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Podiatry crisis point in Australia

Discussion in 'Australia' started by mfeenstra, Mar 22, 2005.

  1. mfeenstra

    mfeenstra Member


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    Podiatry is a a crisis point. This may not have struck home to everyone yet. Teriatry Education in Aus. has reached the point where small courses that are not considered economically viable - nothing to do with needs in the community will dissapear. Education is moving to full fee paying within the next 5-10 years. It has already begun with a 60% raise in fee paying students over last year. The economic rationalisation will fit Podiatry. We have a very low profile unfortunately. Forget about Foot Health Week - it does not raise profile of Podiatry. Any money should be spent in spent towards ensuring our profile politically to maintain Podiatry as a profession. If we loose courses the movers behind economic rationalisation will not set up another course.
    Government does not consider Podiatry has a great need in the community.
    Lets not loose our profession.
    MArilyn
     
  2. DaFlip

    DaFlip Active Member

    get real

    This a supply and demand equation. The demand for the service can be supplied and will be supplied by other health professions. There is no use in crying over the situation. Explain why a government would fund a course which loses money? There is no economic benefit to the institution or the government. However the money can be spent in other professions who can and already have multiskilled to take over many if not all the roles which a podiatrist can perform. :eek: Does that shock you.
     
    Last edited by a moderator: Mar 23, 2005
  3. Cameron

    Cameron Well-Known Member

    Netizens

    Speaking as a displaced podiatry educator the sentiments expressed by the previous correspondents are much close to my heart. However it may be fair to point out the downsizing of podiatry in Australian Universities is not an anti-podiatry lobby. Far from it and all parties agree it is a lamentable situation brought about by economic rationalisation. Universities continue publically and loudly to chase the dollar to exist with the old argument they are under funded by the government. This is difficult to accept without public accountability, something these institutions are vigorously fighting against. Decimation of many small professions caused by the 'cuts' are not helped by
    the absence of proactive professions muted in their protests.


    What say you?

    Cameron
     
  4. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Marilyn wrote:
    >>>>
    Government does not consider Podiatry has a great need in the community.
    >>>>

    I agree with you that Foot Health Week is pointless and lost in the hideous number of 'community awareness' days and weeks in this country. Putting money into political lobbying is far more worthwhile!

    Just look at the Australasian College of Podiatric Surgeons: they have put money into lobbying in Canberra which has put podiatric surgery into the Professional Attention and the Prosthetics Bills within the last 12 months - leading to better recognition and access to podiatric surgery services across the country. This has the potential to do more for the profession than just about any other piece of legislation for as long as I can remember.

    If the government did not see any value in podiatry - they would not back us in these bills. Competition policy in this country is high on the agenda - we need to ride the wave and not get caught in it!
     
  5. pgcarter

    pgcarter Well-Known Member

    Forgive me for stating the obvious but if other professions are/can provide the services.....where is the training they received in the skills necessary to provide the service? And if anyone can do it why do we have to be registered? And if anyone can do it ....without training why are podiatry schools required to provide such expensive training.....like clinical education supervised by podiatrists? are we pretending that physios or nurses want to do this? or could do this without further training?

    Certainly one could argue that cutting toe nails does not require a 4 yr degree.....but recognition of risk issues and streaming of patients will still need to be done even if the bulk of primary care is done by certificate qualified or cross over nurses etc.....I'd be happy to supervise a lower paid workforce of footcare assisstants at a multi-treatment room public health centre.....just watch the productivity go through the roof.....more patients per room per day without a doubt.
    And I'd be happy to treat the tough ones myself.....sounds like a great opportunity....where do I sign up?

    Regards Phill Carter
     
  6. Cameron

    Cameron Well-Known Member

    Phill

    I think you may find there are few entrepreneurs around before you.

    Cameron :)
     
  7. pgcarter

    pgcarter Well-Known Member

    As far as why should a government provide a course that "loses" money?......my godfather....have they convinced you that education is a business? and that quality education should be "cost effective"....how did you get through secondary and tertiary education without thinking a little more deeply about the philosphical issues?
    It's not sensible to think that quality education is or should be cheap or even cost effective.....it should be the best it can be......are you happy to be worked over by ordinary cheap cost effective health carers?....I'm not....I want the Rolls Royce option thanks.... and I'm happy to have my taxes pay for it
    Tanks to take to Iraq on the other hand, we can do without.
    Don't be sucked in by government propaganda....just because they say it does not make it correct...or even right.
    Regards Phill Carter
     
  8. pgcarter

    pgcarter Well-Known Member

    Cameron,
    I'm sure there are....does that mean I should not express my opinion? I was not expecting to copyright it or publish an article.....nor did I think I was first....you just got through saying the profession should be a little more proactive, both inside and outside?....or should I just assume that someone else will do it?

