Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

£12 DOM fee

Discussion in 'United Kingdom' started by Cambs Pod, Feb 12, 2014.

  1. davidh

    davidh Podiatry Arena Veteran

    In the past I have advised both FHPs and Podiatrists not to go straight into dom work.

    But why do you think I support the training of FHPs?
    Do you think I actually take part in their training, or do you believe that the fees paid to my professional body supports the training of FHPs?
    Just wondering....

    I've pointed out the realities of working in a sector of the UK foot industry. If someone really wants to waste their time and training doing that sort of work they can knock themselves out.

    Anyway, shouldn't you be at Med School or something by now - or was that someone else on here:confused: .
     
  2. tonywatson12

    tonywatson12 Active Member

    what sort of fhp do you train?
     
  3. davidh

    davidh Podiatry Arena Veteran

    I don't.
    Never have.

    Your question is stoopid.
    It reminds me of why I don't come on here as much as I used to. That, and the troll post (40, this thread).
     
  4. tonywatson12

    tonywatson12 Active Member

    you ever worked in the NHS?
    might be stoopid but all the pods i know train Foot care Assistants as part of our role
    But i guess as far as doms and you go the people that do them are less qualified then you!!
    and of course it would be beneath you to even consider it!!!!
     
  5. davidh

    davidh Podiatry Arena Veteran

    Your post is incoherent. And I didn't say you were stupid. I said your question was stupid, but I spelt it wrongly so that you might see I was being a little tongue-in-cheek.

    Yes, I've worked in the NHS over the years. Yes, I've trained Support Workers to cut nails.

    I really don't want to get into a discussion about this.
    I don't care how skilled or degree'd-up a Pod is - he/she simply cannot do more than palliative care safely in a dom environment. And that not as well as in a clinic.

    I've done plenty of doms in my time - cut finger-nails too:cool:.
     
  6. tonywatson12

    tonywatson12 Active Member

    what is your clinic charge for routine work do you charge in your area?
    how does that compare to others in the area.

    I agree with your comments but some one needs to do it and we all cannot afford to start practices in surgery's.
    You must agree that in podiatry (private sector) patients are normally routine and most can have adequate care provided in the home environment.
    I guess you don't do 5 days of minor ops all the time?
     
  7. Podess

    Podess Active Member

    DH,
    You said

    Why are you so bothered about what I think if I am a mere "troll" ?:confused:

    I never mentioned Med School, plase try to keep up.

    Now that is a fair and reasonable question from TonyW. Are you going to answer it or is that beneath you? :confused:

    Podess.
     
  8. davidh

    davidh Podiatry Arena Veteran

    I don't have a clinic. I do some work in various private hospitals.
     
  9. Fliss

    Fliss Active Member

    Personally, I think everything through the best I can, problems, consequences, the lot... I have thought about, considered and properly looked at every option open to me.
    You presume that pods haven't first looked at other options before doing dom work. A town, city or county can only support so many practices. With (until very recently) no nhs jobs in my or any other area I would like to practice in, then all there is left is dom work, because I would say most pods post grad can't afford the cost of setting up a practice, especially after spending 3 years at university with obvious debt in tow. This is the key point really, it's about having limited options, rather than being lazy, I'm sure we would all love to have our own private clinics but it's not always possible financially, so doms it must be..... and I'm certainly grateful for them and appreciate the need for them.


    The clinic market is also awash with competition and in every walk of life or practice there is always going to be competition, there is simply no getting away from it.

    To be honest, the only major issue with doms is that you can't do minor surgery because of the need for a sterile environment, most other tasks can be performed, even if not as easily as in a clinical environment.

    From a practical point, yes it is easier to purchase the necessities for dom work to get started, but you are still seeing patients and applying the knowledge you have gained as you would apply it in a clinic. So, I don't agree it is lazy.... but often a necessity due to limited options.
    I left university with a first class hons, was raring to go and use my new skills in the NHS... then no NHS jobs in my area or even close by (this was approx 4 years ago), no way I could set up a practice, no spaces in private practices to work as an associate (moving wasn't an option then) so what was the alternative? Doms. Either do doms whilst waiting for an NHS job/opening at private practice/money tree to grow?? ha, or lose my skill. There was no choice.

    Living where you do, and where I have lived for 25 years (until recently), you surprise me that you say it takes little planning or thought. Powys can be a sparse location for doing dom work, with a lot of travelling on bad roads, in bad weather to remote locations. Doing research, gaining and reaching patients is 20 times harder than sitting in your clinic waiting for the doorbell to go or phone to ring.

    So, to summarise, I don't agree it is the lazy way out at all, it is the essential option for those who are in that position. Anyway, you don't work your butt off at university to just take the easy way out. This honestly isn't personal, and I realise you are probably way more experienced than me, but I hope you take my point of view on board because it can feel like you're being tarnished........
     
