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I took the opportunity to start a new thread to keep the success of Podiatry Arena away from Doctor bashing. Hope you have no objections?

First may I say every discipline has this problem i.e. panning colleagues and medics are no different with specialist physicians at the summit of Mount Olympus and GPs, the plebes, at the bottom. Podiatrists do suffer from noticeable low self-esteem however, which from my three decades working in the business; I still cannot fathom, where this comes from? Frustrated doctor syndrome may have been supportable twenty years ago, but the general demographic has changed and many young people want to be podiatry practitioners first and foremost. So they are far fewer wannabes today than in previous times. So if it is not a latent dissatisfaction within the individuals, then what is that triggers the aggression towards colleagues.

Mandy and Tinley published works recently on the high stressors in a practitioner's life and Mongomery previously cited "lack of the ability to determine destiny" as a main stressor in our professional lives. Much of the apparent dislike for others is our xenophobic fear of strangers and that our colleagues might be better than we might. A natural form of self-protection would be to safely insulate us by becoming paragons of our own virtue. Where better to do that than in the sanctuary of our own surgeries surrounded by our patients.

Spending too much time alone with people who in the main, have self-inflicted injuries, may damage the physicians health?

With little or no real opportunity to halt the all too boring predictable cycle of clinical events in chronic care, not even with our "superdupernobodyunderstandstheart skills” we seek to vent our pent up frustrations on whom? Not out patients because they are our friends but that other group of disreputables, our colleagues. I believe we bash each other out of frustration, which is a natural compensation for the reclusive type of work we do. After all who would understand an insult better than another foot physician would.

In the end of course it is not our enemies we criticise, but it's ourselves.

Cameron
Hey, what do I know?

__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

During last summer, a new graduate from Queen Margaret University Edinburgh, came to work at my local NHS Trust, after completing four years study. He lasted three months and is now at Glasgow University studying Law.

Throughout the four years he was challenged and motivated by the syllabus and at graduation he was thoroughly looking forward to a varied and diverse career as a podiatrist. What went wrong? In his words, he was sold a pig in a poke. What was presented to him at undergraduate level bore little resemblance to the reality of the workplace. There was no support or mentoring for new graduates; his colleagues were hostile and uncommunicative and worse of all, there did not appear to be any professional development at corporate level that would give him the ability to realise the potential he had been given through his studies. Does this ring familiar?

Twenty odd years ago I recall an enthusiastic young lecturer telling me that the profession was standing on the threshold of something big; that within a few short years, we would be competing again alongside the dental profession in terms of status and rewards and respectability. If anything we have lost more ground.

I agree that frustration may be a factor in deteriorating professional relationships and that much of that frustration comes from having a system of practice that inhibits rather than promotes growth and establishment. But the greatest frustration comes from having a professional heirarchy that despite knowing what the issues are that prevent professional development taking place, are content to let things run or worse, to manipulate events to suit their own narrow ends to the detriment of the profession at large.

I certainly agree with Cameron's sentiments. I think there is a lot of jostling about because we are at the lower reaches of the health professional food chain (but by whose perceptions, she wonders?)

But I have a theory! (And now for a long drawn out Monty Python recitation...no, resist). As a profession we have experienced a rebirth in the last couple of decades. This has been made manifest by the change of name, the inclusion of pre-vocational training in tertiary institutions, and the increased scope of practice.

At first we were like children, eager to explore and expand our horizons. Right now we seem to be more adolescent. We have some understanding of where we are, but are reluctant to look back at how we got here. We are keen to push the boundaries, but instead of doing this by exploration, we are sulky and surly and trying (at times). Somes manic and fun, often serious and sensitive, and always fragile and moody!

We'll get there, adolescence is a trying time. We will form wee factions and peer groups among ourselves, and then launch gang wars just as quickly. But eventually ours will be a young adult profession, grateful and mindful of our history, and optimistic and organised for our future.

Like the second coming, will we all still be here by then?

cheers,

Felicity

B]Twenty odd years ago[/b] I recall an enthusiastic young lecturer telling me that the profession was standing on the threshold of something big; that within a few short years, we would be competing again alongside the dental profession in terms of status and rewards and respectability. If anything we have lost more ground.

Guilty. I also try to predict the lotto and football pools sequences but have failed there too.

In my own defense by the time I was in front of the class, I had practised in the private sector, worked in the NHS, retrained as a teacher in further education and had just returned from a two year post teaching experience as a Chief Chiropodist and enjoyed every minute. Of course there were barriers and it was certainly not easy moving (the family) as we did. Just ask the wife but it was doable and I genuinely felt to do the job in education justice I needed to have that experience. I suppose what I was saying obviously badly was chiropody does have its rewards as a career too. Sometimes you have to fight for it, I believe I still hold the record in the UK of three DHSS Variation Orders, all in my favour and a written apology from the then Minister of Health on behalf of his officers for trying to prevent my career path. Did little to endear me to establishment and it took a decade to claw back any respect but I did end oup with a meritorius award from the Society before leaving for NZ and Australia. So I certainly have never had a dull moment in my career.

