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Aren't podiatrists the first in foot health???

Discussion in 'Australia' started by jos, Jun 8, 2008.

  1. jos

    jos Active Member


    Members do not see these Ads. Sign Up.
    What is going on?
    Just received a flyer from HBA (via the diabetes magazine) titled "look after your feet with HBA" aimed at making diabetics more aware of their foot health. BUT the word podiatrist doesn't appear once on this brochure. On one side patrons are advised to see their GP if there are any problems. On the other side, thay recommend patrons see an orthotist for customised orthoses, with a possible 100% rebate..............BUT AREN'T WE THE FIRST IN FOOT HEALTH??????:mad:
     
  2. Stuart Blyth

    Stuart Blyth Active Member

    Its simply a matter of money! Orthotist's have been doing customised orthoses, with a 100% rebate for years and at a lower rate than us, therefore its cheaper for HBA/ BUPA to send patients there.

    As far as telling patients to see their GP its simple! GP visits are covered under Medicare therefore no cost to the health fund!
    Cheers

    Stuart Blyth
     
  3. jos

    jos Active Member

    I know that but why do we never fight back????
     
  4. RStone

    RStone Active Member

    We do still have a public image (or rather ignorance) problem. I've moved around Australia over the last ten years and everywhere I've been I've continually run into the problem that people have no REAL idea about what we do as a profession. Yes they know we do "feet" but the public don't think about feet in terms of the number of muscles, bones, tendons, ligaments, nerves etc in addition to the foot being flexible, a rigid lever, affected by systemic disease etc etc. The public see feet as something at the end of the leg, that allows them to walk and most of them prefer feet to be out of sight and out of mind. Despite an education campaign in the new area I'm currently in I still had a nurse recently tell my husband people should see "a real qualified health professional for foot issues - not one of those unqualified podiatrists!!). My husband decided that then wasn't the time to mention I was the new podiatrist in town! :eek:

    In some respects I think we really need to simplify our education campaigns. Maybe something like "sore heels - see your podiatrist" or "growing pains - don't wait for them to disappear - see your podiatrist" (please don't start a thread on "growing pains" - I'm talking in terms the public understands).

    I'm all for more frequent education too - not just foot health week (which I have publicly not heard anything about in my area for the last 3 years outside of my own education campaigns). I also think we, as individual podiatrists, don't always develop strong enough relationships with the local gyms, kindergartens, diabetes and arthritis support groups, weight watchers, schools, day care centres, new mothers groups, sports clubs etc. The more people we meet the more people who will be aware of what we do (and the more patients who will walk through the door). It doesn't always have to be a "scary and time consuming talk", it could be a poster in the clubhouse, education package (for free with freebies) for new mothers or to new members of the diabetes/arthrits groups. We just need to get this material out there in SIMPLE PUBLIC UNDERSTOOD terms - as a profession and as individual practitioners.

    Isn't anyone else tired of being seen as a "glorified toenail cutter - pity you don't paint nails too" or "a pusher of orthotics"? We have a very valuable and unique role to play and it's about time we stopped being scared and started being proud of the contribution we can make to the public's health.

    Just my two cents worth (still buys something - not much though :wacko:)

    RStone
     
  5. LuckyLisfranc

    LuckyLisfranc Well-Known Member


    RStone

    I think you have identified the crux of the matter, and the reason that podiatry in the Commonwealth countries faces a major PR issue when compared to that shimmering light in the distance (ie the US).

    I think we can spend a fortune on PR campaigns, but whilst we essentially/practically are restricted in scope of practice to being either a glorified toenail cutter or a pusher of orthotics - then the public will see things no differently.

    I never fails to amuse me that we have all these very motivated and capable podiatrists and academics in this country, but at the end of the day they can talk about biomechancs, or other pathological pedal issues till the cows come home - but can do nothing to fix them bar prescribe orthotics or cut keratin! We 9ie in the Commonwealth) are a profession that talks about lots of sh*t to do with feet (ie look at all the biomechanics threads on this site), but can't do much in terms of interventions.

    If we really want to change the public's assessment of us, then we need to walk the walk. Drugs and surgery must be part of our DAILY practice, and not some fringe activity performed by a tiny minority. Then we will have what could be considered an important role to play in health care.

    I say put all those PR funds in the hands of government lobbyists to free up legislation to practice broader health care functions, THEN watch the change in attitude in the eyes of the public.

    LL
     
  6. Richard Chasen

    Richard Chasen Active Member

    Just regarding a few misconceptions...

    Orthotists in Australia have never received a 100% rebate for foot orthoses. Not only that, but their consultations, unlike podiatrists, do not receive any rebate at all. Furthermore, they're far more likely to spend their time actually making their orthoses, rather than sending casts to a lab and marking the finished product up by hundreds of dollars, so we can't really complain. I've personally noticed plenty of published material that lists podiatrists exclusively, without mentioning orthotists or other health professionals, and a Melbourne daily newspaper regularly lists physiotherapy as the exclusive cure for what ails the foot and ankle.

