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FHP's advertising diabetic foot care

Discussion in 'United Kingdom' started by BestyPod, Jan 19, 2013.

  1. BestyPod

    BestyPod Active Member

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    Hi all,

    I was interested to hear your opinions on FHP's advertising diabetic foot care & ingrowing nail treatments.

    I'm a 3rd year student and my thoughts (especially after spending time in a diabetic centre over the summer) are that FHP's are at an increased chance of missing important changes that could be advancing in the feet and with their limited training & possibly are at a much higher risk than a Pod of causing problems....

    Also, I've just seen one advertise treatments for ingrowing nails. Is this not just an agressive nail trim as they are not licensed to administer LA's.....

    It is likely that when I graduate in the Summer that I am going to be up against these guys if I decide to set up a private practice & it just doesn't seem quite right.

    Is it just me?

    Many thanks

  2. David Smith

    David Smith Well-Known Member


    I'm guessing your just dreaming of Oz and not actually there since there aren't FHP's in Australia are there?

    So what they (usually) mean by 'diabetic foot care' is that they can give basic foot care treatment to people with diabetes. They don't (usually) mean that they can treat the type of problems that you might find in a NHS diabetes clinic.

    By my experience, most of the time you don't need LA to treat an ingrown nail i.e. you just cut out the nail spike, clean up as necessary e.g. remove Pyogenic hypergranulation and necrotic tissue, and dress. The patient comes back for regular nail edge profiling and this usually results in no more ingrown problem.
    This is a lot quicker and cheaper for the customer, less sore and less risk of infection post procedure than doing a PNA with phenolisation and you don't need an assistant on hand or have any risk associated with LA (even tho they are very low).

    It would be nice not to have any competition but they are there and lawful and unlikely to be doing anything wrong if they are following their professional organisations guidelines. So do what you do well, don't start up underfunded and / or under motivated and you'll do all right.

    In 1999 I trained with Scholl and the Institute of Chiropodists and Podiatrists. After 14 years I've now got a busy high street practice turning over approaching £100K a year an MSc in applied biomechanics and qualified in LA and nail surgery and loads of other courses and qualifications along the way. As far as I know I've never had a patient with diabetes go on to have any major problem and no patient has ever had an amputation of any limb not even a toe and no one has died for lack of or improper care. I recognise there are many things I can't do but I know when to refer and because there is an NHS service with specialist multidisciplinary teams that can do far more and far better than most private practices could do this will be the same for most private practitioners working on their own. I can be very confident that no one has compromised their foot care by coming to me.

    Just as an addendum: I believe that in the majority of cases my customers will get better foot care than if they went thru the NHS system, first and foremost because they don't do regular routine foot care for most people. 2nd because I think my practise, especially my biomechanics practise, is better equipped and able to respond more satisfactorily to the requirements of a large percentage of foot and lower limb problems. 3rd because NHS podiatrists are often frustrated and shackled by algorythmic treatment protocols and measures to target certain patient groups in a tight financial environment they are unable to respond well to my patient demograpic.

    Regards Dave Smith
    Last edited: Jan 19, 2013
  3. David Smith

    David Smith Well-Known Member

    I wrote
    Hmmm! that's a tautological argument :eek: Because, If I believe a patient will receive better care thru the NHS then I will refer them on, so that original statement can only be true. DoH!:dizzy:

  4. davidh

    davidh Podiatry Arena Veteran

    Well, your first post made sense to me Dave!:D
  5. BestyPod

    BestyPod Active Member

    Hi Dave,

    Thanks for your response.

    Yes I am here in the sunny UK, just dreaming of warm sun and blue skies in Oz :)

    I guess I must have been looking into things a little too deep...... I've just seen a few adverts recently and I'm not sure that patients would know the difference between a FHP and a Pod and whether that is something to be concerned with? Not for me, but more so for the patient?


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