Dr Podiatrist?

Hi Julian,

Thanks for responding to my previous post, I’ve enjoyed reading your posts on this thread … in response to your query:

I agree that medicos may have reasons for a defensive response, however their inclusion may benefit the survey by providing more information to work with. It has also been suggested that their views may not be negative … but without inclusion, we would have no evidence either way. Their involvement in the survey population would ensure representation of the professional group that is most likely to have a response to the title adoption.

Inclusion may demonstrate a prudent professional attitude, which may do much to foster future relations. Additionally, it may be an opportunity to present the details of the proposed use of the title…. that we have scrutinized the issue carefully.

We would not base our decisions on their perspectives, but could use their involvement to obtain useful information.

Just my ideas though ……

Cheers,

Andrew

 

Aha, now I get it !
Yes Andrew, an excellent idea.

So can I paraphrase you and suggest that you want to examine the "Dr' proposal, not from a position of 'competition' or 'antagonism / enmity' but instead from inclusion and engagement ?

That might just be crazy enough to work actually. If I read you right, you take an opposite approach from the Chiropractors / Osteopaths who often (but not always) seem to have a professional gulf to the Medico's. It appears as if you just may be suggesting a 'closing of the ranks' between Pods and Medico's ?

Kind of like making friends with the School Bully?

Still, I am not too sure, what possible reason they could have to support us encroaching on what is often perceived as their professional title, indeed, they use the title as a virtual job description.

Good reading your posts too, and with only 2 exceptions, I enjoy reading all forumers posts on this threads, isn't the ignore feature great !


I am working on a Masters thesis since 0530 this morning.....nearly time for a glass of MadFish I dare say !

have a great weekend...

:drinks

 

Thanks Julian, that would be my approach exactly …… in my view this would be the best way to go about it. An inclusive cross-sectional survey may be a positive step forward on this issue….. and we wouldn't be asking for their support, just their perspectives.

Good luck with your thesis ….. and the ‘MadFish’ !!

andrew

 

Thank you, a. mcmillan,

This was a very useful post! Is there any other information like it? And if possible would you be able to post the link?
Cheers for the ifo,
Dr. Sal (Podiatrist)

 

Hi Sal,

There were 8 'letters to the editor' published within the British Dental Journal between 1989 and 2000 on this issue. Unfortunately only the most recent is available electronically, this is the one I posted previously after registering as a guest with the journal. I think the others would be very interesting, but i don't currently have the time to obtain hard copies, scan the letters and post them on this thread. However, Melbourne University has the hard copies in their biomedical library, and if others are unable to obtain the copies and post them here, I will do so when I have more time.

Harrison. (2000). The title ‘Dr’ for the dentist. Br Dent J. 189: 466-469.

Ferraris, S. (1995). Call me doctor. Br Dent J. 178 (8): 286.

Pike, D. (1993). The title ‘doctor’. Br Dent J. 174 (2): 467.

Farrell, T. (1991). The title ‘Dr’ for the dentist. Br Dent J. 170 (9): 323.

Nil author listed. (1991). The title ‘Dr’ for the dentist. Br Dent J. 170 (7): 252-3.

Waters, S. (1989). The title ‘Dr’ for the dentist. Br Dent J. 167 (10): 333.

Nil author listed. (1989). The title ‘Dr’ for the dentist. Br Dent J. 167 (8): 264.

Fortune. (1989). The title ‘Dr’ for the dentist. Br Dent J. 167 (5): 157.


I have pasted below an article published in the New York State Dental Journal in 1998 on the issue (and attached in PDF), it appears to be written by a lawyer who is providing legal advice to dentists on the use of the title in New York State:

Hope this is useful !

Regards,

Andrew

 

Hi Andrew,
Thanks a million for the very useful info!!! It seems that the crux of the issue revolves around making sure one specifies their profession following their name......Dr. Joe Citizen (Podiatrist) etc..........
Once again, thanks for the info!!!
Cheers!!

