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Will S4 rights contribute to further specialisation within the Profession?

Discussion in 'Australia' started by PodAus, Jul 30, 2009.

  1. PodAus

    PodAus Active Member


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    Hi All,

    The S4 victory is a great acheivement by all those involved and a wonderful advancement for our Profession, and will be of significant value to Patients.

    What we are beginning to see is further specialisation within the Profession, which is inevitable really. This is of benefit both to the Practitioner and the Patient, as the improvement in the standard of care is an obvious result.

    Will we see wound-care pods / Pod surgeons privy to S4, whilst those practitioners with vastly more biomechanical experience privy to orthotic therapy and sports medicine? Will we see aged care and routine foot care limited to those whom develop extensive experience in those fields? Continuing Professional Development possibly should be focused to the strengths of Practitioners and thus reflected in their clinical advancement.

    Will we see Practitioners whom co-specialise to form sub-specialisations?

    It is already difficult for patients whom have a particular concern, to be directed to the most appropriate Practitioners whom 'specialise' in what they really need.

    What are your thoughts?

    Paul Dowie :welcome:
     
    Last edited: Jul 30, 2009
  2. Tuckersm

    Tuckersm Well-Known Member

    Paul,

    the below is a statement from the NHWT developing the new National Registration Legislation
    So S4 will not lead to specialisation. They will remain endorsed as is the case in the Victoria Act. The only specialist group of podiatrists that may currently make the grade are the pod surgeons, though those working with High Risk Feet (I preffer to call it Lower Extremity Amputatioin Prevention), and the Peadiatrics group are in the very early stages of developing standards. I am not sure where the AAPSM is currently at.
    It is hoped that ANZPAC will support the development of profession specific accreditation standards for those areas that can be considered specialist.
     
  3. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Lets be realistic. It's a foot. Lets not get too carried away with the vast array of interest areas in podiatry. Governments won;t listen to that, and we arent big enough and sophisticated enough to cope with more that 2 specialties.

    I think it is appropriate to have a Podiatric Medicine or Podiatric Surgery pathway to specialisation. One 'physician' pathway, one 'surgeon' pathway. In some ways, this is the WA legislative model for podiatric specialisation.

    You can develop an 'interest area' (eg diabetic foot surgery, or paediatrics), but you are trained and assessed to be competent in your given specialty across a range of subdisciplines. If you just end up looking after kids, thats fine, but your base specialist qualification should be the same as someone who just takes care of rheumatoid feet. So too in surgery (eg diabetic foot, vs trauma, vs peripheral nerve).

    This is much more consistent with medical specialisation. For example, completing a FRANZCR and making cardiac imaging your interest down the track. BUT, you have been also trained in musculoskeletal, obstetric, neuroimaging and other subspecialties as part of your broader qualification.

    My 2 cents,

    LL
     
  4. Craig Payne

    Craig Payne Moderator

    Articles:
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    Interesting point.

    The way I have looked at it, is that a specialist does something a generalist can't do.

    The only specialists that we have within Podiatry are the surgeons, as they do something that a general podiatrists can not do.

    I do not see sports medicine, diabetes, paediatrics as a speciality. Those people who work in this areas might be very good at what they do; they certainly do it more often than a general podiatrists does. BUT, at the end of the day, what they do is no different to what a general podiatrist can do (they just do it more often and probably, better).

    There is nothing wrong with people having special interests in these area and practicing in them and doing it well .... just do not call it a speciality until they start doing something that a generalist can't do.

    (I am starting to change my mind slightly as I think diabetes podiatry is changing with the introduction of hospital admission rights for those in HRFC --- that means they can do something a generalist can not do)
     
  5. Tuckersm

    Tuckersm Well-Known Member

    Craig, If you took that position when considering the medical profession, there would be no specialist doctors, as all the drugs a physician can prescribe can also be prescribed by a GP (PBS do exercise some control, but that is a funding argument). GPs can/do perform surgery, deliver babies etc. etc.

    A specialist framework allows the identification of those with increased skill and knowledge beyond that of a generalist.

    my 2c
     
  6. Tuckersm

    Tuckersm Well-Known Member

    Yes LL, but for FRACS and FRACP, there are a multitude of recognised sub specialities that you gain your FRACS/FRACP in, that each have a slightly different pathway. Both Vascular and Ortho surgeon as well as neuro, plastic and general surgeons are all FRACS, but are all quite different in the surgeries they perform, same with the physicians.


    And we all know that a specialist is some one who knows a whole lot about an ever narrowing subject, and as they continue to specialise they end up knowing absoultely everything about absoultely nothing.
     
  7. Paul Bowles

    Paul Bowles Well-Known Member

    Take Dentistry - probably the best model of specialization there is an example of at a Registration level. How it is managed (regardless of how whether you like it or not) is utterly amazing compared to Podiatry.
     
  8. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Yes, an amazing number of specialties for a similar narrow anatomical region.

    Unfortunately, they have had 150 years of formal evolution in 'sandstone' universities and strong associations with government and medicine. We are so far away from that.

    We need crawl before we walk.

    LL
     
  9. ClintonAbel

    ClintonAbel Active Member

    I agree with LL. The thought of having individual bodies responsible for training and accreditation of these different podiatric medicine 'sub specialities' would be at least, an administrative nightmare.

    There would be a gross inability to gain an economy of scale of individual specialty colleges/associations. The costs of running each organisation would make membership almost financially unviable. The RACP oversees the training for 25 different sub specialities.

    Like Stephen has said, they will undergo different training nodes. But a lot of the accreditation systems would be the same. These should be set firmly, once. Each sub speciality should not have to reinvent the wheel. We are far too small of a profession for that.

    My vote would be for podiatric medicine and surgery.
     
  10. Foot Doc

    Foot Doc Active Member

    Hi all,


    I was reading the herald sun the other day and in the careers section there was an interview with an Ophthalmologist.......who very interestingly pointed out that there are AT LEAST 9 sub-specialties :wacko: within the specialist stream of Ophthalmology.

    Just an interesting note............

    Imagine a Peadiatric podiatric forefoot surgeon :dizzy:

    Cheers,

    FD
     
  11. Paul Bowles

    Paul Bowles Well-Known Member

    To take Dentistry as an example, once in a sub specialization you cannot do certain things outside of that sub specialty.

    E.G. If you were a Podo-Pediatrician you couldn't see any adults at all. If you were a Pod Surgeon, you couldn't prescribe orthoses - or something to that effect.

    So specialization within itself is self limiting to a degree. Is that a good idea?

    Time will tell.....

    ...and Tony I don;t know if we are too far away from the Dentistry model even now - Look at what Alan Bryant is achieving in WA, its not that dis-similar really and it comes from a Sandstone University. Sure we don't have the 150 years behind us - but hey, it's only time!
     
  12. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    One sparrow does not a summer make...

    Get back to me when the majority of our current podiatry courses are moved into med schools + add a decade or two for some continued evolution!

    LL
     
  13. Paul Bowles

    Paul Bowles Well-Known Member

    But one sparrow does mean more will follow - and that means summer cannot be to far away!

    :)
     
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