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The March '07 newsletter from the Podiatrists Board of Queensland was sent to us last week.

Quote:

"The title 'Surgeon' is also restricted to medical specialists registered with the Medical Board of Queensland. It is recommended that the appropriate title for fellows of the Australian College of Podiatric Surgeons is 'Surgical Podiatrist'".

In general I believe the QLD Board to be professional and conduct their business very well. However on this narrow issue I feel they are mistaken. I have written to the Boards Executive Officer to express my disagreement to their recommendation. If a Board recognises a College of Podiatric Surgeons, then surely they can recognise a fellow of that College as a Surgeon? I am not, nor plan to apply to the College. My opinon (an opinion is the cheapest commodity in the world, everyone has one), is that surely if an Opthalmic Surgeon is a Surgeon, and a Dental Surgeon is a Surgeon, then a Podiatrist who is a specialist in Surgery IS A SURGEON. Aren't we all "Surgical Podiatrists" anyway? I know we are just talking nomenclature but I feel strongly on the issue.

Hang on...I think my trousers are on fire!

What say you?

__________________
A bientot...

Julian
Podiatrist-at-large

I agree with your sentiments and in particular the query regarding dentists, who regularly refer to themselves as dental surgeons and quite correctly so. I should point out however that opthalmic surgeons are actually medical practitioners and so fall within the description used by the Queensland board, so I wouldn't use them as an example.
Interestingly, although dental surgeons were once able to do further training as oral surgeons who do maxillo-facial work, in the last decade or so an additional medical degree is now required and some of the four year graduate dental courses offer an additional two bridging years to facilitate this.
Just a thought.
I find there exists in certain quarter a tremendous professional insecurity. A colleague from the US asked me why we're not given the title of "doctor" here when the dentists are and we both use anaesthetic, prescribe alimited formulary of drugs, diagnose and of course perform minor surgery. My response was that I wasn't aware that anyone had ever actually lobbied for this in Australia. I'll be fascinated to hear if this is actually the case..

Unless you live in Queensland...

I'm afraid to say your efforts to express your dissatisfaction with the Board will fall on sympathetic, though ultimately deaf ears.

Unfortunately, the Medical Act (Qld) expressly defines who can and cannot use the title of 'surgeon' or 'doctor'. I have not heard that this applies (particularly for the title surgeon) in any other jursidiction anywhere else in Australia, or the world for that matter (although there was some debate for a period of time in the UK, but that has been fought and won).

Any health practitioner who is covered under a specific health practitioner registration act, or indeed provides a health service, may not use these titles, unless they are a dentist or medical practitioner, old hold an academic doctorate (to use "Dr"). Interestingly this does not apply to members of the public who do not provide a "health" service (eg tree surgeon, Dr Smith veterinary surgeon, roast beef surgeon, etc). Medical dominance over 'subordinate' professions??A very clever piece of legislation IMHO.

One must assume that the rationale is that the community can accept and hold confidence that a medical practitioner or dental surgeon are legitimate 'surgeons' - but any other health practitioner cannot use the term, lest they confuse the public that they can actually do legitimate surgery. Even if they do perform invasive surgery (ie podiatric surgery). Or they don't actually perform surgery (eg tree surgeon) - which is quite OK! Or they don't really do any significant invasive surgery at all (eg average dental surgeon).

"Where else but Queensland" ? The Smart State.

LL

In my shaky understanding of the situation, podiatry/chiropody in Australia was barely perceived as little more important than hairdressing when Medical and Dental Acts around the country were first drafted and going through revisions. We just weren't on the radar, politically or in the health system, decades ago when the opportunity was probably there.

In some respects we havent come very far since then either - in terms of legislative equality. In reality, the ACPS rather than 'podiatry' as a whole has generally been the only facet of the profession to lobby successfully against the tide and achieve legislative gains in their favour (eg restricted drugs, professional attention, prosthetics). They only represent 1-2% of the profession in this country, but have fought and mobilised themselves to a far more potent degree than the "other 98%" of the profession. Why should this be the case? I really don't understand. Lack of common goals?

It's all about fixing the squeaky wheel, or being apathetic. If we ALL lobbied hard enough we could change many of these things. Write to you local MP if you feel strongly about it. I know I harrass my State and Federal MPs whenever there is an opportunity to promote change - and it does work.

