Podiatry Arena members do not see these ads

As far as legislation goes (in Australia), there are no restrictions on who can and can't use the title of 'Dr'.
Traditionally, only a person with a PhD, or Dr of medicine should title themselves a 'Dr'. However, more and more health professionals are adopting the title including; chiropractors, osteopaths, dentists, vets, and the list goes on.
And by asking a few people of the general public (by no means a RCT), I found that most people were not aware that a Dr meant the person had a PhD in anything, they may infact have a PhD in Geology and know nothing about medicine. I thought this was very interesting and probed to find that these people actually thought that Dr was actually a title for a qualified health profesional, who could diagnose a health problem.

So after recently being bought up in our (fabulous) monthly newsletter...
Is it time that podiatrists titled themselves Dr, or do we remain the 'good guys' and leave the title for those who have PhDs???

Its a tough one!!!!

Tweet

Share

I moved this to the Australia forum (and it was in the Vic APodA newsletter).

Related threads:
Use of Doctor title
Other Doctor title threads

__________________
Are you addicted to Podiatry Arena?
Have you added your location to the map? (Map FAQ's)
Earn CPD Points

__________________
Are you addicted to Podiatry Arena?
Have you added your location to the map? (Map FAQ's)
Earn CPD Points

MelbPod

As far as legislation goes (in Australia), there are no restrictions on who can and can't use the title of 'Dr'.

I think (and I stand to be corrected) that may have changed in some States. In WA for example I believe pods with acceptable qualifications may now use the title Doctor and be registered with the Registration Board as such. How that goes should the individual move States, I cannot say. This would mean however pods using the professional title Doctor, without being registered could be in breach.

>Traditionally, only a person with a PhD, or Dr of medicine should title themselves a 'Dr'.

As I understand it, the academic doctorate is a stand alone qualification whereas the professional title which most physicians use is an honorary title. Many docotrs will have a Masters Degree as their highest degree but few have completed an academic doctorate.

>However, more and more health professionals are adopting the title.....

These professions are using the professional doctorates which usually means they have completed a Masters degree. In the US the qualification is an undergraduate qualification and the title confered by the institution. Until comparatively recently the pod educationcentres in the US have been private colleges. Now there is a shift to public university education this means there is a closer proximity to UK and Australasian higher education systems and qualifications. So some US pods will hold academic doctorates or Masters degrees but the majority will not. All can use the title doctor because they have completed the podiatry programs which give a qualification which is a doctor of podiatric medicine. This is the kernal of the Sienfield routines, "are pods real doctors?'. What is frustrating for many US pods is thay have completed programs which might equate in length and depth to a medical degree.

>I found.......these people actually thought that Dr was actually a title for a qualified health profesional, who could diagnose a health problem.

It is for that very reason many professions are sensitive to who should use the title doctor. The medical fraternity are wary of others encroaching on their territory and irritated when professions such as you mentioned use a professional doctorate title. Not only that many US podiatrists become uncomfortable when non US pods present themself with a doctor title. In the same vein the term 'chiropodist' which is still legal and synonimous with podiatry is marginalised and in many countries and viewed as a lesser qualification. This has shown itself very recently where US Pods trying to establish themself in other countries and argued to the authorities their doctorate qualifies as a higher qualification than local chiropodists. This arguement is not new and within the Commonwealth the US degree has the acadmic equivalence of an undergraduate honours Bachelor of Science which levels the playing field.

>Is it time that podiatrists titled themselves Dr, or do we remain the 'good guys' and leave the title for those who have PhDs???

I think there is a change. What always amuses me is when medical colleagues reach the status of consultant they drop the title doctor and revert to Mr, Mrs or Ms. This acknowledges they are considered by the world to be experts in their field. :-)

What say you?

toeslayer

__________________
My location

Hi guys,

I feel that it is only a matter of time before pods in Australia will be called Dr. With the new S4 prescription laws on their way, the push for specialist categories (pod surgery / high risk / sports) and the fact that so many other allied health practitioners are already using the title Dr, WHY SHOULDN'T WE!!!!

I feel this is something we should all do together. Organizing such an event is the difficult part, especially if not all pods are happy to take part. On the other hand, I'm sure those pods opposing the use of the title Dr, will soon change their mind once the majority of the profession is using it.


