Medical pedicures

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there is a lady in the town where i live who is advertising herself as a medical pedicurist.
apparently she cuts nails, corns and callus, autoclaves her instruments - but does not paint nails or do foot massages etc.
she doesnt appear to have any recognized qualifications for pedicure or podiatry, it does say she is a "chiropodist" and trained in the uk and has a degree in chiropody.
i did a google search and apparently this is something that is taking off throughout the usa.
what do other people think about this? - surely this takes away from our business, she is charging $25 for a "full treatment"

 

Hi Pillbox

She can call herself what she likes but if she is advertising herself as a CHIROPODIST then she must be registered with the Health Professions Council.

If you have her name it is easy enough to check http://www.hpc-uk.org/ .

If it turns out she is not registered then please let the HPC know

Cheers
Derek

 

Hi Pillbox
I am assuming that she is in the states as you say she charges $25? I would also assume that puts her out of the remit of the HPC as Derek states in the last post. So where does that leave her with regards to American regulations? I would say that she has found a loop hole where no one can touch her unless the title 'chiropodist' is protected over the pond?
It is a clever use of title as it does tell you what she does and that she does more than nail polishing!
It wont be long before they are springing up all over the place. I have just been given a flyer from one of my patients who had it put thro her door, and it is a nurse offering a nail cutting service. I am taking it up with SCP but my feeling is that she is not actually doing anything illegal- she states on the flyer that she is not a chiropodist and will only cut nails.
Further proof that the professiion will never be closed!

heather

 

i should have made it clear - yes she is in the state of texas in the usa.
i think the lady is british.
she has a small "shop" in a smallish town, and appears to have plenty of custom from the older clientele who do not wish to pay at least double that to have their nails cut by a podiatrist.
over here in the states routine podiatry is not covered by medicare (our version of the nhs), so you do them yourself or get someone else to do them for you.
diabetics and at risks get treatment with medicare, so as far as i can tell she is only seeing low risk routine stuff.
im not sure how to feel about it but seeing as i am a stay at home mom right now and not working it is not affecting my business.
it would be interesting though to see what american pods make of it.
as far as i can tell the names of podiatrist and chiropodist are protected and closed titles in the usa - though i could be proved wrong, so she is being clever with regards to title, but i dont know how she gets around insurance, because she must be using blades.
although i have always wondered about acupuncturists, they stick needles right in you lol, how do they get insured!

 

Hi Heather et al

Well picked up ,I assumed on this counties forum the $25 was a typo.

Pillbox,

I don't think our regulatory bodies cross the pond with regard to regulation so you will probably have to fight this on your home front.
Good luck
Cheers
Derek

 

I know from a couple of my patients who used to live in the states for 6 months of the year, that there was a definate niche in the market for a 'medical pedicurist', as they felt a podiatrist was too expensive and they didnt qualify for medicare. They did in fact have a nurse who came around purely to cut toenails.
The situation is completetly reflected in the uk, where the NHS are discharging low risk patients into the private market, and some of them cant afford pod.prices. Age concern does provide a service and there is contoversy over that because it is seen as cheap labour if provided by pods and unsafe if provided by trained nail cutters rather than pods!We do of course, have unregistered Foot Health Professionals who are trained to do the basics but the irony of it is that they can charge as much as a fully registered pod if they want to!
As far as insurance goes over here, I dont believe it is difficult to get, but it is one of the things I will check out regarding the nurse that is advertising.
There will always be a market for simple, affordable, social footcare and so there will always be people prepared to provide it if they see the demand. I personally dont see it as a problem to my practise but I know a lot of pods feel upset.
Regards
Heather

 

Just a correction.

The National Health Service is not discharging low risk podiatry into the private market. Low risk podiatry has been shifted into the realms of social care which then becomes the responsibility of the local authority rather than the health authority hence the adoption of the term "Social Nail Care" by one section of UK Podiatrists.

Use of the term social in this instance does not indicate problem free footcare, low risk or needs not met but which Government Department is going to pick up the bill.