    Regards Phill Carter
     
  9. Marylin, Phil & Cameron

    May I offer some comment to this thread? Although your submissions deal directly with the establishment of the profession in Australia it should be noted that similar issues exist in Britain and North America with variations depending on the system of health delivery. Marylin sings a familiar tune: the problems could be solved by spending money on political lobbying - in other words, raise the profile. With the greatest respect, that is a little naive.

    For too long the heirarchial profession has absolved itself of its responsibility and duty in designing a system of care commensurate with its own needs and requirements. In 24 years of practice, I have watched in dismay various govermental 'initiatives' in the healthcare arena; few, if any, having a beneficial effect on the profession of podiatry. From reading the various submissions on the subject, it would appear that the profession is currently trying to redefine just what its raison d'etre actually is. In the UK the government, through the NHS Modernisation Agency appears to think that podiatry is a wholly specialist profession where clinicians are predominately diagnosticians with a concurrent remit of supervising assistant grade practitioners/foot health nurses/pedicurists - the latter now deemed a desirable addition to the foot health workforce for managing common foot disorders such as pathological nails and skin lesions.

    There is a familiar cry surrounding this - that the graduate clinician is 'too good' to spend time managing such simple tasks - that such care is beneath them. The oft hearlded excuse is that demand is simply outstripping supply and it is only right and proper that these emerging 'professions' take over this area of work allowing the graduate clinician to concentrate in the specialist areas. Personally, I feel such an attitude may well lead to our demise.

    It seems to me that the development of podiatry as an independent, autonomous profession, is being retarded by a number of factors. Consider some parallel professions - dentistry and medicine. Both have a large general practice network where practitioners diagnose and treat common medical/oral conditions. Both professions also have recognised specialist areas of care which the general practitioner can refer to when appropriate. The general practitioner network is the 'engine room' of both professions and is recognised as such. Yet we in podiatry appear hell-bent on giving away our greatest asset! Why?

    I would suggest that one of the primary factors is that the profession is yet to establish a suitable remuneration system for practitioners that would (and I use the term advisedly) 'exploit' the demand from this market segment to our advantage. Many professions and trades would cut off their right arm to have the kind of repeat business that podiatry patients can generate. But instead of considering such an area of practice as an asset, we think of it as a liability. More time is spent devising ways of discharging patients from State provision than actually treating them. I wonder if such an approach would exist if say the clinician was paid an additional fee for each general care patient that passed through their surgery door? It could be concluded that it is the system of remuneration that is holding back podiatry from greater establishment - salaried employment for general practice demotivates the workforce. Change the system of remuneration and you will change attitudes overnight.

    If the profession is to spend money on solutions I would humbly suggest that it does so, not to political lobbyists, but on its own management consultants to assist in designing a system of care that compliments and rewards our own profession. The time has surely come for podiatry to take responsibility for its own future rather than hoping (in vain) for politicians to do so for us. The starting point is a professional report that can be presented to government and the profession for consultation. It may interest colleagues to read the following outline of such a report that was submitted as a proposal to the Society of Chiropodists and Podiatrists earlier this year.


    INTRODUCTION
    What this report is about and why it is needed

    A POLITICAL SERVICE
    The place of podiatry within the health service and why the delivery
    within that service has become a political issue
    The Role of Politicians
    The Five Constituencies
    The Government
    The Civil Service
    Parliament
    The Public
    The Profession
    Managing the Interfaces

    THE SERVICE AND HOW IT WORKS
    The Demand for Chiropody and Podiatry Services
    How and Where it is delivered
    The Basic Cost and Price Mechanisms
    The Public and Private Delivery Mechanisms

    THE SYSTEM AND HOW IT WORKS
    The History of Regulation
    The Scope of Present Regulation
    The Pressure for Change
    The Impact and Management of Change

    THE PRESENT COST AND BENEFIT STRUCTURE TO THE CONSUMER
    How does the Consumer access the Service
    What are the Barriers to Access
    How does the Cost/Price Structure impact the Consumer
    How does the Consumer measure the Effectiveness of Delivery
    The Issue of Compensation for the Consumer