    We would be better as a profession if we put out something positive than merely railing at others for doing something we do as well. The horse has bolted on orthoses... they are prescribed in this country by podiatrists, orthotists and, far more frighteningly due to quickie courses and unscrupulous labs, physiotherapists, osteopaths, chiroprators, myotherapists, naturopaths and many others with no undergraduate training whatsoever. Perhaps, for a change, we could embrace one or two other professions' thoughts on things. If orthoses cost $25, I suspect this would be a much less common bugbear..

    Just some thoughts
     
  7. Richard Chasen

    Richard Chasen Active Member

    incidentally, I fully agree with Lucky LisFranc. If we are ever going to be seen as anything more than nail cutters, we need to push the outer edge of our scope of practice, such as use of prescribing rights and surgical skills, rather than the safe and warm inner scope..
     
  8. RStone

    RStone Active Member

    We could become much better experts at predicting those at risk of disease and educating the public as to how to prevent them - most of us (including myself) are perhaps shakier on our understanding of neurovascular symptoms we observe and what they mean in terms of overall systemic health. We could also do a lot more in the prevention of sports injuries along with the specialised footwear advice we can provide (making sure that we remain realistic - people simply won't wear sneakers, boots, lace ups and orthotics ALL the time - they need to enjoy life and silly, ridiculous footwear without guilt too - within reason of course).

    The optometrists have done a pretty good job of marketing themselves, even though glasses are their main treatment option. Even tyrefitters attract custom with different reasons other than the "your tyres need replacing". They may only be able to replace tyres but you go to them to prolong the life of your tyres, improve your fuel economy, prevent or limit wear & tear to other components of your car, become a safer driver by having tyres that work better.

    Many other specialists have limited treatment options but plenty of reasons why we still see & respect them. No reason why it should be different for us - but we need to do our job well and better than anyone else - that's the definition of a specialist after all.
     
  9. MelbPod

    MelbPod Active Member

    Well said Rich
     
  10. jos

    jos Active Member

    I agree totally! We seem to be on the back foot (ha ha) all the time when it comes to recognition of our profession.......well, what do we do about it????
     
  11. W J Liggins

    W J Liggins Well-Known Member

    Totally agree with Lucky and the other posters. If it's any comfort (I suspect it won't be) the situation is the same in the U.K. Whose fault? Ours! Think teeth, you don't think G.P., nurse or dental technician, you think dentist. They got their act together, we didn't. Unfortunately to change things (in the U.K.) will require 3 elements which are currently missing:

    1/ Money. 10.000 registered practitioners at say £100.00 apeice equals one million pounds sterling, roughly 2.5 million$Aus. That's a lot of money but we seem unwilling to pay upfront

    2/ Will. The exisiting professional bodies need to talk to each other and work out a strategy - but they won't

    3/ Professionalism. As mentioned by Lucky, we really need to provide a complete service for the foot as do dentists for their area. This means a recognition of specialities, so that interprofessional referrals become the norm

    Only if the above pre-conditions are met can we possibly expect to acheive what we want but too many silly squabbles within the profession will prevent it.

    I hope the situation in Oz will change. The situation in the U.K. will not.

    All the best

    Bill Liggins
     
  12. jb

    jb Active Member

    I cannot stand watching television advertisements for Private Health insurers spruiking their benefits payable on "...general dental, optical, chiro, physio, remedial massage, and more..." consultations.

    Podiatry is never mentioned. Ever.

    Being part of the "and more" simply does not cut it for me.

    Jair
     
  13. RStone

    RStone Active Member

    I agree wholeheartedly. By the way how did the so called "alternative therapies" such as acupuncture and bowen therapy etc become recognised by the health funds for advertising purposes before podiatry?

    I know people don't like talking about feet but this is ridiculous!

    RStone
     
  14. Stuart Blyth

    Stuart Blyth Active Member

    Again it always comes back to MONEY Podiatry is one is one allied health group that costs the funds a lot of money so they are hardly going to encourage their members to spend more on it are they?

    Why do you think that podiatry is either being restricted to general treatments only (NO devices) or being left off all together on the new membership tables introduced by several of the larger funds this year?

    Why are benefits to Physio's etc are being increased while HBA/BUPA have left the standard cover 012 benefit at $17.70 for the last 10 years, while our costs have gone thought the roof?

    Heath funds are VERY wary of Podiatry because of the lack of a standardized billing system and the continual gouging of benefits by some members of our profession.

    Our representative bodies continually put Heath funds in the too hard basket and thats why we are being increasing left out in the cold.\

    Cheers
    Stuart Blyth
     
  15. Boots n all

    Boots n all Well-Known Member

    RStone..."I agree wholeheartedly. By the way how did the so called "alternative therapies" such as acupuncture and bowen therapy etc become recognised by the health funds for advertising purposes before podiatry?