 

Interestingly, it appears that chiropodists in America were using the prefix 'Dr' as far back as 1940.

Below is a letter from the Attorney General of California in response to queries about chiropodists using the 'Dr' title, as published in California and Western Medicine:

 

Hi All,
The latest on the use of the title!!

NATIONAL REGISTRATION AND ACCREDITATION SCHEME
FOR THE HEALTH PROFESSIONS

Rather than protecting multiple titles for a profession (or sub-profession), the approach is to protect only those key titles commonly used by the profession, and to include a catchall provision that allows a board to prosecute a person who might be ‘holding themselves out’ as a registered practitioner in a regulated profession.
Proposal 8.1.1: With respect to the use of courtesy titles, such as the title ‘doctor’ or ‘professor’, it is proposed that these not be legislated as protected titles, nor reserved for use only by members of one or a number of regulated health professions.
Therefore, unregistered persons using such titles would risk prosecution only where use of a courtesy title could, in the circumstances, lead others into believing the person is qualified and registered under the Act in a regulated health profession when they are not.

The regulation for Prescribing rights is also oulined!!!! And it looks very promising!!!

Thanks for the link LL,
Cheers,
Dr. Sal (Podiatrist)

 

G'day all

Well it's all quite clear that we can use title, and obviously some people are, wich is great if that what one feels they want to do, but as has been said earlier, what we need is to move as a whoel body towards this, find a point of agreement for everyone, and maybe national registration is the time to do it, and do it as a blanket all of Australia thing?

 

I don't think it can get any clearer than this! And i agree with you, Adrian! I think National registration is the time to make a few changes! Very exciting times!!
Cheers,
Dr. Sal (Podiatrist)

 

Hi Julian,

Apologies if I took you out of context - it can happen in forums - as I have found myself!

I suppose I inadvertantly used your comment to make a point that we need to be aware that our profession is under constant threat in an increasingly competitive and non-regulated market and if assuming the title of "Dr." helps distinguish our level of expertise from the plethera of unqualified "nail-cutters" and "foot carers" then I can't see how this can be a bad thing.

Again apologies for any offence. Keep up the good work and input!


Toe Jam.

 

Andrew,

No apology necessary I now see where you are coming from.

Just wanted to point out the those earing their Phd have done so through their academic achivements - not the sacrifices and efforts they have made for themesleves or the profession.

That is not to say that I do not respect, applaud and acknowledge the importance of those doing or who have done so - as I do for all of those who have sacrificed a lot for their profession and have not qualified with a Phd.

Toe Jam.

 

Sal,

While the National Registration will set the framework for prescribing, and attempt to standardise the process etc. State based poisons legislation needs to be changed in states where prescribing is not yet allowed for prescribing to occur. None of this will be sorted for a period of time after the July 2010 start date.

But July 2010 would be a good date to aim at if the whole profession is to begin using the Dr title, as it will be legal across the country then.

 

Andrew/Julian,

Not a bad idea in theory - lateral thinking and cerainly worth considering I too am more than a liitle bit cynicial as to how the Medicos 'overall' would react - but if they are going to be against it either way - maybe embracing them in the early stages is woth exploring!

Toe Jam

 

Hi Adrian,

I agree it would be ideal to get the whole profession to move towards this. However given that clearly a significant percentage of the profession either feels that they "CURRENTLY" do not want to adopt the title, feel we are unworthy or simply think it is unneccessary exaclty how are is this going to happen?

For example if a board or professional body chose to advise or recommend this would straight away create devision amongst the profession for obvious reasons.

Exaclty how can you "make" someone who does not want to use the title do so? For that matter also stop those that can legally use it? Very difficult.

Yes this would be ideal - but it would take a big call especialy this early in the piece - and I agree it would have to wait until National Registration.