Personally I find the term social linked with any reference to the foot is causing constant and irrepairable damage to the profession of podiatry and some of our professional colleagues are quite happily destroying our reputation in the realm of preventative care.

I give up....

GB

 

Hi George

Don't do that fella there's not many of us left :bash:
cheers
Derek

 

In response to George Re: discharging patients & moving them into local authority care. This is not the case locally (South Yorks) NHS patients who are deemed to be a low risk of podiatric complications are being (you'll like this bit) ''empowered'' to self care where appropriate. They are assessed, given advice & a free foot file & sent on their way.
Personally I believe this to be a good thing. This will hopefully improve access to NHS services for patients who are at risk of complications. I know from personal experience while working for the NHS that it tends to be a case of he who shouts loudest gets seen 1st. Have you never found that it tends to be the patients with the most problems rarely get heard. These are the individuals the NHS should concentrate on & allow those with minimal problems to either self treat safely or pay & seek treatment with a professional. Just because a service was provided in the past for free shouldn't mean that it was provided appropriately. Indeed many patients would reach retirement age (without foot problems) & automatically be referred to the NHS Chiropodist. It wasn't classed as the invaluable service it is, it was considered to be a treat.

 

Hi Twirly

Now there is the crux of Georges point I think.

The trouble is that those that are being "empowered" are in the main being left to their own devices for future podiatry provision and are self treating or being "age concerned" and therefore the preventative care element is now lost.

I agree with George that there are many within our profession who are actively promoting this "empowerment" in the name of treating those with greater need which is right and proper but is any thought given to those leaving may rapidly become a "greater need " Patient in a short space of time without correct treatment by a professional ??

Is it not time links were forged between the private sector and NHS to guide them in the right direction ??

Just my thoughts

Cheers
Derek

 

I agree Derek, However at the present time patients are being ''empowered'' but without the option of a recommended alternative (ie. you are not in need of NHS provision, but I may recommend an alternative clinician should you so wish to choose a private practitioner)
Then both patients and qualified podiatrists are stuck between the rock/hard place. suggestions please...... I wholeheartedly agree that communication betwen the NHS & private practice should be encouraged. However in my experience (I work for the NHS & in private practice) practitioners are not permitted to recommend any individual. This in turn leaves patients with little choice but to meander through the local directory . seeking ''Chiropodists/Podiatrists who claim to be ''fully qualified & can provide treatment without the need of a referral''! I find it is us (those who undertook the 3 year degree course & submitted to the student loan company ) are left in never land. How can patients make an informed choice when the ''Society'' permitted clinicians to be included in a list of ''fully qualified, HPC registered Podiatrists who obtained a postal certificate!

 

I am fascinated in this other NHS coined phrase.

"Empowered to self care where appropriate".

How does one empower a low risk (NICE guidelines) diabetic who cannot see her feet, reach her feet, squeeze the scissors shut? Give her a long nail file and access to a Physio to sort out the sciatica for her attempts at empowered self care. Granted there are those that in the past have taken the Mick out of the NHS free service but come on? Empowerment?

So in actual fact this patient has just been empowered to join the growing group of people whose footcare needs have been hung out to dry in the so called Social Care Sector which has yet to be taken up by the Local Authority in some regions.

Along came Age Concern, criticised for their efforts, but they are the ones to have highlighted the growing plight of many with "Social Footcare" needs not the Professional Bodies.

I am ashamed that without consultation with the whole of the UK Profession of Podiatry, some have relegated many to suffering by advocating empowerment and social care. There may be a funding crisis within the NHS but there isn't within Private Podiatry driven by HPC Registered Podiatrists . We are quite capable of creating and managing our own budgets and many of us can offer a low cost nail cutting service without getting into financial difficulties. (please lets put to rest the them and us attitude that still prevails and get on and look after our elderly).

Its amazing to realise that a good proportion of the elderly can afford a £10 nail cut. All they need is empowerment in the right direction. I thought it was a duty of all HPC registrants to refer appropriately when care of a patient was outside their scope of practice?