    THE PRESENT COST AND BENEFIT STRUCTURE TO THE HEALTH SERVICE
    How is the Profession viewed by The Health Service
    How is its effectiveness assessed
    What does The Government see as the coming pressures on the service
    What are the Barriers to a dialogue with Government re Change
    Why should Government Care

    THE PRESSURES ON THE PROFESSION
    Demographic
    Social
    The Changing Nature of Health Care
    The Need to Finance such Changes
    The Need to Manage the Profession
    The Medical Institutions
    The Society’s Relationship with Its Peer Groups

    THE GOVERNANCE OF THE PROFESSION
    The various Representative Bodies
    The Relationship with The Health Service
    The Society as a Leader
    The Relationship with The Medical Institutions
    The Relationship with The Health Professions Council

    THE WAY FORWARD
    Should Anything be Done
    Who should do it
    A Response to Known Pressures
    An Approach to Change

    RECOMMENDATIONS
    Structural Revision
    Finance and The Financing of Practice
    Private Health Schemes
    Education and Standards




    Mark Russell
    watch out for the nail dust
     
    Last edited: Mar 30, 2005
  10. pgcarter

    pgcarter Well-Known Member

    Mark,
    I'd love to read the finished document. Just because I sometimes make simplistic generalizations does not mean I am unaware that these issues are very complex, (Cameron). I actually agree with the idea that if we want to have some influence over the future of the profession we will have to become the recognized experts in the fields we claim....which means we have to actually do stuff, not just tell others what to do. And this stuff will include lots of mind numbingly repetetive attention to detail. It is this thing which I think separates a good podiatrist from the rest and podiatry in general from other professions.

    The will to attend to the details is what succeeds with feet, near enough is quite clearly not good enough, whatever the attitude of general medicene may be. This kind of thing is difficult to put a price on...it is not $x for a liver transplant or some other life saving procedure.....no-one dies from uncomfortable feet, but their quality of life can be dramatically effected. The issue may become about whether the government provides life savers or quality of life enhancers.....two very different concepts.

    The demand in the community will still be there regardless of what the government or the profession decides to do or say about all these things, and if in the end I have to compete against people with less training then I am not too worried about the idea of competition. Unless things change pretty radically nobody is going to be able to prepackage a foot consultation in China for delivery in Australia at 10% of the current cost....in this country we will all be subject to the same economic issues. And I've never been scared of hard work, or in fact the awkward stuff, I still cover half of Melbournes eastern suburbs for home visits....not that this makes me any better than anyone else...just different.

    Regards Phill Carter
     
  11. mfeenstra

    mfeenstra Member

    Education.

    I agree with your comments Mark. However coming back to the specific Aus. problem. The profession put in enourmous yard arms to establish Podiatry education in Universities in Aus. Once that had been achieved there was a sigh of relief and everyone went back into their little coocoons. The profession continued with its own internal working and Podiatry education was left out there to run happily along by itself.The profession has largely ingored the multifactorial political and internal runnings of a course.within a university.

    There has been comments about Dentistry. I choose this in particular as its evolution in Aus. was close in time to Podiatry. Yes we all need teeth you will say, we also need to be happily upright also. Dentistry boards both state and nationally closely monitor their courses. They also heavily promote the profession to prospective students. When Western Sydney Pod. course was established there should have been a large promotion of Pod. to perspective students by the Uni. as well as by the PROFESSION.This did not occur.Podiatry does not sit as a profession that is promoted to persepctive students. If you fall upon it in a pamphlet you are lucky.As a consequence the academic level of entry is low and so are student numbers. Dentistry would never be where it is today without the efforts of the profession in promoting it as a desired profession to take up.

    Someone made a comment about get real, the course has to be economically viable. Yes that is part of the equation. HOWEVER at the risk of sounding repetitive, dentistry carries huge overheads as a course much higher than podiatry. The equation expands . The government powers that be, look at professions that are in demand in the community. Podiatry is not listed as a profession in demand. The method of arriving at this conclusion is weird, the gov. look at external adds for professionals here and in particular O/S to establish if there is a demand that is not being met. Talk to John Price about this - it is the way they work.So as a UK pod. commented "Podiatry is not listed as an occupation in demmand". So why maintain a course that is not in demmand is their argument.

    The reality is, you cannot get a Pod. to work for you for months as we all have experienced. We advertise in professional journals not necessarily in the general media. The demand is huge and in N.S.W. (which is all I can comment on with correct knowledge,) and is unmet. So we have to call upon nurses and other professions to do our work, where else are people to get any form of treatment.