Who can organize this transition from podiatrist to Doctor of Podiatry??????

What say you!

Kind Regards

Toeslayer,

correct me if this is not the case in AUS, but isnt it the case that our medical colleagues drop the title Dr, when they have gained fellowship of the Royal College of Surgeons, not merely because they are consultants, SpR's in surgery hold the title Mr. Going on with this Consultants in disciplines other than surgery remain Dr

Hi all,

I agree!!!!! I also think it’s high time we all started using the title Dr.
I think we (Podiatrists) are in the same league as Dentists (except the right to prescribe a range of S4 drugs). They, by no means, do anything differently to us in terms of scope of practice. They are known for their expertise in oral health, nothing more. We, as Podiatrists, diagnose, treat, and rehabilitate pathologies of the foot and ankle (and related structures), nothing more. We use the same medical and surgical modalities (surgery, corrective braces/devices, etc etc) as Dentists. My point being: We are almost identical in every way, with the exception of our respective anatomical specialties.
There is, however, one other difference………..They use the title Dr.
What grounds do they have (no to say that they are against us using the title) that we don’t?
I think that using the title Dr is a vital step forward for the profession of Podiatry. It not only acknowledges our expertise in foot health, but also boosts our public image as exactly that.
I have been using the title for some time now, and as well as other things it has built awareness of podiatry and what podiatrists do (apart from nail and callus management) amongst my patients.

Best regards,
Sal

Hi Sal,

Have you received any negative criticism for using the title Dr from patients / GPs / allied health practitioners?


I have been contemplating to start using the title Dr?

Cheers

The use of Mr vs/ Dr title in surgery harks back to the Royal College of Surgeons in England.

As Cameron would have better historical knowledge in this area, I won't preempt him too much - suffice to say the 'surgeons' as a species evolved from the Guild of Barber Surgeons in northern Europe - and were quite professionally distinct from 'physicians' up until relatively recently.

Hence much of the use of the title of Mr. stems from surgeons trying to separate out their field of endeavour from those in physician specialties.

In Australia, the title of Mr. is still voluntarily taken by those in only a small number of surgical specialities involved with RACS, and is more common in southern states that elsewhere. It is a throwback from the time when Fellowship with the RCS was the standard surgical qualification in Australia, and is slowly dying out altogether, albeit with a few staunch pockets of support.

In terms of this debate, I would tend to agree that the time is right for us to use the relative perception value of the Dr title in the public eye. However, if you are a practitioner who spends their days toiling with nails and callus, rather than a broad scope of practice, then I feel it will look rather silly to those in medicine...

LL

__________________
*****************************************
Remember, it's just a foot.

Not in all parts of Australia...

LL

__________________
*****************************************
Remember, it's just a foot.

Hi Spur,
We did receive one query from a person asking whether I had a PhD qualification and if I didn’t then why was I using the title; however, I’m not sure if it was a patient, a member of the community, or another health practitioner. It was the first and there haven’t been any other queries or negativities since. Apart from that, there has been no other criticism from anyone else, GP’s and other health practitioners included.
If fact, I just saw an EPC referral to one of my colleagues from a GP with the title Dr used before his name, as opposed to Mr.
Overall, there have been no other issues with the use of the title so far.
Cheers,
Sal

God I feel sorry for the lay person seeking help for ankle pain....now and moreso in the future.


They will be confused by marketing and subtitles etc.

We will have podiatry graduates after 2012 having a "masters" associated with their name. Now we are proposing that 3-4 year university trained health professionals use the old Dr. prefix.

At least Chiropractors have done the hard yards with 5-6 years of university. Some of us pods have done 3 years university.


About time for less smoke and mirrors. In the future, it may be a good idea (albeit unpalatable) for health professionals to each have an online testimonial that is on the public record...almost an ebay system of positive, neutral or negative outcomes. This will differ from the ridiculous worthless testimonials whereby we include only the positive stuff.


Ron
Physiotherapist (Masters) & Podiatrist

Hi Atlas,

I feel patients will be more confused in the near future with the fact that we are not titled as Doctors of Podiatry, seeing that we perform minor sx procedures, can administer LA, can specialize in podiatric surgery and soon will be prescribing S4 drugs.