  10. davidh

    davidh Podiatry Arena Veteran

    Hi Fliss,

    Everyones circumstances are different, and doms may suit some people. I don't have a problem with that. I just recognise the drawbacks of dom work, from experience.

    In the good old days some Area Health Authorities would pay per head for their backlogged doms to be sorted out. The equivaient of £30.00 or so in todays money. Twelve doms were very easy to do after a clinic session, and worthwhile too.
    But the drawbacks I've outlined were still there.

    Geographically Powys would be a nightmare to work doms in, as you rightly point out. There is one Pod in Builth Wells who charges a decent fee and does good business. She does a few doms but is mostly clinic-based.

    My work takes me to the Midlands, perhaps once a week. Much of my work is clerical though, and that I do from home.

    With a first I assume you looked at the other options which might be open to you?
     
  11. tonywatson12

    tonywatson12 Active Member

    so you have no recent experience in the nhs or doing home visits?
     
  12. davidh

    davidh Podiatry Arena Veteran

    Are you suggesting that dom work has somehow changed:D?

    I have some recent (2013) NHS experience, but not hands-on clinical.
    You?
     
  13. horseman

    horseman Active Member

    Or painted nails for £40+:bang:
     
  14. horseman

    horseman Active Member

    Treatment time plus travel time is equal to two surgery appointments plus travel costs...:eek:
    The only doms I will do are for the genuanly housebound and they don't pay double more like 1.5x I do it because many have been long term patients of mine.
     
  15. horseman

    horseman Active Member

    Ah! but the best bit is when they tell you a long story about how bat the other person was at £12 and then object to your fee.:craig:

    Frankly there has always been competition and as always you win by being better, that includes selling yourself. You won't win them all though.
     
  16. tonywatson12

    tonywatson12 Active Member

    21 years nhs with part time private dom practice and agency.
    yes dom visits have changed as people get older and the increase in diabetes.(more care at home)

    Also changes in the HPC reg and as you point out other types of people doing foot care have made things a little harder.

    You know what gets my goat is the way people compare us to hair dressers taxi drivers cobblers etc.

    supply and demand its as simple as that (to many pods to little work)

    nail cutting is nail cutting and people will always think of it that way a corn is a corn and people will always think its an simple easy thing to treat.

    How do we get them to think of it as a dental procedure or medical procedure?

    after all you can buy corn treatments but I don't think you can buy root canal kits!

    I have always wanted to see the closure of our profession as felt it was the only way to get control of fees and gain more respect

    do you think a price guide would work?
     
  17. Cambs Pod

    Cambs Pod Member

    Horeseman,

    As Arkwright said in "Open All Hours". "Granville get the customer through the door to see the difference"

    The biggest problem is getting people through the door to see the difference in standards of treatment.

    I would argue that a diabetic attending to have their toe nails cut, who has a thorough neuro vas assessment also, together with PREVENTATIVE limb saving advice, is worth far more fee wise than a diabetic who just has their toe nails cut.
     
  18. tonywatson12

    tonywatson12 Active Member

    ah
    the fax refs I see coming into many nhs dept all around the uk from gp and practice nurses read
    "new diabetic need nails cutting" umm yep we are very respected for our skill.
    On the other hand I was working with a foot salvage team were the respect is massive.

    In the private dom practice I have, the 1st words patients ask is how much do you charge
    it is at this point what you say will determine if you get a patient but you have to convince them they need to pay you more then other foot health providers
     
  19. horseman

    horseman Active Member

    I agree, but the message needs to get to the prospective patient. The problem (and resultant arguments) has been with us for as long as I've been in the profession. (SRCh or not, HCPC Poditrist or FHP etc.) I would not treat a domicilliary patient for £12 or even £30 as it wouldn't cover my costs (SE Engalnd practice). Private practice requires many hats and advertising yourself and the profession is just one of them. Personally I love my work but that does not mean I'm prepared to work at a loss.:drinks
     
  20. blinda

    blinda MVP

    Tony:

    I think you make some valid points and ask pertinent qustions..…however, I often struggle to grasp the gist of your writing as it is often incoherent. So, with respect, could you please utilise punctuation and grammar in your posts?

    Cheers
    Bel
     
  21. Cambs Pod

    Cambs Pod Member

    Was listening to 5 Live's money programme.

    A top business advisor said that "what something is worth is what a customer is prepared to pay for it at the end of the day."

    I heard another business advisor say this.

    With plumbers dentists, locksmiths, they aren't prepared to work for pittance , where as some individuals in this profession are.

    And the customers know that they are going to have to fork out BIG money to a receive the services of a plumber/dentist/locksmith.
     
  22. tonywatson12

    tonywatson12 Active Member

    hahaha
    doz not na wot yee on aboot!!

    what bit do you want me to change bel!
    Never liked grammar but will try harder!! :dizzy:
     
  23. wdd

    wdd Well-Known Member

    Good advice if you can or have surmounted more of the barriers to entry but if your on the bottom rung following the above advice may well lead to penury and professional suicide.

