Podiatry Assistants

Hello Colin and Others

My point, as moderator, did not relate to FHPs. However, at one point you rather wandered off into the realms of orthotic prescription, which is well covered elsewhere on this site.

In my view Quissu is absolutely right. The question of Podiatry Assistants, both within and without State Health Services, revolves around control by the profession. I understand that this issue has been dealt with in the States. Perhaps a poster from the U.S.A. could share their experiences?

All the best

Bill Liggins

 

Hi Bill,

True on orthotic's but I believe in answering a question when asked by anybody when asked? That been the case with Dipper even if it is off the point! Possibly trying to apply good manners!?

A reason for asking Quissu to contact me in the Break Room Forum. I know he is wanting to talk, and what he is going to talk about is at a guess most defiantly not going to be on Assistants in podiatry? It will be off the point here!

Never the less Bill, FHP. as an Assistant does not go down very well with me and it might not go down very well with FHP's. who I'm sure do not considered themselves as an Assistant. They will still consider themselves to be their own man/woman!

For instance as a Chiropodist I could not print here the retort to, "Oh, are you a Podiatrist's Assistant?" Without being banned from this Arena forthwith!

Regards,

Colin.

PS. Still attempting to write this in a friendly manner, Bill as Moderator should you not be breaking off subject matter not in the spirit of the Thread Subject when you find it here???

 

Podiatry Assistants in the States!

Hi Bill,

Quote:- 'I understand that this issue, [Podiatry Assistants], has been dealt with in the States.'

Bearing in mind Podiatrists in the States have elevated themselves to DOCTORS (MD.s here), I do not think this can have to much bearing on our situation!

Here if a Podiatrist elevates himself to the rank of DOCTOR without the necessary degrees to qualify himself to use that title he would be committing an arrestable offence and would find himself sitting in front of the Charge Desk in the local Police Station!

The point being they are not compatible with the state of Podiatry in England, when we are considering how a Podiatrist would rank with an FHP. is this not a red Herring, (Who as yet has not been reduced to assistant level, anyway.)?

Who has the authority to make this judgment?

Outside the NHS. is there any Assistants?

Regards,

Colin.

 

I am a little wary about commenting on FHP's now, as I feel that whatever I say may be taken the wrong way, or that I will find the comments upsetting! However, I would just like to follow on from my post earlier in the week (now that Bill has said that he wasn't trying to stop the FHP discussion angle!). I do not consider myself to be an 'assistant' as I am an autonomous professional. I have been taught by a body who to my knowledge appear to be reputable (College of Foot Health Practitioners) and give a good all round, basic teaching of the necessary coursework to allow me to practice in safety.

I would very much like to be able to work without being made to feel like a lesser being, as a Foot Health Practitioner. I am proud of the fact that I undertook the course and completed it. I do not, and will never try to pass myself off as a Chiropodist or Podiatrist as they have a far wider and more indepth knowledge of foot care, than I have. I always stress to my patients the difference between the two areas of foot care, and would happily refer on to Chirpodists anthing about which I am unsure. However, I have a large number of patients who have now become regulars with me, as they are unhappy with the way they were treated by local Chiropodists. I have been working since March this year, and have now just reached my 50th patient on my list. Of these, only 3 have not re-booked after the first appointment.

I am not really too sure whether there is any 'point' to this post, apart from the fact of saying again that I am proud of what I have become, and would like to be able to carry on offering routine foot care for people in the County. If I felt I would get a better reception, I would happily look at setting up a regular referral system with local Chiropodists.

Somebody posting earlier suggested that there might be a Foot Health Practitioner area on here somewhere..... good idea!
Ian

 

Hello Wizzard

Thanks for making your point, which is as valid as any other.

For the present, I think that is reasonable to run with the subject of FHPs on this particular area of the site, since it is not covered elsewhere, and as far as the NHS in Britain is concerned, some form of recognition may be in future prospect. This is not to state that I have any strong feelings or knowledge of the matter, but if it satisfactory to you to continue posting here, then I am happy too.

Bill Liggins

 

Fhp

Hi Wizard,
Thank you for your reply, is there confusion about FHP'S and Podiatry Assistants, after reading some of the posts,I thought it is obvious that Podiatry Assistants are just that assistants.
How does the training you did differ from a Podiatry Assistant?

 

Good manners

Hi Colin,
Thank you for your remarks on answering the questions and good manners, being new to this forum, I am still finding my way around the various forums.

As you say I may have wandered off the thread, but knowledge comes from asking questions from others who have a far greater understanding and knowledge than ones self.

With out wishing to be rude.

Perhaps Bill could put questions onto the correct forum or better still, answer the questions as well, stating it is on the wrong forum board.

 

A Late Comment, Wizard!

Hi Ian,

Quote:_ "I am a little wary about commenting on FHP's now."

Don't worry! I've got big feet and you will get used to it!

Quote:-............feel like a lesser being, .........."