    The course at Western Sydney had been given the gong 12 months or more before the profession recognised there was a problem. Even the Uni staff were convinced it would not close.We have to stop leaving the courses out of sight and on their own. They need the profession to maintain their viability. It seems politically everyone knew about the demise but podiatry even though it was glaringly obvious that it would be a prime target.It was very frustrating to be told that all was well and the course would not close when the decision had been made at a political level and the decision was not being concealed. Every state is different and we cannot leave all this to one person our national EO who is an excellent political advocate for us, he can't have eyes and ears everywhere. It is our responsibility as a profession to protect our development. If we dont maintain our courses we wont have a profession. We are far too politicall naive and lack proactivity and fail to take responsibility for our own development.
     
  12. pgcarter

    pgcarter Well-Known Member

    I'm sure you are more up to speed with all this than me...but how does podiatry get on the preffered immigration list published in the Age a few weeks ago if the govt does not know we need them?
     
  13. Al Kline DPM

    Al Kline DPM Banned

    I'm a little 'green' when it comes to the state of Podiatry in Australia and other parts of the world like Canada and Britain.

    Can someone tell me:

    1) How is Podiatry classified in these countries? i.e. physicians?, Allied health profressionals?
    2) What is the usual education requires?
    3) Can DPM's from the US enter these countries and expect the same privileges? i.e. surgery? Hospital consultations? etc. etc.
    4) Are podiatrists required to have malpractice or is medicine "socialized" and are podiatrists considered 'doctors' in these other countries?

    Thx,
    Al
     
  14. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Allied health professionals
    In Australia its a 3 or 4 (mostly 4) year degree in the state subsidized university sector (ie student debt very low compared to USA). ~2/3rds students come straight from high school (college) aged around 19-20 (compared to the requirement for a UG degree in USA before Podiatry college) - the Podiatry degree in Australia is classified a UG degree. The surgical component of the course is minimal compared to USA, so the emphasis is on conservative/biomechanics/etc (I would put any 2nd yr podiatry student up against the average DPM on biomechanics knowledge). Once graduated after 4yrs (still 3 in South Australia), they are registered (licenced) to practice (minor surgical procedures are part of the UG program and they can be performed). They then have the option undertaking the postgrad surgical program while working (most don't) - at the end of that they are probably no different to a DPM in USA after a residency. The final outcome of the education between Australia and USA is not really that different - just the route (model) there is very different, most graduates don't go that way and there are more limitations on the scope of practice.
    Usually - provided they meet the requirements of the Australaisian College of Podiatric Surgeons.
    The bulk of podiatry is in the private sector and Australia is not as "socialized" as the UK. Malpractice insurance is required, but we complian about the ~$600 we have to pay.
     
  15. Hylton Menz

    Hylton Menz Guest

    Marilyn Feenstra wrote:

    The dentistry comparison is a flawed one. The first school of dentistry opened at the University of Sydney in 1901. Schools of dentistry have always been associated with schools of medicine and have benefitted greatly from this relationship. Dentistry courses also attract far more government funding than podiatry courses. See the recent extract from the Hansard in which Amanda Vanstone, in response to a question from Meg Lees regarding funding of podiatry courses, states "I cannot believe that I heard you ask whether we were prepared to fund podiatry to the same level we fund dentistry. Dentistry is terribly expensive".

    To suggest that podiatry would be in a similar position to dentistry if it was simply promoted more ignores the very different historical development of the two professions. If you can get hold of it, the book Medical Dominance by Evan Willis provides a comprehensive historical perspective of the development of dentistry, optometry and chiropractic in Australia, and highlights that the current standing and scope of practice of these professions is largely due to how the medical profession chose to deal with them.

    Regards,

    Hylton
     
  16. Al Kline DPM

    Al Kline DPM Banned

    Thx Craig for that update.
     
  17. mfeenstra

    mfeenstra Member

    Hilton reply.

    Thanks Hilton, I will try and get that publication. 2 things - yes I have the Hanssard quote and knew about it at the time.
    2. I have had a considerably amount of contact with the powers that be in dentistry sitting on a board with their current president and past vice president. I assure you the amount of effort etc that they put into maintaining their statis is quite incredible. They work at keeping their political profile high. They also carefully watch their uni. courses.I have also had a graphic account of their early years when they set up the Dental Hospital in Sydney - the route was not all easy.
    I have been told before that things are impossible! It was thought too hard and too impossible to set up a Uni course in N.S.W. It may have taken 4 years of very hard yakka but it was achieved regardless of the negatives.
    We are a profession that lacks the foresight to maintain and better what we have to the extent that it will be lost unless we do something.
    This discussion arose out of a question regarding funding for Foot Health Week, was it worthwhile?I feel we should concentrate our efforts to education and its maintenance and improvement.
    Where I am now sitting externally, in a large multi disciplinary association, it is very obvious as a profession we need a more rational. politically aware approach to the direction we are going.All the replies so far have raised all the negatives that most of us know about. How about creating some positives!
     