Kind Regards

I feel sorrier for them now, as they are more inclined to go straight to their GP who, in some cases is proficient in knowledge of the lower limb and biomechanics, but often, is not and then makes a referral. Which is beginning to be recognised as a waste of patient time and money (and medicare funds)
Did the patient select the GP because he was a Dr and perhaps thought podiatrists were not as knowledgeable?? Maybe.
I would hope that the lay person would recognise that podiatrists can be just as knowledgeable. Hopefully in the future the Dr title + PODIATRIST after the name, will encourage patients to seek treatment as the first line of call.

(Physio's included Ron).

Sally

" I agree that chiropractors having adopted the title "Dr" is good cause for our profession not to follow suit, but for a completely different reason:

Chiropractic theory describes the cause of all disease as being due to 'subluxation' of vertebral bodies blocking the flow of 'innate intelligence' or 'innate energy' from flowing out through the nerves. Chiropractic theory has no basis in medical science and is contradicted by basic human anatomy and neurophysiology - and they have called themselves 'doctors' !

I think this might be a good reason to tread carefully if we want to maintain the respect of our medically qualified colleagues.

As the old saying goes, I think it is quality not quantity.

Good call.

A hospital ward scene (not too far in the future) all medical, allied health, and nursing staff referred to as "Dr" ............ damn confusing for all an' sundry!

The whole idea of wanting to use the title " Dr" is somewhat pompous, ego tripping, and pretencious. A masters in medicine, or ph.D should be considered the minimum.
Sorry!!!!
Will

I would think that patients may prefer to visit the GP as they get a Medicare rebate, or may even have the consult bulk billed. In order to become the primary healthcare providers of the foot and ankle, maybe our efforts would be better spent supporting the role of podiatry on the political forum (with reference to the federal Health Minister's interest in primary healthcare reforms), rather than assuming the title Dr.

I also think that assuming the title Dr. may have the opposite effect to what is described above, patients may perceive podiatrists to be misleading or fraudulent (I know I would).

What do you tell your patients when they ask : Are you a doctor ?


I agree with the comment by whamilton3330 above.

What does your dentist or vet have to say when you ask, "are you a doctor?"

Now, don't get me wrong - this issue of title, on the surface, appears to be a bit of a w*nk. However if you scratch beneath this then very important issues of professionalism and public perception come into play.

The vast majority of medical, dental and veterinary practitioners only hold a Bachelor or dual Bachelor degree, so the academic PhD/Prof Doc argument cannot be held up as the only pure reason to use the title of Dr.

I know I spend most of my day hearing my patients call me Dr, even though I can't (and don't)use the title in the State that I practice. The resounding expectation from these people is that I practice and conduct myself in a manner consistent with their expectations of what a "Dr" is to them, regardless of my profession. The general public makes its own determination here, regardless of law and professional attitudes.

Most widespread use of the title of Dr where it is allowable will not change the health system in and of itself, however it would be a hell of a lot more useful in the PR department that 1000 of those ghastly and pointless 'foot health weeks'.

LL

__________________
*****************************************
Remember, it's just a foot.

G

Accept the point and I was restricting my comments to surgery.

netizens
There is provision in the WA legislation to hold a doctor title if it can be shown the board you hold the requisite qualification and experience in podiatric medicine. Todate as far as I am aware only people with surgical qualifications have been granded permission to the professional title of doctor. We await the first podiatric physician in Australia.

In Australia resiprosity is important across the States and Territories because it is such a big country and for the purpose of labour movement. With the introduction of a national registration board imminent how will that effect the present inequity that exists i.e. the doctor title is only recognised in one State.

What say you?

toeslayer

__________________
My location

Cameron

If you read the Inter-Governmental Agreement (IGA) on National Registration & Accreditation (google it) you will see that only the profession-specific titles will be protected - barring last minute AMA politiking (unlikely given Roxon's attitude to the AMA so far).

This means that only the title "medical practitioner" is to be protected, and it looks very likely that 'surgeon' and 'Dr' are to be unprotected titles.

It is also clear from the meetings I have been to that the intention is to move to the highest common denominator, and not reduce any gains made by professions in individual states. Hence, the Victorian model on title I feel will be the one that is used (ie any podiatrist may use the title of Dr, followed by the term Podiatrist - as is on the Vic Podiatry Board website).