Some of us in Chiropody know the feeling well!

If you use the words "CHIROPODY/CHIROPODIST" use them as you have done weighing your words CAREFULLY and well! (Particularly when describing yourself!).

Not your fault. Our Government in their wisdom hedged the word, "CHIROPODIST" leaving "CHIROPODY" at first glance unprotected? Give both a wide birth when describing yourself! (The TITLE more so than the subject?). Follow the advice given by your School to the letter. I haven't had sight of it by the way, (But I can imagine, maybe you could enlighten me?).

Somewhere down the line HPC. will quite probably use and make CASE-LAW, (It could take years to put themselves into a comfortable position with everybody? They might decide that it is not their business to try and it certainly is not you or I's. business to help them!).

Regards,

Colin.

PS. Bill, I fear this is off the subject too???

 

Hello

Thanks for your comments.

On the home page, on the left, there is a list of forums which is topic specific. Since this is an international forum, there is also a forum for the U.K., where a topic may be relevant only to Britain; NHS or specific HPC for instance. For more general comment, there is a forum for that too.

If any new member is 'lost', or requires advice, please do not hesitate to post accordingly.

Bill Liggins

 

The Australian Perspective

In Australia we are commencing training of Podiatry Assistants (through the Australasian Podiatry Council, State Podiatry Associations and educational providers - in the first instance La Trobe Univerity) in a couple of weeks.

Graduates of the 6 week theory/12 week prac course will be able to offer assistance in the running of podiatry practices, in infection control/sterilisation, in procedures such as surgery and in the provision of basic foot hygiene (nail cutting, but no conservative sharp debridement).

The Podiatry Assistant must work under the supervision of a Podiatrist, and any patient who is referred to them for foot hygiene must be assessed by that Podiatrist as suitable (ie low risk). The Podiatry Assistant cannot work as an independent practitioner.

I believe this kind of role exists within Podiatry Departments/the NHS in the UK. In Australia there have been some preliminary moves to train "Foot and Hand Carers" through our Technical Training Institutes, however these are not in any way affiliated with the Podiatry Profession, and are essentially beauticians. They can, of course, work independently.

From my reading of the various forums on this arena (and by crikey, I am standing behind the blast screen on some of them!), the situation in the UK with the two tiered educational provision/profession is unique. In Victoria, Australia, when our first Chiropody Registration Act was introduced in 1968, all members - regardless of their training etc - were grandfathered in. It simply worked. There was a process of attrition, with some people finding the pace of development too fast, others became and still are our revered and respected Doyens! As to the rest, well market forces determined the outcome there.

I'm off to finish writing the new Pod Assistants Course - wish me luck!

cheers,

Felicity

 

Hi Felicity,

Quote:- "I'm off to finish writing the new Pod. Assistants Course - wish me luck!"

If the UK is anything to go by you don't need luck but have you taken out Accident Insurance?

Regards,

Colin.

 

FHP. Query!

Hi Bill,

An interest only query Bill! In another place on 21/5/05 you wrote:-

"I have it on excellent authority (An appointed member of the HPC.), that FHP's. will become registered under Chiropody/Podiatry section of the register."

Have you any more up-to-date information on this or has to much water gone under the bridge?

Regards,

Colin.

 

Thanks for that Felicity, very interesting and it looks as though you are going down the sensible road of control in Aussieland.
A similar system works in the U.K., mainly it must be said in the National Health Service. However, there is nothing to prevent 'Foot Care Assistants' from setting up as FHPs or however they wish to describe themselves outside the NHS; ie. the profession exerts no control whatsoever, so you are one up on us!
The current situation in the U.K. is due to the profession embracing 'indicative' rather than full professional closure, as acheived in the U.S.A., although there were those who warned again and again of precisely what would happen. Full 'grandfathering' did take place, but since only the titles 'Chiropodist' and 'Podiatrist' were protected, training programmes for 'Foot Health Professionals' - essentially carrying out many of the activities of the aforesaid, are taking place. As Colin Bains has mentioned, there will shortly be a period of consultation by the Health Professions Council (the regulatory body) after which the Foot Health Professionals will be considered for inclusion on the register. The fallacious element in all this is that anyone could then set up a school to train podologists, podologues, foot treaters, even corn operators (or any title that you wish)!
Naturally, there is a political agenda behind this to ensure the Department of Health has an effectively endless supply of workers whilst depriving the profession of any element of control over its own members.

I should add that the opinions above (although not the facts) are my own, and not those of a moderator!

All the best

Bill

P.S. Sorry about the test match.

 

Bill,

That was certainly my understanding of the situation up to the beginning of the summer. However, it would appear that the government are taking a more strident line with regulation and have proposed new measures to halt the type of scenario you illustrate. Following professional consultation with CHRE, it seems likely that new legislation will be introduced early in the New Year to bring in a series of "controlled acts" which can only be performed by regulated professionals on the various registers. For example "incision of dermis by scalpels" or "communicating a diagnosis identifying a disease or disorder of the foot", may be controlled acts applicable to chiropodists/podiatrists. If such legislation is introduced we would have, effectively, functional closure, and the emergence of "new" foot health professions out-with the regulatory scope, would be inhibited comprehensively. But as always, the devil is in the detail.