  18. Tuckersm

    Tuckersm Well-Known Member

    Phill Wrote
    Phill, The Victorian state Government (DHS) is currently assessing the the best way to introduce a course similar to that proposed in Gippsland, ie: learn everything a podiatrist knows in 18months, at Mayfield education centre in Malvern, to fill a percieved current podiatry workforce shortage, despite that in the next 20 months there will be about 120 Victorian Podiatry Graduates. They are asking questions such as why can't these people provide sharp scalpel debridement of skin lessions? do gait analysis? Bandage and strap etc. And Phil, if they can, then why are we registered?

    Unfortunatley I have heard some in the profession entertaining such ideas, and having discussions with government about how such outcome can be achieved.
     
  19. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Which is exactly the reason we need to start breeding our own "assistant practitioners" with at least the competencies that would be expected from such courses.
    because we can stick needles into people.
     
    Last edited by a moderator: Apr 6, 2005
  20. Cameron

    Cameron Well-Known Member

    Netizens

    There are strong podiatric parallels between Australiasia and the UK. One basic assumption we all make as podiatrists is the profession has had universal acceptance as “the” speciality which provides both primary and secondary health foot care. Common sense would support this assumption but sadly there is no legal mandate in either country or unanimous acceptance by peer professions to uphold such beliefs. As we are informed, the majority of people with sore feet seek care (including self-treatment) elsewhere. This they have done for centuries before.

    Whilst closure of the profession and protection of title has safeguarded the group of registered professionals, “a rose by any other name would smell as sweet”, and foot health professionals (UK) and pedicurists and nail sculptors (Australia and NZ) continue to offer their professional services to the public perfectly legally. Thus maintaining by custom and practice a validated work force.

    Three major political issues of late have superimposed themselves upon podiatry services. These are, need to provide employment and qualification for young people, exponential demand for service with an ageing population, and a national political agenda for change in health service provision across the board.

    Ironically at least in part this new agenda for change reflects the rhetoric expressed by podiatrists for years. How often have we heard and read the argument “we are not toe nail cutters or corn scrapers.” I believe that message has been listened too and action taken based upon it.

    If the podiatry profession were saying they were too well qualified to care for corns then what a perfect “window of opportunity” for others to fill the gap in the market. After all “somebody has to.”

    I am reminded of the Sydney Conference where the keynote speaker reminded delegates not to blindly give up their core skills, in pursuit of ethereal specialisation. When driven by governments there is “No Surrender” and I think the political wing of podiatry in both countries has consistently shot itself in the foot by promoting specialisation to the exclusion of the foot soldiers that have dedicated themselves to general practice.

    Meantime, I agree with Craig and as a pragmatist better we are all in the same profession than continually fragmented by petty and parochial agenda.

    What say you?

    Cameron
    Hey what do I know?
     
  21. Andrea Castello

    Andrea Castello Active Member

    Interesting Thread

    Hi all

    I have been following this thread with great interest and am enjoying the debate immensely.

    My personal feeling is that it is extremely important that as a profession, podiatry is aware of the changing healthcare landscape (predominantly in public health), and rather than fight the changes (which in my mind are inevitable) we should be looking at cementing our position as a viable and highly regarded profession. We should be working with governments to ensure that we are there for the long term. I am in agreement with CP and Cameron regarding the need for the podiatry profession to "own" those other foot care providers.

    Let us look at the facts. There is a shortage of podiatrists, there is no argument here. Only 47% of podiatry vacancies are filled (I got this figure from a discussion paper provided by Aust Pod Assoc Vic). There are currently 2000 podiatrists in Australia at a ratio of 1:10,000, with an increasing demand due to ageing population, increased rates of diabetes, and other numerable reasons. I don't believe that as a profession, we will ever be able to meet the required demand.

    Many podiatrists compare us to dentists. This isn't healthy. Dentists are the only profession that can provide the type of treatment they do. Professions such as orthotists, biomechanists, nurses, doctors, surgeons etc can all provide a service that we do. Our claim to fame is we know more about feet than all other professions, and we can perform all required treatments on feet and, as a rule, do it better than anybody else.

