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Students and foot & health practitioners

Discussion in 'United Kingdom' started by StudentPod28, Aug 20, 2017.

  1. Rizal

    Rizal Member

    Well no need for me to further elaborate, if not you would not respond and take my comments so personally. Watch your language and grow up. Period....
     
  2. Catfoot

    Catfoot Well-Known Member

    "Well no need for me to further elaborate, if not you would not respond and take my comments so personally. Watch your language and grow up. Period.... "

    ^^^Sounds like a troll :rolleyes:
     
  3. Speedy

    Speedy Welcome New Poster

    As a FHP I would also be looking at the reasons for foot conditions and how best to advise my patients. I work with a chiropodist clinic where I can refer patients to if they so desire. Many patients prefer to just deal with the symptoms and relief I offer. I am not competing with podiatrists but working alongside them.
     
  4. Catfoot

    Catfoot Well-Known Member

    Speedy,
    You say;
    "Many patients prefer to just deal with the symptoms and relief I offer. "
    Which I find surprising as I have very few patients that fall into this category.
    Are they made aware of the alternatives to symptomatic treatment?
    Just curious :)
     
  5. davidh

    davidh Podiatry Arena Veteran

    Sadly, I recognise where you are coming from. I felt exactly the same in around 1974 or 1975 (four years after I qualified). Unfortunately the fact is that unless/until you specialise, you will be doing basic footcare stuff, much the same as most FHPs do now.
     
  6. RobinP

    RobinP Well-Known Member

    I'm not a podiatrist and I find the animosity between FHPs and Podiatrists interesting.
    In Dentistry, Dental Hygienists and Dentists have a close working relationship, the income of one being greatly affected by the other. The model seems like a good one?
     
  7. StudentPod28

    StudentPod28 Member

    Maybe not , I will do private MSK assessments and provide a custom insoles. nail surgery and also all the basics , I could use my degree and learn non Podiatry clinical skills that I could also offer.... preferably I will get a NHS gig and specialise in a particular area .
     
  8. Catfoot

    Catfoot Well-Known Member

    You are correct that, in dentistry, it is a good mutually beneficial symbiotic relationship.

    However, I would say that the reason is because each discipline has a clearly defined scope of practice and nationally recognised standard of training. Dental Hygienists don't claim to be dentists

    Training to be a Dentist takes 5 years F/T study at University.
    Training to be a Dental Hygienist needs either a Foundation Degree in Oral Health or as Dip HE in Dental Hygiene which is 2 years F/T study.
    Both disciplines have an extensive practical content to their courses.

    Now all Podiatrists are trained to degree level after 3 years F/T study whereas FHP is a title that can be used by anyone regardless of training levels. (usually it's 12 modules of a correspondence course followed by 10 days practical training.

    Some FHPs claim in their advertising to be able to offer the same services as a Podiatrist at half the price and Joe Public, who knows no better believes them and engages them. After several treatments with no resolution of the problem or an exacerbation of the condition, Joe gets fed up and my 'phone starts ringing.

    I won't continue with this sorry tale as I've made my point, but it's no surprise that there's animosity. I didn't spend 3 years of study and hours of CPD to clear up other peoples' c@ck-ups.
     
  9. StudentPod28

    StudentPod28 Member

    Our scope of practice seems very limited , that's why they can cut in ... in the USofA they could never get away with it, I think podiatry could offer so much more in this country .
     
  10. Catfoot

    Catfoot Well-Known Member

    I wouldn't actually agree with that ^

    There is always the opportunity to specialise in MSK,/Sports Injuries, Podopaediatrics, Orthotic provision and Diabetics/High Risk Patients.
    With LA we have the opportunity of an extended toolkit for o/c, VP needling, crosurgery, use of Swift Microwave and blunt dissection of VPs. etc.

    One must not decry the Generalist Practitioner.
    I have been in "general" Chiropody all my life and earned a good living at it, many times because of what I know, not so much because of what I do.

    I believe it can be referrals that can enhance our reputation as much as our Chiropody/Podiatry skills.