Personally I think it needs time to develop and for Podiatrists to come around to the idea. I am sure you will find over time many objectors will warm to the idea - and find that they will reluctantly come on board.

Regardig the POLL - it would be intersting to know what percentage of the "NO" voters are from outside VICTORIA - where legally they can't use the title and what percentage of the YES voters are from Victoria!

Just curious!

Toe Jam

 

Hi Toe Jam,
No need to apologise!
I assumed that in all probability, after 240+ posts, we all 'blur' into one another.

Its great to have another supporter here, and I echo you notions that we as a collective, often seem happy to 'beg for crumbs' at the health care table. We seem to suffer from a generalised self-sabotage (except the Surgeons). TIME TO CHANGE...

Andrew's suggestion is intriguing, to say the least, but like yourself, I can't really envisage why the Medico's might support us. Nonetheless, he suggests inclusion and consultation, purely for informations sake.

Strategic liasons such as at UWA with my old lecturer Alan Bryant, are a breath of fresh air, and serve nothing but good, to identify us with the Medical Profession.

Please keep posting...
:drinks

 

Hi Toe Jam, the "unworthy" word. If you mean by this that the "nay" podiatrists believe that, along with all other non-PhD persons, podiatrists (non-Phd's) are not entitled to use the title, then fair enough. If you mean something else please set me straight. Thanks, mark c

 

Hi Mark,

Sorry, I am not sure exactly what it is your a querying from reading your post. I will try and explain where I am coming from with my coments and hope it provides the answer.

Essentially through many discussions and from what I have read there are many Podiatrists (with and without PhD's) who feel that Podiatry graduates with "undergraduate" degrees do not have the skills, knowledge or feel that their current qualification makes them "worthy" of adopting the honorarary title of "Dr." as compared to he skills of some other health professionals who have.This is why they won't adopt it.

I have shared my views on this already - but for what ever reasons, as a profession, I feel we generally suffer from lack of self esteem. At the same time, for what ever reason many of these practitioners may simply be working in an environment where they are not applying or challenged to apply the full range of skills that Podiatrists are trained to provide and maybe they feel that they need to reach such a level before they feel comfortable using the title. Is this a bad thing? If these Pods feel the need to better themselves or the way and environment in which they practice before they choose to adopt the title then this can only be a positive step for the profession in my opinion.

Accordingly, there are many Podiatrists who think we are worhty - however don't want or feel it is necessary to use the title or for other reasons feel uncomfortable doing so. Again this is their choice.

Of course there are others, such as me, who have felt worthy of adopting and subsequently using the title based on the skills, procedures, qualifications and work environemnt I have currently have and that I apply daily. That is my current choice in Victoria.

I hope this helps answer your query!

:morning:
Toe Jam

 

Wow.

Aaron/Toe Jam, I find this comment very naive.

There are lots of activities that define the profession, beyond clinical practice. These include advocacy and work within professional organisations, but also include teaching of undergraduate Podiatry students, and research.

Podiatrists who undertake higher degrees, including PhDs, have made substantial 'sacrifices and efforts' to ultimately benefit the profession.



Dr. Adam Bird, PhD
Acting Head of Podiatry
La Trobe University

 

Dear Saleh,

no, I think many people would perceive the crux of this issue is individual Podiatrists self-titling themselves. In comparison, the 'worthiness' and medical dominance issues are far less important.

I have read through the pages of this discussion, and the considerable angst and sensitivities that surround the issue could be overcome if the 'renegade' Podiatrists worked in a reasonable and professional way to achieve their aims. Like Adrian, I believe that the best path would be to enlist support of the majority of the profession.

The response to the question posed at the start of this thread is likely to be biased (potentially to either answer). There are a number of posters in this forum who are board members for the APodA(Vic), and are in a position to organise a general questionnaire to gauge the thoughts of Victorian members on this issue. I believe this should be the first step to to resolve this issue.