    As a result I don't support the invention of a new profession of "foot hygeinists or carers", but I do see the possibility to move SOME of the more simple tasks to already skilled workers (such as nurses) with some further upskilling. And contrary to a comment made in an earlier post, some nurses are actually keen to introduce some BASIC foot care into their daily practice. We just need to ensure that there is sufficient boundaries in place, such as a Podiatrist needs to oversee the service, no scalpel work is to be done by anybody other than a podiatrist, and an adequate referral pathway available to a Podiatrist should the need arise.

    The issue here is that we need to work quickly. I don't agree with 18 month short-courses. It's like a "shake and bake" cake. The idea is great, but generally the end product is pretty bad. In Gippsland (where I am currently employed) we see community health services using District Nursing Services to provide foot care. The issue here is not that the service is bad, and people are getting below par service. The issue here is that members of the community are happy that they can receive foot care in due time, and do not have to wait months for treatment. In turn, management of these institutions are supporting the idea because of the general content in the community. Take into account that these services have generally had very little success in attracting staff even when offering very good positions, well you know where I am going with this. I feel it is our role to be involved with the overseeing of these services, ensuring that the quality of care is of appropriate quality, and be there in an advisory role, in conjunction with all the other services we provide.

    As an Endicrinologist is to a Diabetes Educator, perhaps we can be to those nurses who wish to perform BASIC foot care.

    Just my thoughts :rolleyes: . I'd love to hear other people's thoughts.
    A
     
  22. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Andrea - keep an eye on the next few APodA(Vic) newsletters (I assume it may be the same in other states) ---- APodA(Vic) board members and office staff are putting in a lot of hours (I assume it may be the same in other states and at the national level) into what is potentially "profession changing" stuff, or at the very least will have a significant impact on the delivery of "foot care" services in the public and private sectors. Some predict doom and gloom .... I find the prospects of what we can do with what is happening to be exciting.... "a new dawn" - to be embraced .... either we take the lead or we get led (talk about use cliches :) )(sorry to be a bit cryptic, but the final policy document is not yet finished)

    Marilyn is right in the first message about podiatry in Australia about being at a crisis point, but I would prefer say "turning point"
     
  23. Andrea Castello

    Andrea Castello Active Member

    Craig - I look forward to it.
     
  24. Matthew Oates

    Matthew Oates Member


    I think it is important to point out to people that the Department of Human Services has enlisted an independent consultant to gather the opinions, thoughts, ideas, etc. from the key stakeholders involved. I believe his report is to be presented in the near future.
     
  25. Tuckersm

    Tuckersm Well-Known Member

    The Key stake holders did not include representatives from the A.Pod.A., A.Pod.C. or the Registration Board. They were in the main health service managers, with a small sprinkling of podiatrists and I believe that he did meet with representatives from LaTrobe and TAFE based organistaions
     
  26. Al Kline DPM

    Al Kline DPM Banned

    Craig, I read most of the posts in the Crisis section concerning Podiatry in Australia. Now tell me, is someone educated out of highschool in a postgraduate program for 3 years considered a "Podiatrist"? You say that the program is much like an UG degree, so how can you call UG training for 3 to 4 years after highschool PODIATRY? I think this is probably similar to what is going on in Europe concerning the Chiropodist. Why doesn't Australia just start a "Podiatry School" like in the states and educate people in the Sciences and general medicine , like we have in the States? I think as a Podiatric Surgeon performing surgery in the states, general chiropody techniques are great in the office, but our knowledge of biomechanics as it relates to surgery is what really seperates us from the orthopedic community. So, I ask you again, start a Podiatry School in conjunction with a medical school (like the one I went to in Philadelphia (Temple) so people are actually qualified to be PODIATRISTS. I don't think anyone in Australia can call themselves a Podiatrist after a 3 to 4 year course out of highschool? This does not even compare to the educational requirements of the United States. Perhaps, THAT is the real crisis in Australia?

    Also, can you give me more information on the "Australaisian College of Podiatric Surgeons"?
     
    Last edited: Apr 13, 2005
  27. admin

    admin Administrator Staff Member

    They can and do in almost every country in the world except the USA.

    Australasian College Of Podiatric Surgery
     
  28. Al Kline DPM

    Al Kline DPM Banned

    From the ACPS:

    "Most podiatric surgeons have undertaken at least 10 years of training before they have qualified for membership as a Fellow with the ACPS. "

    Training , where? In the United States?

