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I have plenty of patients that come in for C&C. Lots of C&C. I get paid well for C&C. It takes less years off my life compared to when I do TMA's. But I still do TMA's. I keep a few pics in the office of some of the nasty things I deal with and do a little show and tell....I respect my patients and I think for the most part they respect me. When I am questioned as to what I do besides C&C I tell them. Opens their eyes a little. But I still do C&C. And I still do surgery. I certainly don't get wrapped up about it. My dentist did my crown. He also cleaned my teeth.
The Following User Says Thank You to mtdpm For This Useful Post:
I believe you can fulfill your professional role and give a high standard of care incorporating initial vascular, neuros, basic biomechanical assessment, education and preliminary treatment within a reasonable time-frame. It's called multi-tasking! My new patients usually comment favourably on the comprehensive treatment and see the rationale behind diagnosis and advice. They are more likely to be compliant if they can see it is in their best interest. The usual comment is...I didn't get all this information and health checks from my last Chiropodist, they just cut my nails!
I agree Freddy. Each new client has a comprehensive assessment and medical history taken. After that, even if it is just routine care required, they respect you.
Nice biomechanical and anatomical posters, models and charts also help.
Remember that to clients who are vascular impaired, diabetic, low mobility, etc, basic nail care can reduce the risk of further complications and prevent more intensive treatments.
When you see a dentist 6 monthly for a check-up, you dont always need a filling or crowns or surgery. Normally a scale and polish is all that is required, but boy you feel good after knowing that you have been checked by a professional and that everything is fine!
Maybe your clients tease you because they do get a rise out of you. Perhaps you should write down a couple of humourous replies and practise them. Then when you are next asked, you can joke and then change the subject gently.
One more thing. The fact you are so busy is excellent, but maybe you are suffering from slight burn-out. Perhaps you should reconsider appointment times and what exactly you want to achieve from your job and then gradually adapt things to optimise your abilities for both you and your clients.
All the best.
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Duct tape is like The Force. It has a light side, a dark side, and it holds the universe together.
I can empathise. I think it's because for this generation of patients (In the UK) many podiatrists were educated to diploma level and mostly did basic foot care. Now podiatry is a degree and we are taught pharmacology medicine, surgery ect.
Hopefully the next generation of patients and healthcare workers will realise the important role we play and the level of education that we have.
I quite agree with the original post. Why do we podiatrists have clip toes nails? I do not know of any orthopaedic foot and ankle specialist who clips toe nails.
So long as we continue to clip toe nails and calluses in the name of it being "our bread and butter" we will never gain the respect of the general public, let alone the medical community.
I think you'll find the general public will respect the practitioner who takes away the pain that they are feeling in their feet - if that pain is caused by long nails they are physically unable to cut, pathological nails or callus/corns then that is part of our job.
Adopting the same philosophy stephaniepod, as one of the podiatrists who was educated to Diploma level (DPodM) almost 30 years ago - I can assure you that as a general podiatric practitioner I've delivered all aspects of foot care - from routine and basic nail care to minor surgery and orthotic management. The level of education is simply a starting point on one's career-line and education and professional development continues every day and week as you continue to practise. Regrettably, I've also met a number of BSc graduates whose level and standard of practice was comparable to a retarded hippopotamus.
'The level of education is simply a starting point on one's career-line and education and professional development continues every day and week as you continue to practise. Regrettably, I've also met a number of BSc graduates whose level and standard of practice was comparable to a retarded hippopotamus.'
Mark Russell I was just trying to make the point that podiatry is constantly evolving and it may be hard for the public to keep up with our increased skills.
Of course it is - but read you last post again and see if you could have expressed it more accurately. Every time a patient sits in front of you is an opportunity to educate - what most of the contributors are suggesting on this thread is that respect is earned. And that respect can be gained in a multitude of ways - by imparting your knowledge, empathy, kindness, fairness and good communication. There are plenty people who work in healthcare - some very educated - to whom I wouldn't give the time of day. Good professional skills encompass a great deal more than what you learned during your training. And Joe Public is much more discerning that what you might imagine.....