I'm not sure how much protection the profession enjoys in Australia - from reading Felicity, it would appear they are in much the same position as the UK when it comes to the independent sector. This is at variance with New Zealand, Ontario and the USA where there is licensing and specific regulation. Thanks to Cameron for posting the item from the Charlotte Observer earlier this week - I've attached it at the end of this message - don't you love the headine!

Best wishes

Mark

Salons getting nailed over callus shavers


Whoa! Watch who's wielding that callus shaver.

The N.C. Board of Cosmetic Art Examiners this summer reaffirmed its 2002 ruling that callus shavers are a no-no at nail salons.

Only trained professionals such as licensed podiatrists are allowed to use the dead-skin slicers. Blades in the shavers work like a plane to scrape off skin. The shavers can inflict cuts that lead to infection. The board ruled that callus removal with a shaver is a medical procedure.

The state fined 97 salons $300 each through June this year -- many in Charlotte -- for merely possessing the devices, according to an Observer review of public records. The state fined no salons for that infraction during the same period last year.

Pedicurists can still use pumice stone, rasps and certain lotions and chemicals to remove calluses.

The issue of who can use callus shavers has national resonance considering the raft of high-profile infections and lawsuits in the pedicure industry over the last few years. Bacteria infection from pedicure whirlpool baths has prompted states such as California to enact stricter footbath regulations.

Moreover, the focus on hygiene and customer safety comes at a time when pedicures account for a growing share of salon business. Five years ago, pedicures generated $75 million in revenue globally, according to industry experts. Today, the figure is $200 million.

A full pedicure at a beauty or nail salon typically includes callus removal -- legally with a file, pumice or lotion -- and costs about $38.

Callus removal at a podiatrist generally costs about $45. But that won't include a foot massage and nail polish.

Salons throughout the state kicked up a fuss this year when they asked that the callus-shaver law be repealed, state officials say. Some cosmetologists cited the devices as time-, and thus, money-savers.

Yet the N.C.'s cosmetology board fielded an increasing number of complaints this year about shaver-related infections, says Bernetta Smith, the board's operations officer. One was from a diabetic who feared her infection would lead to amputation.

Dr. David Tucker, vice president of the N.C. Board of Podiatry Examiners in Raleigh, notes that diabetics are particularly at risk of infection from improper callus removal.

"If there's shaving and debriding (cutting) of a callus, that's a very dangerous thing to do in untrained hands," Tucker says.

He adds that he's seen a 10-fold increase in fungal infections in patients, which he attributes to improper hygiene at nail salons.

The Podiatry Examiners board weighed in this summer with a letter to the state cosmetology board, reminding it that, "cutting of soft tissue and debriding of calluses is defined as the practice of podiatry ... therefore, outside the practice of cosmetology and manicure arts in North Carolina."

Even the beauty industry has issued warnings.

Folica.com, a Web site devoted to beauty care, notes that the popular Tweezerman callus shaver has a razor-sharp blade "and should be handled with extreme care."

The caution adds, "Do not shave live skin. Diabetics and hemophiliacs should not use this tool."

The Law

• N.C. and most states consider callus shavers "invasive surgical" devices.

• Possession and use of callus shavers in commercial salons is illegal.

• The state fined 97 N.C. salons $300 each through June, out of a total of 172 disciplinary actions, for illegal possession callus shavers. The state fined no salons for possessing callus shavers through the same time last year.

 

Thank you for this information, I will attempt to put comments on the right forum, however when looking at lots of forums, tend to forget which ones are which.
Best wishes,
Dipper

 

hello Felicity,
At last a sensible approach from Australia, pity england did not do this.

 

The FHP's. have been Born!

Hi you Specialists and Routinists,

Worth a look at a new Thread entitled, "BIRTH OF THE FOOT HEALTH PRACTITIONER."

Definitely not an Assistant Podiatrist or Podiatry Assistant either!!!

Regards,

Colin.

 

Hi Colin,

Quick, show me! Where's this FHP thread!! Help! Can't find it!
Please tell me where it is, Colin!
Cheers
Wizard

 

Directions?

Hi Ian, (Wizard),

Yes you've stirred it up, we are going to blame you! A typical, Routinist!!!

1. Goto the Arena Home-page and look down the right hand column.

2. You are looking for,

"Birth of the Foot Health Practitioner." United Kingdom!

3. Other way goto the left hand side column of the Home-page and look for the United Kingdom Forum!

Regards,

Colin.

PS. I would be obliged if you could confirm what Little Tony is saying if you have seen the article in your Journal. I'm sure Janet will be a busy woman on a Friday afternoon, I'm not going to disturber just yet?