Sincerely,

Dr. Adam Bird

 

Thanks Toe Jam for the reply,

... that's clarified it. I see it as not a matter of worthiness or not. Obviously we have skills/knowledge, some far greater than others, that make us great, the best, at podiatry. I don't see the use of the title as a mark of worthiness, I just see it as a title used historically by the medical profession for yonks. It certainly doesn't make them more worthy than non-title using professions, just convenient for everyone, patient and clinician.
An aside, which actually appears to back your point, to clarify my position on this and related issues; 20 years ago in a large public hospital "group discussion" (forget the correct term) where a patient would sit-in on a multi-clinician discussion of the patient's case, the co-ordinator, a nurse, would initially introduce the pt to the group, commencing with "Dr ......", a physician who being the primary carer was first in line, fair enough. Then the nurse introduced everyone else by their first name/surname. This seemed to me to show disrespect to the other clinicians so I requested that in future the other clinicians be introduced as Mr .... or Ms .... etc. I was subsequently dropped from the team. It still occurs, as everyone probably knows from experience.
I hope I haven't confused you further , all the best, mark c

 

A PhD holder (not necessarily Dr Bird) could feel somewhat 'miffed' that a colleague may not have done the hard yards to use the Dr title. If I had a doctorate I would probable feel the same. The same goes for 4 year undergraduates you are entitled to a Podiatrist title, and might feel the same about a TAFE graduate from years ago with substantially less academic credentials.

However, we are talking about the use of a courtesy title, and have deviated into the realm of the perception of podiatrists in the community.

I agree with Dr Bird that a survey initially in Vic, then nationally, could be very worthwhile.

However, like most of the referenda proposing change, I would assume from the outset that most respondents will vote in favour of the status quo. It is human nature.

LL

 

Adam,

Not sure exactly what point you are trying to argue.

I agree with your statements/comments entirely and have stated as such - so what are we arguing about?

I am also stating that many others within the profession (who don't have PhD's) have ALSO made substantial 'sacrifices and efforts' to ultimately benefit the profession. Which is a fact.

I also making the point that they don't hand out PhD's purely for good works and sacrifices made for a profession but for their academic acheivements - which is true - so what exaclty are you saying I am being naive about as we seem to be in agreeance on this particular matter?

As for the board doing a survey - what exactly are you hoping this will achieve that we don't already know from reading this forum other than the fact that it is devisive issue and that no matter what the result may be it will not change the fact that the law allows those that want to use the title in Victoria to do so and those that do not want to do not have to.

Personally I don't have a problem with doing a survey and presenting its findings if that makes people/you feel better. But having said that we may as well simply print this entire forum and place it in the newsletter - the result will be the same.

Toe Jam.

 

Dear Aaron/LLisfranc,

well, therein lies the rub. Many posters on this forum belong to the professional union (the APodA), which works best when there is strong support for issues that relate to the Podiatry workforce.

This forum isn't representative of the general podiatry profession. If you want the support of the profession, you at least have to ask them as a whole, and to be prepared for the discussion to be an extended one.


Adam

 

Thanks Mark,

Interesting comments and I have encountered similar experiences working in collaborative groups with "Dr's" whereby they would get paid handsomely for being involved in such groups whereby the "allied health" practitioners are treated like second class citizens and equally when raising this issue was ignored.

As you suggest this could provide further argument for us assuiming the 'honorary' title if not for anyhting other than for fairness and equality. It would be a nice world if this was unnecessary.

I agree it is not a matter of worthiness - but unfortunately this is the word that has come up in discussions with colleagues and I also agree it "should' not be an indication of other professions being more (or LESS) worthy than another as you suggest.

Unfortunately, in the public arena, my experience has taught me that historically a large percentage of ignorant clients do place an element of 'worthiness' of the title in the clinical setting and they subsequentally do judge our profession by this to some extent.

Toe Jam.