GB

 

Hi Twirly , George et al,

OK here goes

You are not alone there, those of us that qualified in the dark ages where degree's and student loans ( mostly paid by parents I understand) were unheard of in this profession. The required qualification was the a diploma and further education in specialist subjects. I myself took out a £30,000 mortgage to pay for my surgery to be built and to equip it ( all paid for by my skills and good practice.) (getting the message yet??) that was some 20 years ago.

We are also in "never land " by pods with obviously very little factual understanding of the professions history that insist on perpetuating old prejudices for their own self aggrandisment ( you have a degree so ?? doesn't make your clinical skills any better than the next pod) and that is what matters.

You should note that ALL PODIATRISTS are qualified whether you like it or not so to try and separate by innuendo is actually pointing out your lack of understanding to the whole world :wacko:

Perhaps you could enlighten us all to your mindset behind that statement please??


(

Perhaps George ( who is more eloquent than I) has put the situation into perspective in this one quote.


Get over yourself twirly many of us have been out here giving good practice to thousands of patients before you were born and still have the fire in our bellies to continue to do so and are willing to put the record straight with fact not fiction.

Of course you could always PM me and I will set the correct facts of history with you ?igs:

Cheers
Derek

 

Gentlemen, I appear to have caused some ruffling of feathers. Alas I believe you think me a recently qualified practitioner. Ah, my giddy youth has been passed many a year now. You may be quite accurate though in your assumption that the posterier area of my ears is still tinged a tad green. But I would be most grateful if you would allow me to elaborate on my reasoning on the statement I made previously RE:'' postal certificates''. My mother in law holds such a qualification, as does my brother in law. Both responded to adverts a number of years ago in a national newspaper. My mother in law has since retired (a blessing I believe given that she is now 74). Her views on infection control were very straightforward, when instruments required cleaning she popped them (along with a milton tablet) into a bowl of water. Her assessment of patients involved 1) name, 2) address & of course a brief mention of any treatment provided. The certificate on her wall is indeed impressive, it cost her almost a thousand pounds to obtain. My brother in law has also ceased to practice due unfortunately to ill health. He was accepted by the HPC & therefore was entitled to use the terms Chiropodist/Podiatrist. He also during one patients treatment was using a drill to remove callus & managed to allow the drill to not only breach the skin but also to penetrate the bone in the unfortunate persons medial 1st metatarsal. Accidents can happen I grant you but surely it is more appropriate (given a choice) for clinicians to have a thorough knowledge achieved through prolonged study, continual assessement & review by experts in their field. Mine is not a ''high horse'' attitude, mine is purely my own thoughts on a subject which rarely fails to create a response. I am proud of my degree, I worked extremely hard to obtain it. Indeed I am continually working hard, as I am sure most of us are, to maintain & update my skills. I must admit to feeling a little perplexed by the use of your suggestion that I ''get over myself''? This is a place where professionals in our field share their views. Is it not? I too look forward to a time when only one course is made available. If you take the time to google FHP on the internet you can see perhaps how many loop holes there are currently. Oh, one last thing, I (not my parents) paid for my student loan.
Kind Regards.

 

twirly

My mistake please accept my apologies. I arrived at that assumption through the somewhat immature posting you made.

As did many and probably was still using solid scalpels to strop and hone as well . That was how it was done then.

I now use a Prestige century 3 vacuum autoclave, Oh how times have changed .

Now call me old fashioned but is this not perhaps exaggerated ?? I cannot believe anyone (unless they have a neuropathetic foot) allowing any practitioner to cause that amount of pain without pulling their foot away

Where is the fitness to practice hearing details that would surly have followed ??

Yes we ALL are

Yes I believe you should. Your "superior attitude shines through in your post and your obvious dismissive attitude to any practitioner that has gone before you that does not hold you coveted degree should not be in practice is arrogant and shows a lack of understanding of the clinical practice /training history within.

I cannot speak for your relatives as but from my standpoint the main difference in the SCP course and the one I did was in clinic time which was from memory 100 hours against 250 hours . The theory side was in the main the same.

