Hi all

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Hi all, i've just found this site and had a look through. Lots of good ideas and answers. Im a foot health professional, qualified with the smae institute 4 years ago. Is there still some problems between foot healths and chiropody/podiatrists? I've heard some rumbles of problems but never come across it myself and have always been welcomed by other foot health professionals, chiropodists and podiatrists!!!!!

Jenni

 

Oh dear, Jennifer,
You have certainly moved into a sensitive area!

I can't speak for any other Chiropodist/Podiatrist but my problems with FHPs are as follows :-

1. Some like to pretend to be Chiropodists/Podiatrists even going so far as to advertise in the wrong section of Yellow Pages - I can't believe that they are so naiive as not to know the law in this area.
2. Because they don't have the underpinning knowledge that goes with a Podiatry qualification or the clinical experience, they don't know when to refer on or use orthotics to address the root cause of the problem.
3. They can either undertreat, which means for example, not enucleating HDs fully so that the patient needs an appointment every 2 weeks instead of every 8 weeks.
4. Or they can overtreat, causing haems or soreness and laying the patient open to infection. One example of that has been quoted on another site related to foot health matters, where an FHP apparently took a scalpel to some VPs without knowing what they were !

At the moment I am dealing with a steady stream of "hatchet jobs" from 2 non-HPC regulated persons in my area, usually connected with ingrowing toenails that have been chopped and poked at for so long, that the only recourse for the patient is now nail surgery.
I have made several referrals to the NHS for those patients who need the specialist intervention of Community Teams such as District Nurses and the local Podiatry Dept. This should have been done by the original practitioner.

So FHPs aren't exactly on my Christmas Card list - and you can see why. I could tolerate them if they knew their limitations and stuck to cutting simple non-pathogenic nails. The trouble is that they don't.

If you get on well with pods as you say, then I would certainly advise you have a referral system in place so you can pass on any cases that fall outside your scope of practice. I would also check out the other referral pathways for NHS Community- based Services which you will no doubt need to access if you are acting as a responsible practitioner.

Dido

 

Hi Dido, all that is common practice with me. If its out of my scope i re-refer on, to me this is just common sense, im here to help people and keep there feet comfortable not make them worse. I stick to my knowledge and to what i am good at and have no problem with putting my hands up or referring someone if its a problem i can't deal with.
I would say in the cases you have said it is very poor training and working knowledge for the practioners. Surely they should not be practicing if they have such a lack of knowledge.
We are not all perfect and do make mistakes but certainly should be mature enough to correct mistakes!!!!

Thank you for your honesty. I do hope you find a FHP that you will find is actually a good practioner and you will learn we are not all bad.
Jenni

 

Hi Jennifer,
I am pleased to hear that you would refer on if you felt something was outside your scope of practice.
However, as the scope of FHPs seems to vary so much, perhaps you would indicate what sort of patients/conditions you would refer on?

I would agree, but how can these persons be stopped from practising when there is no statuatory body that regulates or controls them?

Dido

 

Gosh thats a tricky question as i refer without thinking. Diabetic patient with Onychocryptosis is one i done recently. It was quite severe and i knew i couldn't risk touching it. I've referred for orthotics and other bits.

As far as I was aware our training body governed us. I think maybe people need to be more sensible about their practices and need to think of the patient. I empathise with patients and try to do whats best for them. but like you i cant talk for everyone.

Kind regards Jenni

 

Hi Jennifer,
I'm not sure what you mean by

and

sounds a bit vague to me.

Surely you keep records and copies of all the referral letters you write ?

Last week for example I referred ;-

2 housebound patients to DN for ulcer redressing and contacted Social services and Community Psychiatric Nurse on behalf of one of them.
1 patient to pod surgeon for ? Morton's Neuroma.
1 patient to GP for further investigation of vascular problems .
1 patient with leg-length discrepency to pod who specialises in sports podiatry/orthotics
1 patient with RA to Community Podiatrist


and I'm a generalist practitioner not an NHS specialist Pod !

Your Training Body is just that - A Training Body - it has no regulatory controls and cannot stop any practitioner, no matter how incompetent, from practising. Hence there is no safeguard for members of the public.

Dido

 

Jennifer

Your posting indicates that you are a practitioner with the most basic of skills- but at least you seem to understand your limitations which is more than can be said for many FHPs.

My advice to you would be to do a lot more reading around the subject, and if possible, as much CPD as you can do to increase your knowledge base enabling you to direct patients appropriately when referring on.

Cornmerchant

 

I do. I keep all records all letters of referrals and i do as much CPD as i can possibly to keep up-to-date and learn more about as many aspects as i can. I try very hard to do what is best for my patients.

I think i've opened a can of worms with this question!!! I was just trying to find out other peoples opinions and feel like i'm getting dragged through the poop heap due to other peoples incompetance's. I have not listed my referrals dido as I feel it unnecessary to prove my worth and to be honest, do find you rather abrupt. I thought this was a friendly site where foot healths asked others for advice, help and opinions. Clearly you have to be within a certain area of expertise.

I know my limits. I know what i can and can't do within my practice. Im aware that there are those who do ruin it for others and don't do there job properly but i can not improve them or change there way of practicing.

 

Jenni

I am sorry but I do believe that you knew full well that you were opening a can of worms with your posting. I fail to see any other purpose of posting here in the first place. If you had read the site at all beforehand it would have been obvious that there are issues which will not go away while FHPs continue to be unregulated yet claim the same exertise as Pods.

I am glad that you are aware of your limitations, although I would add that you do not know what you do not know so maybe not always the best judge of what some patients may present with.

Cornmerchant

 

Hi Jennifer,
I am sorry you find my postings abrupt, but when you say that

it sounds pretty unprofessional and doesn't exactly impress me with your grasp of the issues.

I have given you a list of referals that I did last week, but apart from an IGTN on a diabetic you don't seem to remember many of yours. I wonder why?

So I get more than a little fed-up with FHPs who say that they "practice within their limits" but then are unable/unwilling to define them.
The scope of practice for Pods is very clearly defined in the Health Professions Council booklet "Standards of Proficiency". Unfortunatley there is no equivalent information regarding FHPs.

Cornmerchant has excellent advice :-

then you will know what "other bits" to send where and to whom.

I can't help wondering why you are here and not on the SMAE members site which is much more "touchy feeley"?

You might find this website more to your liking as there is a special forum for FHPs where everyone will be very nice to you and you won't have to deal with all the unpalatable issues that occur in the nasty big wide world out there :-

www.davidmhol.proboards29.com

And to say that you are unaware of the enmity between Pods and FHPs indicates that you are either very unread or very naiive.

Dido