 

Dear Adam,

The issue, in my opinion, has very little to do with Podiatrists "self-titling" themselves. The fact that the APodA (Vic) has left it up to the individual Podiatrists' discretion clearly shows this. It is up to the individual.
Using the title (and supporting its use) is not wrong and if people chose to do so does not make them a "renegade" Podiatrist. They are simply voicing and implementing their opinion.
There is no opposition when it comes to obtaining the opinion of Podiatrists within Victoria. It would serve well.

Just my Opinion.

Sincerely,

Dr. Saleh (Podiatrist)

 

Hi Saleh,

my understanding is that this discussion has not even properly started yet within the APodA(Vic). One subset of the board has put forward the issue for discussion, but the issue has progressed no further.

Please advise if this is incorrect.


Adam

 

Hi All,

Although I am a supporter of the Dr title for podiatrist, I will not use the title until I am encouraged by the APODA to do so (as we are aware the most recent APODA bulletin stated that the APODA neither encourages or discourages the use of the title).
As Adam said, a survey would be the best option, as once all the opinions are in, the APODA may then encourage (or discourage:boohoo the use of the Dr title.We could then introduce the Dr title as one united profession:boxing:.

Cheers

 

Hi Adam,

Who says the board has not progressed further? Just because the board has not instigated a survery does not indicate that no progression has taken place or any background work is being undertaken or communication being made on this particular issue (as well as many other issues that may be considered more a prioirity than this one at the current time).

The fact is that an opporuntiy already exists and has been invited by the APODA via "letters to the editor" for anyone wishes to provide comment to APodA (Vic.) on the issue which I htink is a good start and allows open discussion.


Toe Jam

 

Hi Adam,
As far as i am aware, the APodA (Vic) changed the wording in their policy (regarding title) which enables Podiatrists to use the title if they so wish. Im not sure if they have discussed the issue further.
To the best of my knowledge, this is the only discussion going on regarding the use of the title (correct me if im wrong).
I am, therefore, going on what is most recent. And my choice is to use the title.

This really is a great forum. Please keep up the brilliant posts.

Sincerely,
Dr. Saleh (Podiatrist)

 

G'day all,

I think a common consensus vote across all podiatrists woudl be a great idea, as we all seem to agree, this needs to be a blanket implementation if we are to make this move. However I ask the point, what about the rest of podiatrist who aren't A.Pod.A. members? And since this is a change of title, I'd saty it has more to do with the A.Pod.C and the registration board, and this needs to come from them and surgey ALL podiatrist practicing in Australia, not just a select few who are A.Pod.A (Vic.) members. Send it out with the registration I say.

?

 

Not to harp on about an old point, but as I suggested earlier, if we are going to do this, and do this as a whole professional body, lets make it part of a bigger move, and cement our right to title.

As I said earlier

Lets not do it in dribs and drabs, with some using the title and others saying no and disagrements and confusion and all the rot. If we are going to be Dr. Foot (podiatrists), lets make it worthwhile, and lets make it reasonable and unquestionable by other professions.

 

Hi Saleh,

Sorry to correct you - but the APodA (Vic.) was not responsible for the wording of the Policy - this was the Victorian Regsitration Board's responsbility. They are the governing body that determines the laws to which Victorian Podiatrists must abide - not just those who are members of the APodA (Vic.).

APodA (Vic.) was merely forwarding this information on as it was thought to be necessary and of interest to Victorian members.

Hope this provides clarifaction.

Toe Jam.

 

Thanks, Toe Jam, for the clarification. Much appreciated!! BTW i have enjoyed reading your previous posts!!! Very insightful.
Cheers

 

Hi Adrian,

Yes it would be ideal for the whole profession to embrace it accordingly - just not sure how a survey can achieve this (especially Nationally at this time). Be intersted in your suggested process.

If an Association was to make such a suggestion to its members (which incidentally is often only a fraction of the registered Podiatrists) could this potentially alienate members or Podiatrists that disagree with the recommendation then what has been acheived? This is especially the case whereby Podiatrists are not actually doing anything legally wrong.