LL

In Victoria, the title doctor is not protected and anyone can give themselves the hounory title Dr. You just need to ensure that you are not holding yourself out to be a medical practicioner. The Podiatrists Reg Board of Vic does have a policy on the use of the title Dr recomending that it only be used by those with academic qualifications (PhD or Professional Doctorate) or those who have had the title granted by a professional college, but this is not enforcable. The national registration currently being discussed in Australia should resolve the Qld Surgeon issue, as national consistency will prevail.

From what i understand the history in Qld to restricting use of the title surgeon came about from a dispute between plastic and cosmetic surgeons, with the Plastic Surgeons all FRACS claiming that cosmetic surgeon not FRACS were not appropriately qualified and every one else got caught up in it.

LL

I tend to disagree with you here. Back in the happy 70's the profession lobbied succesfully around the country to allow Pod access to LAs. Plain film imaging was sucessfully lobbied for some 10+ years ago for all podiatrists, and yes we now need access to more. Medicare plus has been another step forward for podiatry in the last couple of years, and the prescribing by podiatrists is moving forward with Victorian legislation allowing all appropriately qualified pods to prescribe. There have also been the lobbying of health funds to improve rebates for an expanded range of podiatric procedures over the past 20 or so years, so while things may have slowed a bit it hasn't just been the surgeons making inroads for the profession

__________________
Stephen Tucker
Eastern Health
Podiatry Manager

My location

Steven

The Medical Act, as far I as I can tell does not restrict any medical practitioner group (ie cosmetics) from using the title surgeon - it is more to do with who is a "specialist" and who isn't. In the booming cosmetic surgery market in Queensland I am yet to see any cosmetically-trained medical practitioner not using the surgeon title.

Sorry to be a little skewed in my comparison of the ACPS activities and the general profession - I do recognise the important gains over the past 20 or so years. It just surprises me that there has been a disproportionate amount of legislative wins achieved by a tiny interest group, relative to the resources of the massive majority of the profession, which represents the interests of 'non-surgical podiatry'.

My only guess is that this tiny group might not be weighed down by so many competing interests, allowing it to focus and act on its objectives with greater effect?? Just a hypothesis - but an interesting professional sociological engima to chew over no less.

LL

LL,

Thanks for your informative take on the vagaries of the QLD system.

I wonder why the Board is making this "recommendation" when according to your information, they have no choice?

Secondly, I wonder how the Chiropractors and Osteopaths are not prevented from using the honorary title "Doctor". I am friends with several and am unaware of any defending themselves from any Boards for transgressing (!) the medical act of QLD.

__________________
A bientot...

Julian
Podiatrist-at-large

Julian

I too am astonished and bewildered that this continues to occur.

In fact the Chiropractors Registration Board (Qld) publishes the names of all of its registrants on its own government owned and managed website (at least time I looked) with the title "Dr" - a flagrant breach of the Medical Act by both the Board and the profession itself.

However - if a podiatrist/surgical podiatrist were to do this - warnings and prosecution would/have occured.

LL

looking at your post. wow, you have problems. If only you had a government as we do in the US. What's a tall poppy? robert bijak, dpm

Robert DPM, DABPS,

Wow, forgot about that post - two years old, you must have really dug through the archives.

Yes we certainly have problems here in Australian health care - no argument. What distinguishes many Pods here on Podiatry Arena is that they are willing to engage in discussion/debate (often heated, usually good-natured) and accept criticism where it is merited. It appears from your earlier posts that perceived criticism against anything American elicits an animated response - that is your prerogative.

As for your Tall poppy comment, it reminds me about a kid I went to School with. He would tell anyone and everyone about hid Dad's new Mercedes, or his trip to the Caribbean, or his house being worth 'x' dollars etc. When he started to lose friends because of his incessant bragging over his 'superiority', he lashed out and accused all and sundry of being jealous of his success. Last I heard he is now an accountant and ensures that all of his business cards/letters/emails list every single degree, certificate and acronym after his name. I Guess it reminds him of how important and 'envied' he is? Sad story isn't it?

Have a nice weekend!

__________________
A bientot...

Julian
Podiatrist-at-large

did that cryptic story answer my question? you are not very clear and direct.