    My advice. Do your best to climb a few more barriers and as you swing your leg over try to raise each barrier higher behind you. Otherwise the versatility of Mark's hairdresser has a lot to recommend itr?


    Best wishes,

    Bill
     
  24. tonywatson12

    tonywatson12 Active Member

    I love that word incoherent is that like been ******?
    coz most of the time you have to be to read the crap on here!!!!!
     
  25. davidh

    davidh Podiatry Arena Veteran

    This post certainly sums up some of the views on the thread:D .
     
  26. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    I know that this is stating the bleeding obvious, but there was a comment earlier in the thread re the need to take a medical history etc at the first appt .... I see in the HCPC hearings for next week that a podiatrist is up for a hearing and one of the allegations is
    therein is the irony. If you are registered with the HCPC you have to do it; if you are not registered, then you can get away with not doing it .... sorry for stating the obvious.
     
  27. blinda

    blinda MVP

    Stating the bleedin` obvious
     
  28. wdd

    wdd Well-Known Member

    The reason plumbers, dentists, locksmiths, electricians and many others command high incomes has nothing to do with them being people who are 'not prepared to work for a pittance' and everything to do with the fact that the barriers to entry to these occupations are significantly higher than those of podiatry.

    Bill
     
  29. tonywatson12

    tonywatson12 Active Member

    Hi david
    sorry for the post, something to do with beer!
    I must remember not to go on pod arena when drunk!!!

    yep we are screwed!
    did you see that correspondence foot health practitioner course run by a set up called stonebridge? whats that about? how many other places "train" foot carers?
     
  30. horseman

    horseman Active Member

    a quick google finds https://www.stonebridge.uk.com/course/foot-health-practitioner-advanced

    They even have "professional association":rolleyes:

    HCPC?:sinking:
     
  31. davidh

    davidh Podiatry Arena Veteran

    Yes, but they aren't the problem. The problem is that nail care is easy - we all do it to ourselves.

    If you want to do doms you have to accept that some of them will be nail care, and your competition will be (in no particular order), the well-meaning friend, Age Concern, FHP's, the spouse, the other Pod down the road who works for the NHS and does a bit on the side for peanuts.

    No-one can blame patients for not recognising that we are good at spotting problems, or that we can write a research project, or the Stonebridges of this world who train their people a little better than Age Concern.
     
  32. Suzannethefoot

    Suzannethefoot Active Member

    ooops! seem to have posted this twice
     
  33. Suzannethefoot

    Suzannethefoot Active Member

    Having a dom practice in not a lazy way out! It is a necessity for those of us who have very little money when we start out.
    More openness about prices charged, on websites etc, would help. If you are setting out and are trying to assess what to charge and all you get from patients is, 'ooh that's a bit expensive dear!' Then you may begin to believe them. If we all published our prices on our websites and other adverts, it would be much easier to gauge the average price an area charges.
     
  34. davidh

    davidh Podiatry Arena Veteran

    I know the justifications for dom practice - I stand by what I wrote.
    It is a very hard way to make a living.
     
  35. Claire72

    Claire72 Active Member

    Hi David

    You wrote above 'It's a lazy way out, and its full of low-priced competition', with regard to building a practice on dom care, and I wonder if you could explain further please. (Its not a loaded question).

    Kind regards

    Claire
     
  36. Claire72

    Claire72 Active Member

    Hi again David

    Ignore my last post, as I have now read the remainder of the thread and now understand :eek:
     
  37. davidh

    davidh Podiatry Arena Veteran

    No problem.
     
  38. Suzannethefoot

    Suzannethefoot Active Member

    If it's a very hard way to make a living, how can you say that it's a lazy way out? It took me 11 years to be able to afford to open a surgery, and then only with a loan. I always intended to have a surgery, but having absolutely no money when I started out it was not an option. Please explain why you think it is a lazy option.
     
  39. davidh

    davidh Podiatry Arena Veteran

    Hi Suzanne,

    Please see my post 39, this thread, for a full explanation.
     
  40. Claire72

    Claire72 Active Member

    Hello again David

    In your response to Fliss, who stated she received a first, you asked her if she had considered other options open to her, did you mean options outside Podiatry?

    I know that it appears I am your creepy stalker....but I tend to look to your posts as the voice of reason - even though they sometimes make my eyes sting! (Suzanne, if you look back further you will see David's explanation of the 'lazy' comment.)

    I qualified in 2011 and haven't practised since apart from around 6 months in private practice. I am now looking to go back into Podiatry coz I love/miss/need it, but am in a position where my options seem to be bits of associate work, or setting up my own dom practice with no finances available to set up a clinic at present. There are no NHS vacancies local to me. I have thought of perhaps a move towards teaching, but I do love lower limbs. I wondered if you were me/my dad/my husband would you encourage me to stay or move away from Podiatry?

    Kind regards

    Claire
     
Loading...

Share This Page