    This may indeed be a crisis if we don't have uniform agreement on educational requirements to be called "Podiatrist" or "Podiatric Surgeon".

    I say that the educational requirements set forth in the United States should be the model for the rest of the World. We have the best and most up to date educational institutions to earn the degree of DPM. Most literature and post graduate courses are given in the United States. The US should indeed be the model for the rest of the Podiatry World. And , I say this from experience, because even in the US, we have problems with Podiatrists who are not properly trained and pose a risk to the general public. I could only imagine what that would be like in Australia, UK or Canada. I shudder to think of it!
     
  29. Al Kline DPM

    Al Kline DPM Banned

    I don't mean to be a downer in this forum, but can you really support the notion that a Podiatrist deserves the distinction of "doctor of Podiatric Medicine or DPM" after only having trained after 3 or 4 years of High School Education?
     
  30. Al Kline DPM

    Al Kline DPM Banned

    Another question:

    How is a "Doctor" classified in Australia. Do "doctors of medicine" or MD's go to a "medical school" , or is this also an UG program right out of high school. I'm sorry if I seem ignorant about this, just trying to gain some information.
     
  31. ARB

    ARB Guest


    They don't. Only Podiatrists in the US have this distinction.

    In Australia, qualified podiatric surgeons can use the title 'Dr.', but undergraduate podiatrists have to complete a PhD or clinical doctorate to use the term.
     
    Last edited by a moderator: Apr 13, 2005
  32. ARB

    ARB Guest

    ... MD's in Australia undergo a 6 year undergraduate degree program to graduate, then most go on for further specialist training.
     
  33. Cameron

    Cameron Well-Known Member

    Hi Al

    I suppose one of the benefits of blissful ignorance is you can be forgiven for saying anything. :)

    Most of the centres for podiatric education in the States have been until now ex-public university, with Temple one of the few exceptions. In Australia and the UK podiatry is taught at public universities and the three/four year programs lead to licence to practice as general practitioners. Part of this includes the use of local anaesthesia and nail surgery. The track to surgical podiatry specialisation involves post graduate professional studies (college of podiatric surgeons) as well as academic achievement to Masters level (and above) at a public university. This means that high school graduates with a first degree are not likely to practice surgery until two to thre years after graduate qualification.

    Well that was the case ,but there is a new kid on the block in WA and it looks like the intention is to produce a surgical podiatrist after four year undergraduate training (presumably based on the US model). Details are scant for the project has just been announced but it will be interesting to see the student criteria selection. If entry to the new pogram entails attainment of a first degree then this would mirror the North American system, on the other hand if the criteria is based on highschool grades you would have the "minor surgeon " you speak off.


    Cheers
    Cameron
    Hey, what do I know?
     
  34. Cameron

    Cameron Well-Known Member

    Netizens

    There are several differences between Commonwealth secondary education and the American System. Some debate surrounds the senior years and the function of upper school/ community college. The curriculum in both would equate to first year university level education .

    In good faith and for further clarification here is a website which outlines the American System

    http://c2.com/cgi/wiki?AmericanSchoolSystem

    Cameron
    What say you?
     
  35. Al Kline DPM

    Al Kline DPM Banned

    I see, because here in the States, you can't call yourself a podiatrist until you do the following:

    1. Graduated from High School
    2. Have an undergraduate degree from an accreditied University, usually a bachelors or 4 year degree.
    3. Complete the MCAT examination (same exam that MD's take before gaining acceptance to medical school)
    4. Graduate from a 4 year "Podiatry School".

    To do surgery, we now are implimenting mandatory 3 year residency programs accredited by the council of podiatric medicine.

    Most, if not all podiatry schools in the US are now under the auspice of major Universities and teaching hospitals.

    So it appears the term "Podiatrist" is what is at issue here. Maybe we should just call all "Podiatrist" in the states "Doctors of Podiatric Medicine" and if they have completed a residency, "Doctors of Podiatric Medicine and Surgery".

    What you describe is more like "Chiropody" not "Podiatry". It also appears that the struggles taking place in Australia and other parts of the world is similar to the struggles we have made in the United States to distinct ourselves from simple "toe nail clippers and callus removers" to bonefied doctors and surgeons? I believe to win this battle, you have to use the US model and get accredited Universities and "Medical Schools" to accept this notion. Temple University in Philadelphia has a Medical, Dental and Podiatry School all under 'one roof'. Governmental reform, Education and acceptence is the road to success in this 'crisis'.
     