I can empathise. I think it's because for this generation of patients (In the UK) many podiatrists were educated to diploma level and mostly did basic foot care. Now podiatry is a degree and we are taught pharmacology medicine, surgery ect.
As one of those podiatrists who was "educated to diploma level" I can assure you that we did and knew more than "basic footcare". When I trained LA was just becoming accepted practice and that opened up a whole new range of modalities for us. We were taught to be able to use a complex range of padding and strapping techniques. We were also taught how to make splint boots and adapt footwear for talipes patients and amputees. (This work is now done by Orthotists)
We too studied pharmocolgy and medicine.
In the 2nd year we had a secondment to go the lectures at the University School of Medicine. Our anatomy was learnt by dissection on cadavers that we shared with the dental, medical and physiotherapy students. We joined ward rounds with the orthopaedic surgeons and were allowed to attend their operating sessions. We attended placements at the local Skin Hospital and sat in on their minor surgery sessions. We studied pathology and watched a pathologist explain the causes of various diseases using actual specimens
We were taught to recognise systemic disease as it manifested in the foot and were trained to be health "gatekeepers", referring on as appropriate.
None of us were allowed to sit our Finals until we had at least 1,500 supervised clinical hours under our belts.
CF
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"Thousands of years ago, cats were worshipped as gods. Cats have never forgotten this."
I have just re-read what I have written and it does seem incorrect. Sorry. I was just trying to emphasise the greater role podiatrists have in medicine now compared to in the past. Such as when podiatry was first available on the NHS, supplementary prescribing rights, nail surgery, LA, IRMER, injections of silicone, steroids, podiatric surgery, advanced practitioners.
Its a band 8 podiatrist in the NHS, do things like steroid injections and vascular triage. Services that would have previously been delivered by Doctors.
Stephaniepod,
I'm not sure why you gave the info on Assistant Practitioners, but as you have done, what is to stop them leaving the NHS once trained and setting up in the Private Sector as FHPs ??
CF
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"Thousands of years ago, cats were worshipped as gods. Cats have never forgotten this."
I was just trying to emphasise the greater role podiatrists have in medicine now compared to in the past. Such as when podiatry was first available on the NHS, supplementary prescribing rights, nail surgery, LA, IRMER, injections of silicone, steroids, podiatric surgery, advanced practitioners.
Indeed the scope to advance oneself post graduate has certainly developed - whether that be post graduate diploma or post graduate degree but I do not necessarily agree that podiatrists have a greater role in medicine now compared with the past. In reality this may actually not be so as NHS podiatrists are having to accept a narrower, more specialised field of practice which is being forced upon them by management decisions. GPs are certainly expanding their "podiatry" skills and not necessarily utilising these advanced skills that Podiatrists are offering.
Thankfully in the private sector it is more likely that you are able to practice your full skill base but with less emphasis on the more specialised aspects of practice. It remains a duty of care that whilst you may be annotated with "POMs" that you actually use this skill on a regular basis to maintain your competence. My guessing is that post graduate Podiatry degree you are seldom able to use this skill and therefore your competence becomes questionable. So entering the market with an advanced skill base is not always an advantage.
I think it's because for this generation of patients (In the UK) many podiatrists were educated to diploma level and mostly did basic foot care.
I am relieved that my diploma skills are so predictable. Shame my clientele doesn't share your opinion and yes whilst the profession is constantly evolving, practitioners young and old are embracing these changes, but the one thing that remains a constant is human nature. Bless you Stephanie for being so predictable. Managing the human being is the hardest of skill bases to achieve.
So I must away to my diploma status private practice and my unpredictable client base. Thank goodness somewhere along the way I became equipped with an earned status and an ability to never stop learning.
aahhhh the importance of ones status as seen by others.
the UK from an outsiders perspective
NHS v´s private practice
New grads v´s older grads
specialist v´s non-specialists
Everyones better than the other, everyone seems to think.
