to fully understand what to expect with your recovery.

The other main reason you may want a second opnion is foot surgery. If you have painful bunions and are considering bunion surgery, you should absolutely get a second opinion. There are over 100 different surgical procedures used to correct bunions and its important to be educated and certain about your doctor's surgical plan. If you surgeon tells you that you will need crutches for two months after bunion surgery, you are having major foot surgery. Maybe another surgeon would have a different approach that allows you to walk after surgery and avoid crutches.

By the same token, let's say you are planning on having a bunion removed and the podiatrist tells you that you will be able to walk right after surgery. It is possible that a more aggressive surgery requiring a cast or crutches would help prevent the bunion from coming back in the future. In the long run, this might be better for you.

Either way, once you have had foot surgery, the rules change. You can't undo a bad surgical result. There is no question that it is worth the time and expense of a second expert medical opinion prior to scheduling any foot surgery. Afterwards, it is just too late. By getting a second opinion you are more likely to learn what options are available and best suited for your circumstances.

Many reputable surgeons recognize the value of a second opinion. If fact many of them will hand a second opinion referral list" to anyone considering surgery. This list will provide you with an easy way to choose from all of the foot surgeons in the part of town where you live. You can then take the list, pick a foot surgeon, and get a second opinion.

If you ask your doctor about getting a second opinion and they seem offended or annoyed, this should be a red flag. When a doc believes he is making a good judgement call, he won't have anything to hide. Remember, it is your foot and you have to walk on it years from now. You should be like Kesha. If you think something is wrong, seek a second opinion and demand answers.