    Only this week I have referred one patient to the GP for a suspicious "bump" under the skin of one toe, which I suspect could be the wire from a surgical procedure working loose. Another had an irregular pulse ? Atrial Fibrillation. Another c/o progressive lack of sensation in one foot - back to GP for neurological tests. Another had excruciating forefoot pain and opted for a referral to a Pod surgeon - diagnosis was a Plantar Plate Tear.

    "Cutting in" IMO is achieved by clever marketing, low prices and appealing to those who think a massage with cream at the end of a one -hour treatment is de rigeur - there always will be customers for this type of low-level service.


     
  11. davidh

    davidh Podiatry Arena Veteran

    You do realise that your competition in the MSK assessments market is pretty sharp? Not just other pods, but also physio, chiropractors and osteopaths. Carry on, and I hope it works out for you.
     
  12. StudentPod28

    StudentPod28 Member

    As it stands ,Competition will diminish as the years go on. Without funding the numbers of pod students studying at university level are getting lower every year , down south it's 9k a yr to study podiatry , add on SAAS money to live. its a big ask getting ppl to sign up for that with the prospect of a 22k a yr NHS gig.
     
  13. Catfoot

    Catfoot Well-Known Member

    Can I ask, student pod, if you are so negative about podiatry why are you still studying it?

    There will always be competition if you opt for working in the private sector.

    And to go back to your original post (where you ask about running a business as an unregulated footcare provider) you will find that the lower end of the market is at saturation point in many areas. There are dozens of these type of practitioners being trained and all come into the market-place offering the same services.

    All this leads to a a price-war in some areas with treatments in nursing homes being offered for £7.00. Yes, you read that right £7.00 Do you seriously wanted to go down that road?

    My advice to you would be to continue your training and get an NHS job. The 22k "gig" as you put it could develop into a Band 6 £40k a year over time.

    Podiatry isn't a get-rich-quick area of employment. If you wanted to make money in a health related field you maybe should have taken up dentistry :)
     
  14. RobinP

    RobinP Well-Known Member

    Unfortunately, the battle against FHPs and how regulated (or not) they are is probably a losing one. Irrespective of the relative qualifications of the professionals involved, the situation exists as it is and it would seem logical to me that getting on board with FHPs could prove to be a mutually profitable venture. The podiatrist then has some regulation over who sees the FHP and the FHP has a steady stream of income from the basic skin and nail care that is perhaps not worthy of the skills of a podiatrist. In order to see the FHP at the cheaper rate, you need to first be assessed by the Podiatrist who may, or may not simply pass on this management to a less qualified professional.

    Why are you concerned about clearing up other people's cock ups? What could possibly be bad about something that gives you an income stream and improves your word of mouth referrals?
     
  15. Catfoot

    Catfoot Well-Known Member

    Robin P - you said; "it would seem logical to me that getting on board with FHPs could prove to be a mutually profitable venture. The podiatrist then has some regulation over who sees the FHP and the FHP has a steady stream of income from the basic skin and nail care that is perhaps not worthy of the skills of a podiatrist. "

    I think this notion has been discussed before but if you haven't seen it.....

    I'm assuming that you are talking about "joint working" ie in the same building?

    Why do you assume that FHPs want to work with Pods?
    FHPs are trained to be stand-alone practitioners, not employees, and, as I understand it, have several modules of their training devoted to marketing, advertising, business management etc. Why would they want to take direction from a Pod?:confused:
     
  16. StudentPod28

    StudentPod28 Member

    They dont want to work with pods , the FHP course is expensive they will want to build a business after it , the scope of practice is quite advanced for FHP if they do all the courses available to them , they bascally can (or are allowed)to do everything a pod does out with LA and meds . One of the girls from class done a week with a local FHP , the girl said she was getting about £500 a week and had a fairly relaxed lifestyle working mobile , just doing basic footcare . definitely worst jobs...............my original question was could i work as a FHP just now (whilst studying Podiatry) without having done the FHP course , I want to start making some cash , uni does not come cheap
     
  17. RobinP

    RobinP Well-Known Member

    I am not assuming anything. I had an FHP apply for a podiatry post recently. They were very upfront about it and knew that they were not a qualified podiatry professional but wondered if there was any scope within the business to use a FHP.