But the greatest frustration comes from having a professional hierarchy that despite knowing what the issues are that prevent professional development taking place, are content to let things run or worse, to manipulate events to suit their own narrow ends to the detriment of the profession at large.

Now that I did not reckon for. Not guilty.

But I see where you are coming from and agree if we have an enemy it is within and not without and I believe , but hey what do I know, that enemy starts with A and ends in pathy.

John Head wrote a nice piece yesterday which I think is sympathetic to the dangers of an apathetic profession and the potential repercussions to 2a no action policy.2

What say you?

Cameron

__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

Of what - being a realist? I didn't think you were mistaken at the time and still don't. But changes in practice don't come about on their own. I think the mood in the profession was more enthusiastic and optimistic back in the 1980's - the Podiatry Association was a lot more than just a narrow interest group in surgery - and if the flair and ideas had been developed with the whole profession in mind, we might have found ourself at a different juncture to the one we find ourselves now.

It is always easy to state that one must aim high, but it is imperative that we remember this profession is as diverse as the needs of our patients. Core value chiropody is much underestimated and probably despised by a sizeable portion of people in this church. Modest aims are often not recognised as such but carry the danger of not being seen to be ambitious enough. It is always easy to push the boundaries at the cutting edge of development but if we do so whilst neglecting our core skills (and the patients who seek them), this profession will never reach its full potential.

Could it be that in the pursuit of academic excellence (or professional snobbery) we 'sell' the podiatry programme as something it is not and never could be in the current practice environment?

No argument from me Mark. Again I think John Head is saying the same thing in his posting.

I would like to be an adolscent with Felicity.... and before anyone of a gentle disposition complains about improperness

Felicity and myself are very old friends.

__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

I have spent the past 13 years wondering why I re-trained as a Podiatrist.

My first profession was as a Biomedical Scientists (Microbiology) and again twelve years into that career (which was going well) I decided to change profession. The reason! well mainly low self esteem. We were the "back room boys" of the NHS. Skilled, hard working, on-call and life saving work. It all went on furiously behind the Pathology department doors.

I must say that as a biomedical scientist I felt less appreciated than as a Podiatrist. Its the patient contact.
However, I think the skills demanded were greater in that role than as a Podiatrist.
hard to qualify but I guess its proven by the non-registered group about which I believe I know a lot.
Anyone can have a go at Chiropody and its how pleasant and attentive which seems to matter with patients. Some know a "silk purse from a sow's ear"
but many do not.
Couldn't get away with that in Pathology. Too many deaths!!

Agenda for change: Well here is a real eye opener.
My NHS Podiatry department has completed the process and in my opinion its a bit of a disaster.
We really know where we fit in the scheme of things. Our true value!

Compare yourself to a Doctor or Dentists. No you can't. They're not included
Sour grapes! No BUT

would I recommend taking up the profession.. Certainly not


SORRY


Mike Staines NHS and Private Podiatrist UK

Mike,

When I completed my Degree in Podiatry I went on to do a Masters in Medical Microbiology and during it came into contact with a number of MLSO's and I agree with the feeling of low self esteem amongst those that had worked in the UK but those working outside of the UK and most of my year were from outside did not seem to exhibit these symtoms.

My conculsion the NHS is to blame. Of course I maybe wrong and my year was only composed of people from about 40 countries European, African and Asian mostly.

My opinion on Podiatry is that I meet very few people working outside the NHS that have esteem problems, I know I was ready to give up the career within 1 year of graduating, now I am happy to recommend Podiatry as a career. How many jobs can you work the hours you choose and earn a respectable living.

I would recommend Mike that you take time out to visit other Podiatrists that are happy with their jobs, I am happy to meet with you and we can have a chat about why you are not happy and maybe what you can do about it over lunch maybe. The NHS is not the be all and end all there is a whole world out there that you haven't seen yet.

Thanks for your comments. I actually worked overseas as an MLSO for six years.
I agree the esteem problem was not the same. Perhaps the NHS has a lot to do with it.
Lets face it, money tends not to flow into Podiatry services. Its not so many years ago we were asked to cut down on the use of Cotton Wool to save money!

I said I wouldn't recommend Podiatry as a profession but did not qualify why.
I'm not so unhappy with my job believe it or not. There are so many reasons involved in my comments.

Remember I am both NHS and Private and I don't base my reasonong on NHS work alone.

To potential students of the next cohort I raise my hat. Go for it.

Thanks Akbal


Mike Staines