    I know people don't like talking about feet but this is ridiculous!"



    Dont you think you are preaching to the choir here or are you trying to organize a lynch mob for the health insurance companies?:butcher:

    Become pro-active:D, it not that hard, ring up the health insurance companies and have a chat to them:boxing:,
    Why do they not mention your discipline ?
    Why do they mention other disciplines?
    Why do they mention disciplines that are alike (e.g Physio/Chiro/remedial massage)
    Do the other disciplines subsidize the TV commercials in some way?;)

    Think outside the square l am sure you will come up with some other questions.
    l am sure we would love to hear back from one of you as to how it all went and their reasons :drinks
     
  16. RStone

    RStone Active Member


    Thanks for the suggestion - embarrassed to say ringing the health funds as an individual practitioner for something other than a problem with a patient claim had not actually occurred to me :eek:

    Do I understand correctly that you haven't actually tried this seeing as you're keen to hear the results? ;) It sounds like a challenge to me and as I'm quite prepared to think outside the square for marketing and podiatry promotion I'm humbled in not thinking up this idea!

    Anyway I'm off to speak to the health funds - when I get off hold I'll let you know the results :D

    Cheers
    Isn't it more correct that money shouts rather than politely talks?
    RStone
     
  17. Cameron

    Cameron Well-Known Member

    netizens

    I suppose I take a totally different view point here and think podiatry is far better recognised in the general public than most members of the professions are willing to accept. Certainly in the study of GP attitutes to allied health conducted at Cranfield Institute, Social Policy Unit UK (published in the UK podiatry journal), GPs had nothing but high praise for pods and thought they were well trained and proficient but the only issue they did have was pods rarely communicated with them. In a study in Australia where pods and members of the public were polled for an opinion, the general public again appreciated the service offered by podiatrists, they found pods likeable and trustworthy individivals. These finding heavily contrasted with the pods opinion of themselves which was pretty low indicating a low self esteem. From the available statistics the majority of pods work a scope of practice well below their legal range yet scan any promotional material for the profession and you tend to see the more specialised aspects highlighted as the 'norm'. Ask any busy private practitioner why they are busy, and their answer will confirm the public are delighted with the service (no matter what that may be). As already stated today , when it comes to marketing it is not professional capabilities which sell a service it is the quality of service to the client that matters. So I would agree there maybe pods ill at ease at their narrow range of practice but increasing capability on the pretext there is a market for it may not prove such good business sense. All the more frustrating when skilled with the capability and no one wants your range of services. This might be likened to openning a shop and selling only what you would want to buy. Chances are customers will stay away.


    Wjat say you?
    toeslayer
     
  18. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    RStone

    While you are on hold waiting for the health funds to speak to you, get your local federal MP on the other line and support Nicola Roxon:


    A major political lobbying campaign is needed to support the Government and oppose the AMA on this critical fight.

    LL
     
  19. Boots n all

    Boots n all Well-Known Member

    If l was a concerned Pod l would have done that by now :D but l am not

    l am still looking forward what the outcome is :empathy:
     
  20. pscotne

    pscotne Active Member

    I know people don't like talking about feet but this is ridiculous!

    RStone[/quote]


    ;) Oh? I'll bet they'll start talking about feet when they are crippled from an excruciatingly painful attack of bilateral gout-ridden, infected hallucal onychcrytptosis with gigantic shiny-red, bulbous swellings and smelly draining exudate just before they were to don their pumps and do a spot of ballet !!! :D

    Pete the..........................mmm............I forget.

    :santa2:
     
  21. PowerPodiatry

    PowerPodiatry Active Member

    Not the first in foot health because we choose to tread the easy path. I have talked to Pods that have not done even nail surgery since they graduated and others that don't even have a set of instruments in the practice. When I was a surgical registrar we called these girls and boys the "orthotic sluts" and they called us the "Slice Boys". I believe we need to provide the service first before the recognition. Pick up the ball and run with it and stop whinging boys and girls. Do a little less prostituting (orthotics) and a little more surgery and how about a little physical therapy (manipulation, electrical therapy, therapeutic exercises and even massage) and a novel idea of diagnosis before treatment (back to orthotic slutting) and end up giving the community what they ask for and we will be the first in foot health. I've fought for nearly 22 yrs. in private practice to become the first in foot health and the fight seems to get tougher each year. The orthotic horse has definitely bolted and good riddance . We should call the orthotic to our beck and call rather than relying on it as our only gravy train. In an evolving world the overly specialised specialist is in danger of becoming extinct. Take back the lower limb and lets start showing the Physio's and associated cohorts who have started to say "they're only toenail cutters what would they know about biomechanics". Remember we are the only allied health professionals that still pick up a scalpel.
    Stirring the possum
     
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