As it sits Podiatrists in Victoria currently are (in my opinion) fortunate to have the freedom CHOICE and to exercise their preference either way. In such a case everyone should be happy and can't complain about being told by anyone (group or individual) what they should or should not be doing by others until such time that the laws say so.

In essence this is exactly what the registration board is there for - to enforce the laws and provide the guidleines for which we all must abide to remain a registered Podiatrist.

A tough one that is for sure - but one that may be resolved via the NATIONAL REGISTRATION process either way - in which case it could be argued that we should hold off until we know the exact outcomes decided at this level and then we can deal with this NATIONALLY rather than on a state level.

Just some thoughts and questions to consider!

Your constructive input is greatly appreciated.

Toe Jam.

 

Saleh,

You are welcome - just thought if you were unaware that others may not have been clear on this also.

Cheers
TJ

 

Sorry Adrian,

Just in regards to the 4 points you mentioned. I understand that all those excellent recommendations are all in process and agree that these will be an important ingredients for all Podiatrists.

Interestingly, having said that, does having these things necessarily make for better Podiatrists? It could possibly be argued that many Podiatrsts hardly use the 'tools' we are currently afforded (eg. X/Ray, Ultrasound).

I thing Craig shared his views on the point of continued education and the benefits this is seen to offer which I respect and understand his point. Personally whether it is beneficial to the individual or not - for sake of our profession's credibility we should have robust and monitored CE program for many reasons not least of all as community responsibility (but that is another discussion).

As I mentioned in an earlier post - we can currently request Pathology, CT's (just that our clients are not afforded Medicare Rebates like GP's) so it is not that we are not qualified to do these things (except S4 drugs of course)- just that the Governement has not yet considered funding these for Podiatrists for various reasons. Along with you I hope this changes in time and hope these (and your suggestions ) are all on the agenda and being actioned byAPODC (our representative body on issues effecting Podiatrists Nationally)

Good discussion points though huh?

Regards,

TJ

 

Cheers Toe Jam:drinks

Certainly we have these tools, and they are in our scope to use them. If we are not using the current tools we have, are we adequately exploring every possibility in our diagnostic and investigative scope, and if we are practicing as foot doctors and using the Dr. title, should we not be making use of these tools? Also, by having bulk billing rights to other tools like CT, bonescan and MRI, and making appropriate use of them for the benefit of our patients, we are offering teh best service we can, and demonstrating that we are teh foot specalists and deserving of the Dr. title.

I agree with this, and I agree with Craig, however if we are arguing that the use of the Dr. title is, in part, an effort to be percieved as specalists at what we do, and elevate our status, should we not also take other steps to demonstrate this. If other professons see that we as podiatrists are demonstrating a committment to professional development as a professional body, wont this also go part way to elevating our perception by the community and other health professionals? Even if research shows that attenmding conferences doesn't seem to change practice.

Cheers for the great conversation!!

 

Hi Adrian,

Yes, it seems we are on the same page with this issue. No arguments here on your suggestions and ideas.

I just made the point that having the tools you mention and those we even have now does not ultimately mean certain Podiatrists will use them or necessarily make for better Podiatrists. As the old saying goes - "...you can lead the horse to water!"

The point that we will still have you "do" & "do nots" either way as we do currently.

That being said, those that will and do use them should not be left to suffer or miss out on the opportunity to better themselves by having accessibility to them and as you point out overall the profession will undoubtedly be better off if we do have them.

Cheers to you also!

TJ.

 

Toe Jam,

The registration Board does not detirmine the laws to which podiatrists must abide. That is the role of Government. The Board interprets and enforces the legislation according to the Act, hence the boards policy on the use of the title Dr reflects the law. If the board chose to have a policy that did not allow the use of the title, it would be uninforcable.