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Hello everyone,

As a practicing Canadian chiropodist, I view custom orthotics as one of many possible therapies available to patients.

There is an expanding industry of orthotics-focused clinics who offer very little in the way of general practice.

Is there anyone out there who is familiar with any literature which illustrates the connection between offering full scope chiropody/podiatry services and improved patient loyalty, referrals, and clinical outcomes (versus only providing orthotics in the clinic)? In the absence of any literature, can anyone speak more generally about their experience or opinion in this realm? Is this link as clear as I think it is?

-Chiropody Girl

Hi Chiropody Girl,

I'm not really sure I follow - what do you regard as general practice? I suppose that would depend on the type of clinic worked in and the type of patients seen?

Are you asking for the comparison between a purely musculoskeletal clinic Vs a more 'routine chiropody' clinic?? I'm pretty sure there is sparse literature on this if so.

Maybe I have misinterpreted your question - please feel free to correct me if so

Ian

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Hi Ian, thank you for responding. My apologies for being unclear.

To cut to the chase, a few months ago I accepted an offer of employment in a clinic that, to my surprise, is focused almost exclusively on orthotic sales. I am currently working on a proposal to my employers wherein Im trying to expand the clinic's footcare services. I believe footcare is extremely valuable and to be honest, I do not want to be nor believe in being an orthotic salesperson! I am looking for some proof to an assumption I have that offering footcare in an orthotics-focused clinic should lead to better patient retention, referrals and outcomes so that I may present a more convincing argument to my employers.

I hope this helps. Again, my apologies for being unclear.

Hi again,

Thanks for clearing that up. Are the clinic purely focused on orthotic device issue, or on orthotic device sales (the latter potentially questioning your own ethics)?

I would assume if it is a musculoskeletal clinic in which the caseload is representative of this then as long as patient care and outcomes are top of the list and orthoses are being issued appropriately and with good clinical reasoning then the feelings of being an orthotic device 'salesperson' should recede.

I think you may have a case for offering more 'general' footcare if you wanted to - and would have to put this as a business proposal to your bosses (i.e what will it cost them to set up and what the benefits for them would be etc). I'm afraid I dont know of any literature or proof regarding this leading to retention, referrals and outcomes - but maybe someobne else on the forum can help.

Ian

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Thanks for getting back to me. The issue in this case is the focus on orthotics revenue so I do believe I have a case for offering more chiropody services. Thank you for your input!

Hi Chiropody Girl, I do not know of any studies either. When submitting your proposal you could include these points:
1.Offering full scope of practice will allow you to provide comprehensive patient centered care and win loyalty from your patients.
2.If your company only provides orthotics, they may be viewed as another product provider(and be viewed the same as all the other orthotic providers in the market) and not a specialty health service provider with the utmost expertise in the field,
3. Patients want to develop a personal relationship with their care providers, orthotics once a year will not achieve this.
3. Not addressing all the other foot care needs opens the door for more competition, as the patient will be forced to look for another chiropodist who will be willing to do it and provide them with their next pair of orthotics, shoes, stockings, fancy creams, etc. while they are at it too.

4. If you as the chiropodist feel you are not permitted to work to your full scope it may affect your job satisfaction and truncate your professional growth. This is a very important aspect for employers to consider when attempting to retain employees and decrease staff turnover.

Sorry if I am stating obvious things, but they are meant in good faith to ensure you cover all your bases.

Good luck!

Melva

Thank you!! You have articulated exactly what I had assumed to be true. I present my business case on Monday!

Guys,

Quick question - is 'Chiropodist' as a title still commonly used in Canada? I was under the (perhaps inaccurate) impression that it was a title only really used over here in the UK - and even we are generally pushing hard to get people to move onto 'Podiatrist'

Thanks in advance

Ian

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The Ontario trained foot specialists were originally chiropodists, in fact the programm adopted was the British model and we were taught by British instructors (D.Pod.M.'s), but the program is undergoing some changes and now the new graduates (in two months) will likely be D.Pod.M.'s. We also are fighting to switch to the podiatrist title but getting much oposition from the US trained DPM's who practice here.

Hi Melvita,

Thanks for that info - I had no idea that was the case, I assumed all of North America/Canada were DPMs. Does this mean UK trained Podiatrists can legally practice in Ontario?

Ian

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Yes they can. Last I heard there is a steady trickle (2-3 per year) of D.Pod.M.'s coming in. I have read a few threads on working in Canada, good information on it. The college of chiropodists of ontario is the regulatory body in charge of seeing who gets to practice here. I think you just need proof that you have a job offer. Some jobs are posted in the Ontario society of chiropodists and in the Canadian Federation of foot specialists websites
www.cocoo.on.ca
www.ontariochiropodist.com
www.podiatryinfocanada.ca

Thanks for all of the info Melvita - I had no idea. Will check out those links.

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