    If an FHP is keen and confident enough to approach a podiatry practice, that is the type of person that shows a desire to work in a team, wishes to be part of something more established perhaps and benefit from a steady income stream. Something worthy of consideration?

    There will be disreputable FHPs out there in the same way that there are disreputable podiatrists. There will be technically poor FHPs in the same way there are technically poor podiatrists. Surely it is in the interests of the entire foot care community to make sure that bad people are the ones who lose out. Unfortunately, I think it is short sighted to think that the good ones are the podiatrists and the bad ones are the FHPs

    If the issue is that FHPs are offering everything that podiatrists offer, but at lower prices, I would see that as an opportunity to have a tiered pricing structure. If your foot care requires a basic level of skill, you see the FHP and you pay this much. If your complaint requires the skills of someone more qualified/better/talented, then you pay this higher amount. Hairdressers do it all the time. You are still getting your hair cut but what level of expertise do you want?
     
  18. Catfoot

    Catfoot Well-Known Member

    Robin P you said "If the issue is that FHPs are offering everything that podiatrists offer, but at lower prices, I would see that as an opportunity to have a tiered pricing structure. "

    and that is not the issue at all.

    And take exception to your statement inferring my skills are equal to those of an individual who may or may not have undergone appropriate training & examination. How can this statement be factual without proving each practitioner has undergone equal training?
    My brother (who has never attended any foot care course) can indeed cut his nails. He is also capable of determining when his feet are uncomfortable or in need of more intensive treatment. I would be less than confident in saying that he is capable of assessing, diagnosing or treating anything but the most basic of his (or anyone elses) foot health status.

    I feel sure there any many unregulated practitioners who feel they practice safely. I feel however that is wholly wrong to compare a practitioner who has undergone a nationally recognised path of tertiary education to another of unknown quantity The former is subject to the ongoing scrutiny & boundaries of their given profession by an external body (HCPC) & who pays a large sum of money both in gaining their education & continuing their education, insuring their practice & their patients & also adhering to stringent clinical guidelines.

    This view is not because I believe I am a better person. This is because I have undergone a nationally validated tertiary level education to practice Podiatry.
     
  19. RobinP

    RobinP Well-Known Member

    I was careful not to infer that your skills were equal, hence the phrase, "requires the skills of someone more qualified". I am also not comparing the qualification of a podiatrist relative to a FHP. What I did say is that what is being offered by private podiatrists is not, in many ways, different to that of what an FHP offers, depth of knowledge underpinning notwithstanding. And it is the depth of knowledge that is the critical phrase.

    I refer again to the hair salon that charges a certain amount for a junior stylist and 2 times that amount for a senior stylist. If the client is paying for the removal of hard skin, enucleation of HDs and nail cutting, then the FHP and the podiatrist might be on equal terms as far as their skill set goes. However, if that same client has several other health complaints that mean that they are more at risk, then the podiatrist is the superior practitioner in most cases and the client should be paying a higher cost for that service.

    So, again, if your concern is that unregulated practitioners are operating out there, that seems like even more reason to incorporate them into an environment where their competencies can be monitored. Clearly, this would need to be a bilateral relationship. Podiatrist takes the more challenging cases where more underpinning knowledge is required. FHP takes the cases where the care is routine. If a routine case presents with something unusual then a qualified podiatrist is on hand to give advice and perhaps take over care as required.

    In the podiatry course, how much time is devoted to the study of orthopaedic footwear? The manufacturing processes, design, measure and fitting. How much time is devoted to the study of the biomechanics of an AFO? How to prescribe, cast, rectify and manufacture? My guess would be not that much. It may have been a module or two on each? Yet, there are plenty of podiatrists out there prescribing and fitting AFOs and orthopaedic footwear. These 2 facets cover months and years of study in the Orthotics course. Does that mean that only Orthotists should be able to prescribe and fit those devices? Should Orthotists be trying to protect their profession from the creeping scope of podiatrists, osteopaths, chiropractors and physios?