LL

__________________
*****************************************
Remember, it's just a foot.

Lucky Lisfranc,

Very Good Point. I agree!!!

I think it is a vital step forward for the profession.

As Lucky Lisfranc stated: "very important issues of professionalism and public perception come into play"

Dentists, Chiropractors, Vets, and Osteopaths, like Podiatrists who use the title, will make sure it is clear that the patient is not being mislead by putting "Dentists" or "Podiatrist" after their name.

It is illegal for a Podiatrist to call oneslef a medical practitioner, a chiro to call oneslef a Physio......but by the same token, it is illegal for a medical practitioner to call oneself a Vet or anything else they are not.....

The issue is about recognising our expertise as foot health practitioners, just as we recognise that of a dentists expertise in oral health.

cheers,
Sal

many thanks for that L L, now better informed.

Cheers
toeslayer

__________________
My location

I appreciate the need for professionalism in podiatry, but tend to disagree that this would be the way to go about achieving it. Both dentists and veterinarians have long- standing rapport and respect in society, it’s because of this well developed regard that it is acceptable for them to use an honorary title. It seems to be suggested that in order for podiatry to achieve a similar level of respect, we should adopt the honorary title first and the rapport will follow. This seems to me as being the wrong way around.

There are also many examples of professions that are highly regarded in society based on what they do, not what title they have adopted. Clearly an honorary title is not required in order to develop professionalism, but is the result of professionalism.

Maybe we should focus on making the most of the increased scope of practice that has been awarded to podiatrists in Victoria, and build professionalism based on our actions and new-found responsibilities.

Using a Dr title will not achieve anything on its own, as I have said before - it is a small component of the vast work we need to do to increase the level of professionalism in this country.

I am not sure of your knowledge of contemporary socio-political history, but please be aware that dentists and veterinarians have no longer history of professional activity than podiatrists. As hinted at previously, podiatry (nee chiropody) evolved from the corn-cutter origins at the same time as dentists and the Guild of Barber-Surgeons were doing blood-letting and using leaches in 17th century Europe.

It is only in relatively modern times (during the early 20th century) that organised medicine and dentistry, through their respective trade unions lobbied governments around the world to allow a variety of the powerful Acts to be enabled to support their position and standing in society. Only in ONE country in the Western world did organised podiatry get its act together and form a powerful union to lobby for similar protection of title and scope of practice (USA). Hence, for example, podiatrists were legally administering and prescribing narcotic analgesics in this country as early as the 1940s. Anecdotally, I have often heard from US podiatrists that it was the high prevalence of Jewish podiatrists in the profession that were responsible for the gains made over the decades.

In the Commonwealth countries, there was none or little of this organised trade activity, and the UK model of non-surgical, non-drug conservative chiropody flourished up until the latter part of the 20th century. Unfortunately this lag time of several decades meant that organised medicine and the rise of state health bureaucracies had embedded some quite rigid frameworks regarding the division of labour in the health professions. In short - podiatry had achieved too little, too late in these countries - a price we continue to pay now in the 21st century.

The rapport and respect already exists. Lets just formalise it a little.

However health care is its own industry, with its own peculiararites regarding the use of the Dr title. i dont think we can compare this to law or accountancy, for example.

If patients choose to call me 'Dr' all day, every day for the past decade or more...what does that say to you. My business card and stationary clearly state that I go by 'Mr', but the public makes its own determination about how they perceive me based on the work and do, and the professionalism I attempt to provide. I do not think I would be unique by any stretch.

I have little doubt that when more podiatrists are prescribing drugs, or practicing podiatric surgery (a la the US system), then you will see a great degree of chest-puffing, and a raging demand to use the Dr title.

LL

__________________
*****************************************
Remember, it's just a foot.

Thankyou LuckyLisfranc for the above reply, very informative and encouraging.

I would appreciate your opinion on a further concern:

That the current public perception of podiatry seems in my experience not to correlate with the level of academic rigour expected of a clinician with the honorary title. For example, as a student on placement I have often found the patient to be surprised that podiatry is a degree program, and many clinicians from other disciplines have questioned the need for 4 years of study to qualify as a podiatrist. Of course I provide convincing answers to both queries, and have also had more positive experiences.

