Do we need NZ Podiatric Surgery?

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I have practiced in New Zealand for 22 years, 16 of which as a Podiatric Surgeon. I have continued to try and promote the benefits of Podiatric Surgery and try to change legislation to help better its accommodation with the NZ health system. I am currently in the belief that there seems to be an active resistance within the Podiatric profession against New Zealand trained Podiatric Surgeons being able to perform foot surgery, or a least a resistance to acknowledge or support this area of Podiatry? I may be incorrect? Can anyone comment?

 

Hi Stefan.

If you will forgive a comment on the Pommie experience, we were in exactly the same position years ago. I have to say I am a little surprised because I thought that 'down under' you are a little less surrounded by reactionary forces in the profession. However, the UK 'powers that be' at the time did everything they could to torpedo the emerging podiatric surgeons, one of the most senior members of the then Council of The Society of Chiropodists and a senior educationalist, even writing to the British Orthopaedic Association asking them to 'protect the profession of chiropody against podiatrists'. I can only put this down to a 'dog in the manger' attitude and a hatred of those who have the temerity to challenge the status quo..

Please do not be downhearted but stick to your guns; you will be vindicated when new generations arise.

Incidentally, you've got a good cricket team. :drinks

All the best

Bill

 

I am Podiatric Surgeon in Australia, but unlike yourself I am very recently registered. I met Trevor Tillotson in Perth a few years ago, when we were trying to create a common training pathway between the two training courses in Australian and your NZ course. We failed to reach agreement, which was not NZ's fault. Anyway, I have been baffled by the lack of support by the general podiatry profession for the surgical specialty. We have 30 Pod Surgeons in Australian (15 in Western Australia) and over 4000 general podiatrists. We should be run off our feet with referrals from general podiatrist, but the opposite is true. I have assumed the reasons to be;
1) General podiatrists are worried they will lose their patient to you, as you could be perceived as better trained. Most surgeons (that I know) provide both general care and surgery. It would be great to do surgery exclusively but we don't get enough referrals!. 2) General podiatrists don't know when to refer. They will happily debride an ID corn forever, and devise very creative ways to offload a hammer toe, but will rarely advise patients to get a surgical opinion.
3) Cost. Many assume we charge too much. I have heard a podiatrist say he refers patients back to the GP for referral to Orthopaedic Surgeons since generally insurers and medicare provide better rebates for them.
I think education is the key and I have been thinking of sending out a survey to general podiatrist to find out what the barriers to referral are.
My short answer is yes, Podiatric Surgery is needed in NZ and everywhere else for that matter. It is part of our scope of practice, and with it we can offer continuity of care.

Regards
Burke

 

Dear Bill and Burke

Thanks for your reply. I heartens me to have your support and at the same time frustrates me that you have had the same journey.

Podiatric Surgery (The New Zealand College of Podiatric Surgery (NZCPS), has been here since 1985. Trevor (The president of the NZCPS Ret), and his wife Kathy , good friends, more like family on mine, championed this scope driven by the need to train those who had interest to give curative rather palliative care to their patients, to safely undertake Podiatric Surgery in a manner set out by the exact same standards required to achieve board registration in America. During the early stages of the college they were attacked by well articulate, charismatic Americans who practiced here in NZ and insisted that they were superior to anything the NZCPS could offer and tried to stop "normal NZ Podiatrists" from practicing or learning surgery here in NZ. Thankfully they left NZ. To me it seems history is repeating itself. I am now the president of the NZCPS with Trevor and Kathy passing on their flames to me. I find myself surround by a profession who rarely refers, 3 patients in 16 years, a Podiatrist Board who spent tens of thousands of Podiatrist's subscription fees, (approx 57K) NZD on trying to prove that I was unsafe, this failed as their punitive clinical, surgical and personnel audit that I was subjected to proved that I was in fact competent. they have also tried to pursue me via a recent Profession conduct committee aimed at investigating my treatment of my son for verrucae's, my other step son for placing a splint on his broken hand prior to an orthopaedic consult. Heaven knows what this will cost. A Podiatrist board who has refused to meet the College of NZ Podiatric Surgery. The professions collegial non-official body, Podiatry New Zealand have searched legal loop holes, telling their group insurer not to insure me and then proceeded to kick me out on the basis my new insurance doesn't exactly match their cover. The stood by and watch the board and the Tauranga 13 local Orthopaedic surgeons do there best to stop me practicing. PNZ did nothing. Luckily I am of Welsh decent. I tend to be incredibly stubborn so I will be here for a while. In the mean time I would love to here from others to see how they may help me grow NZCPS and help Podiatrists become Podiatric Surgeons and grow this wonderful scope. I have recently returned from Chicago, on a course ran by ACFAS. I have been inspired by their professionalism, positivity, celebration of excellence and above all, collegiality of this group. If only we had this here.

Thanks again for your feedback, its really appreciated.