Divide and conquer from within.
Podiatry is one profession with many parts which make a whole . Everyone has an important roll to play- if this is not being drummed into education and from the various boards then the profession will go nowhere .
[quote=stephaniepod;180761]I have just re-read what I have written and it does seem incorrect. Sorry.QUOTE]
It seems like on the internet apologies are not accepted and points are misconstrued?
I do not think anyone is better than anyone, I have written articles and done a lot of work trying to increase the public and medical professions knowledge of podiatry and how it greatly increases patients quality of life and prevents amputations and limb threatening infection.
....and it's fantastic that you are enthusiastic enough to do all this and contribute on a podiatry forum like Arena - long may it continue. Like everyone else you are starting out on that long road you call "career" - and one thing you will note is the view on that journey will change from time to time, sometimes with an outlook that is radically different from where you started. Open eyes and an open mind are essential travelling companions- and a sense of humour if you wish to retain your sanity - especially if you're working in the NHS. Advanced practitioners? Just a title dreamt up by the NHS - it means nothing. Just like "specialist practitioner". They are simply a grade on a pay scale - nothing more. And there is no need for an apology either - everyone makes mistakes, especially me!
In private practice you can be all these things, go on courses and become competent, you then can do these " specialist things " ie silicone and steroid injection.
The problem is the NHS generated titles. We are Podiatrists, now if PCT's allowed all their Podiatrists to gain " advanced skills " without having to become a super assistant associate extended scope Podiatrists, everyone would have a plethora of treatments to offer from their general practice.
Instead often in the NHS people get given job titles and forget where they came from.
I admit i am mostly NHS, however in my private practice i may see someone to cut their nails then notice pain associated with a perineural fibroma, request an x-ray to rule out osseous abnormality around that site, then schedule them to have an ultrasound guided steroid with me. Or maybe x-ray guided joint injections if needed. You don't have to be a super duper Podiatrist to do this, "JUST" a Podiatrist.
Regrettably, I've also met a number of BSc graduates whose level and standard of practice was comparable to a retarded hippopotamus.
It all depends on the person in question, irrespective of podiatry, you only need to look at the GP referrals you receive - some are excellent, some should not have been bothered with. I've worked with a number of so-called "diploama pods" who are the best I've ever worked with and a number of "BSc pods" who I shall say are less good. But this also works both ways... (not trying to sit too painfully on the middle of that fence).
So as has already been said on several occaisions, educating of the patient is the key. Can you not talk to the patient and educate them....whilst you're skillfully cutting their toenails.
Another point that seems to have been missed (or the force is working very poorly with me today) is that your patients have friends. If you do a good job with that patient, whether that be a simple nail cut (avec education) or a complex biomechanical assessment, they'll tell their friends, and they'll tell their friends and so on...........
Then you've got a practice with patients coming out of your ears and your wife is saying "kerching!"
I have an ageing Merc E320 diesel which is very reliable and needs only an oil and filter change every 10K. I don't use a Merc dealer but I have a local time-served Merc mechanic who operates on his own. I know from other people that he is very competent (he used to race prepare McLaren F1 cars around 7 years ago) and very fair. Plus he is an all-round nice bloke - and always has time for a chat if you happen to be passing his workshop. Now he has never said to me - take your car to Quick-Fit or change the oil yourself; you can manage that quite easily - I buy the oil and filter and he takes £10 for his time. But when (not if) the time comes for a major overhaul or remedial work, I won't hesitate or consider taking my car elsewhere. He treats every customer the same way, irrespective of the amount of work they take to him.
Treat the customer the way you would like them to treat you - is a notice that's pinned on the wall of his office. He doesn't need to refer to it very often.
Re: Seen as pedicurist and not as podiatrist
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. But this also works both ways... (not trying to sit too painfully on the middle of that fence).
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