    Of course, the question is rhetorical. Just because one holds a qualification, does not not make one the best person for anything related to that field. I personally don't care who does these things for clients, only that they are done well.
     
  20. Catfoot

    Catfoot Well-Known Member

    Robin P,

    You said
    "What I did say is that what is being offered by private podiatrists is not, in many ways, different to that of what an FHP offers,"
    This would only be correct as applied to most Grandparented pods as they had the same traning as today's FHPs. So why these pods would want to engage an FHP is puzzling because all they are getting is more of the same!

    "if your concern is that unregulated practitioners are operating out there, "
    My concerns are that some are claiming to be as good as pods and are confusing Joe Public by calling themselves "Foot Health Specialists" and claiming " I am not a pod but I do the same things".

    There is also the much discussed issue of referring on. They just don't do it. That is my gripe.

    "even more reason to incorporate them into an environment where their competencies can be monitored. "
    They don't want their "compentencies monitored". Why should they? They have been sold a package that "gives them all the skills to run a sucessful business", and passed out as competant.

    Then we get into the issue of clinical responsibility. A pod cannot refer to an FHP, only delegate.
    If a practitioner who is Regulated under Statute (pod) refers to a practitioner or not (FHP) then this is deemed to be delegation and not referral and the Regulated Practitioner is still responsible for the outcome.
    Whilst FHPs may well carry their own insurance, this is irrelevent if they are acting under the instructions of a pod.
    This why SOCAP prohibit their Members from working with FHPs as they don't want to get involved in this legalistic minefield.

    I don't know what an AFO is, so I can't comment on that, or the Scope of Practice of Orthotists.
     
  21. Catfoot

    Catfoot Well-Known Member

    Just seen the typo para 5 :oops: - should read:
    "If a practitioner who is Regulated under Statute (pod) refers to a practitioner who is not (FHP) then this is deemed"

    Apols, that should now make more sense :)
     
  22. RobinP

    RobinP Well-Known Member

    This is a reasonable point but it gets into semantics. A pod would not necessarily refer to the FHP, nor are they delegating. The choice is given to the customer and they choose based on the information that the Podiatrist or FHP has given them. In a good working environment, something that you obviously cannot conceive of existing, the goal would be to work towards the patient receiving the best care at the best value for money.

    As an informed Podiatrist, you surprise me. Given the level of potential crossover of practice and interdisciplinary teamwork, I would have thought that you would be very aware of the scope of a profession that is so closely linked
     
  23. Catfoot

    Catfoot Well-Known Member

    "This is a reasonable point but it gets into semantics. A pod would not necessarily refer to the FHP, nor are they delegating. The choice is given to the customer and they choose based on the information that the Podiatrist or FHP has given them.
    In a good working environment, something that you obviously cannot conceive of existing, the goal would be to work towards the patient receiving the best care at the best value for money."

    ^^^ That aim is laudable but doesn't work in practice IMO. The only situations I've heard of where there is cross-working between pods and FHPs in a practice is when the pod is a grandparented pod ie; one who has done the same training (an FHP under another guise if you like). I can't see any benefit to the patient in this arrangement, except for getting a valid receipt to claim their fees back from an insurance company.

    In all the years I have posted on this forum I have never heard any pod explain how they benefit from using an FHP in their surgery.

    "As an informed Podiatrist, you surprise me. Given the level of potential crossover of practice and interdisciplinary teamwork, I would have thought that you would be very aware of the scope of a profession that is so closely linked"

    There isn't any "interdisciplinary teamwork" or "crossover of practice" for me in the private sector because I don't refer to NHS ProstheticsOrthotists and they don't refer to me.
    I don't know of any orthotists who work in the private sector.
     
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