  36. pgcarter

    pgcarter Well-Known Member

    I can't resist the chance....should we also give up the English language and use your American version? Our surgeons are not "bonafied"...(is this from a US college movie?)....they are bone surgeons, there is a Latin term of similar nature I think.. No personal insult intended...just couldn't help myself from the pun.
    Regards Phill....one of the terribly under done 4 yr trained podiatrists out here at the bottom of the world where everything is smaller and less good. I don't know how we cope without some one from overseas to tell us what to do.
     
  37. Virginia Hall

    Virginia Hall Active Member

     
    Last edited by a moderator: Apr 14, 2005
  38. Cameron

    Cameron Well-Known Member

    Al wrote

    >What you describe is more like "Chiropody" not "Podiatry".

    Historically there is no difference.

    >It also appears that the struggles taking place in Australia and other parts of the world is similar to the struggles we have made in the United States to distinct ourselves from simple "toe nail clippers and callus removers" to bonefied doctors and surgeons?

    Agree, although recognistion of specialisation may have come back to bite the UK chiropodists and podiatrists on the fanny. The Government NHS "Agenda for change" is a little like managed care but with attitude and may well leave many of the profession as corn cutters (Not that there is anything wrong with that, to paraphrase Seinfelt).

    > I believe to win this battle, you have to use the US model and get accredited Universities and "Medical Schools" to accept this notion.

    It all comes down to critical mass and their in sufficient interest at present I fear. As Hylton rightly points out in an earlier posting, the way other disciplines have established their position has been related to how medicine could use them. A bit like it is not what Ameria can do for you , but what you can do for America.

    Whilst the logic for foot physicians is obvious, to establish them may well come at the cost of the very profession. Only time will tell.

    >Temple University in Philadelphia has a Medical, Dental and Podiatry School all under 'one roof'. Governmental reform, Education and acceptence is the road to success in this 'crisis'.

    Yes a good move when you can get it. There have been some affiliations with orthopadics and podiatry in the UK but so far piecemeal development. Glasgow Caledonian University looks good to go and they are not alone. The UWS in Australia is another marriage of convenience (orthopaedics and podiatry) but it is too early to say.

    Good to chat

    Have a good one.

    Cameron
     
  39. C Bain

    C Bain Active Member

    Regulation???

    Hi Virginia,

    The UK. is about to go down the same road with regard to monopoly restrictions, REGULATION!!! They didn't expect the f.h.p.'s to try to go it alone, however! I think that was a bit of a surprise to them! Australia seems to still be in the grip of the trade unions? Hope that suggestion is not to bigger brick in the pool at this time???

    Our lot seem to have taken fright over the Shipman affair, serious though it obviously is one must keep our heads in a crises, (Yes over here it is plural!),( Crises, not heads! Although I don't know though?).

    I do wonder whether in our case Government is really trying to neutralize the powers of the doctors and dentists in our NHS. and their ruling bodies, it's always been allergic to any form of opposition!!! Is Podiatry about to be NEUTRALIZED at your end I wonder!!!

    Regards,

    Colin.
     
    Last edited: Apr 13, 2005
  40. Al Kline DPM

    Al Kline DPM Banned

    Sorry if I set off a few nerves, no need to change the English language. However, there is a huge difference between Chiropody and Podiatry as seen here in the United States. Firstly, we don't even use the term in the US and any inference to Chiropody brings us back to the 1940's. Call it what you may, but PODIATRY in the rest of the World is not PODIATRY at all, but CHIROPODY.

    The US is in its position of acceptance, largely in the medical and lay community, because of our political prowess and advances in Podiatry as a well established discipline. Much has been made in the advancements of foot surgery and the understanding of foot biomechanics published here in the US. Most of the World regards Podiatrists to be experts in the foot and ankle including its biomechanics and surgical reconstruction there of. This is mainly, in part, to the acceptance gained here in the United States.

    I just don't see that level of expertise in the rest of the World, sorry. Facts are facts, the educational requirements to call ones self Podiatrist doesn't compare to our system in the US. I shutter to think of someone doing surgery on my foot without any formal training. Maybe the rest of the World is riding off the coat-tails of our hard work and political strife and just calling them Podiatrists, but are rather Chiropodists? I think that if you have a system based on the educational requirements of 3-4 years of training out of high school, you’re going to get that type of response from physicians trained in the US.

    I wish you luck in gaining the polital strife and acceptance that we have so long and arduously worked for here in the states. I would like to see the day when our World is more uniform in its requirements for such a great profession.

    *Ignorance is bliss, but fact is fact.
     
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