This lack of academic regard may have a historical context and may be of relevance to the socio-political differences between dentistry and podiatry as you have described above. There seems to have been a significant lag on the academic front in addition to the political between these two professions. In 1897, the curriculum was drawn up for the Bachelor of Dental Surgery at the University of Sydney, the course opened in 1901 as a 3 year (full-time) program and became a 4 year program in 1905. In contrast, after formation of the Chiropodists Association of Victoria in 1929, the first formal chiropody courses required attendance at two evening classes per week for 1.5 years. The Melbourne College of Chiropody opened the first full-time program in 1968 (3 year course), with the Lincoln Institute offering a 3 year Advanced Diploma in Chiropody in 1978. I’m unsure of when the course finally became a Bachelor Degree, but it took approximately 80 years for the two professions to be on a level academic playing field.

Do you think Podiatry needs more time to become publicly recognized as a profession with a strong academic background and significant clinical responsibilities, or are recent advances in our profession (both academic and clinical) well enough established to support an honorary title ?

Much appreciated,

Andrew

(Schnock, W. (1989). Annotations to the history of chiropody-podiatry in Victoria, 1929-1979. Melbourne : Walter Schnock.)

Andrew

This is an excellent point you raise, or for which I don't know if there is a right or wrong answer.

Just as the current Australian economy is considered to be a two-speed situation (ie mining states vs. the others), I see Australian podiatry in a similar context.

There are, by my humble assessment, three types of podiatrist in this country. The classic chiropodist who provides important basic foot care provision but has never developed any further professional skills, and a second group who practice varying degree of more contemporary podiatric practice with some minor surgical care and varying musculoskeletal therapies. The final group is the smallest and arguably the most effective and strategic group, that being those involved in podiatric surgery.

If we consider this third group, Fellows of the Australasian College of Podiatric Surgeons, you can see some remarkable political achievements. Firstly, they are the only 'allied health' group to be recongnised in the National Health Act as providers of professional attention (along with medical practitioners, dentists and midwives). They have been singularly mentioned in at least two major pieces of Commwealth legislation, various State regulations, and other significant statutory instruments. This group also has a policy of utilising the titles of 'Dr' and 'surgeon' wherever State/Territory juridictions allow so. As practitioners of reconstructive bone and joint surgery, with various degrees of access to restricted and controlled drugs, I think it would be difficult to argue that an honorary title would be inappropriate here?

The second group (hopefully) represents the bulk of the profession, however I have not seen any reliable workforce data on the day-to-day activities of our workforce. Suffice to say this group hopefully represents the usual depth and breadth of activities taught in undergraduate podiatry degrees in Commonwealth countries. Some of these people will arguably be perceived as "Dr's" by the public, and other professionals, regardless of their academic credentials.

The first group, I think, demeans the term 'professional' by failing to continue on the path of life-long learning and failing to meet the expectations of the community and the health system at large.

You extend on my points about the 'lag' that exists in Australia and the Commonwealth nations very well, both acdemically and professionally. However, we now have at least one podiatry course located in one of the esteemed 'sandstone' university medical schools, and I have heard some anecdotes about these new graduates feeling slighted that they train alongside medical and dental students for about 1/2 of their degree, but cannot use the Dr title at the end of their studies...I digress. I would argue that the relocation of the all/the majority of current podiatry schools to within medical schools in Australia would be a more positive professional step than decades of political lobbying.

I feel the greatest failure and impedence to the growth of the profession for decades has been the relatively ineffectual and malaise-stricken APodC, who have failed to differentiate the profession from the mob of 'allied health' groups who we share little in common with. One only has to look to the work of the ACPS (watch this space!!!!) for how effective podiatry can be in pushing professional boundaries and professionalism to a level on par with the USA. It just begs the question as to how 2% of the profession can achieve infinitely more than the group representing the remaining 98% of the profession...

Look forwarding to discussing these interesting issues further with you.

LL

__________________
*****************************************
Remember, it's just a foot.

Thank you, LL for the informative information you have provided

I have seen, first hand, the benefits of using the title "Dr" and until things change from a legal standpoint (if and when the law restricts me from using the title) i will continue to use it.

I think the dialogue here has been very helpful in raising awareness about the whole issue of "title" and i look forward to reading the opinion of others.

Cheers,
Dr. Sal
(Podiatrist)