But that was 20 years ago ,what is the point of dragging that up here ?? Will it alter anything ?? If you are that bored that you are Googling FHP's and posting inaccuracies on here then perhaps you should turn your mind to a more constructive mode ??

Perhaps how to unite and move the profession forward may be a good start?

Of course it is and that is how it should be. But you should really make sure your views are not based on fiction and fantasy and that a percentage of your"facts" are at least partly correct , shouldn't you ??

Cheers
Derek

 

Greetings once again Derek,
I do not hold with your opinion that I consider my degree to be the epitomy of Podiatric excellence. My view is based on my own experience. Granted I have not been a practitioner for as many years as your good self but I still believe that a 3 year course of study is superior to an educational course which encourages individuals to believe that from the receipt of a certifiate that they have the sound knowledge required to safely treat individuals.

This view is hopefully a thing of the past given that our governing body requires its members to provide evidence of their ability & knowledge.

Would I also be correct in assuming that the Health Professions Council now only recognise any future applications for those wishing to become registered as Podiatrists/Chiropodists
from individuals who attain a degree through a recognised school of podiatry? Or am I again allowing my imagination to run wild once more?

I would bow to your greater knowledge should you wish to enlighten me further.

Regards,

 

Hi Twirly

Any educational advancement can only be for the good. Times change, things move on and I agree that the degree system is now the way to go.

I am not sure if you are now talking about FHP's (of which I know very little) or are still having a pop at distance learning from the past ??

I am not sure that anyone would believe in this day and age they have a sound knowledge of every situation when the come out into the big wide world ( from uni or otherwise) but we do have referral systems, scope of practice issues to be considered and a disciplinary system.

What you don't seem to comprehend is that EVERYONE was diploma trained years ago. EVERYONE used solid scalpels ,Milton or such like for steralising.

That was the profession then.

We have now moved with the times and with CPD ,new technology computer orientated lifestyles/ clinical hardware etc those of us who have moved with that have survived. Those that did not have fallen by the wayside.

While we( that is both of the old "sides" remember) were evolving we gained a thing called experience where our clinical skills and judgment were developed and we continue to carry out safe effective practice to many thousands of patients routinely. I don't remember hearing of any massive medical negligence claims being made on our side in the past so.......... cant be all bad can it ??

I have no "greater knowledge" than you Twirly I have just been doing it longer but I do hope I have opened your mind to review your prejudices with regard to the "Older Pods" some of whom still care passionately and want to move the profession forward and not dwell on the past.

Cheers
Derek

 

Thank you Derek, We do appear to have taken off on the wrong foot, (no pun intended) my sincere apologies if my initial post seemed to be a tad contentious. I am quite sincere when I stated that I bow to your superior knowledge.
I also admit that I hope to learn a little more each day. It would be an extremely unwise person who believes that a degree or a certificate, automatically provides the holder with even a modicum of common sense.
Heres to the future, :drinks
Regards,

 

Hi Twirly

Ahh common sense that old fabled saying

It is a great shame that has not been integrated in many ways in this profession and this country.

Perhaps then if it had, things would be better for us all .

Heres to the future,

And may you and yours in you comparative youth carry it forward with passion and fortitude::drinks

Be Lucky
Cheers
Derek

 

Alas, I too am of the vintage that instruments were kept 'sterile' by immersion in what was little more than nicely coloured water - a delicate green at the Birmingham school as I recall - and stropping a scalpel was a damned sight cheaper than buying blades from our own poor resources (which most of us eventually did). At the end of the day we would carefully clean and place our instruments back into their nice tidy little cases - I still have mine and am open to offers if anyone wishes for instant nostalgia and probable instant infection.

Just one point though, the Society (or any other professional body) was not empowered to 'permit' anything or anybody. The HPC have accredited all HPC registered practitioners as podiatrists or chiropodists and that is now the law. Had the Society chosen to listen to good advice (and I don't include myself) then it is entirely possible that we could have had a General Podiatry Council and not been involved with the HPC.

The current movement in the halls of power appears to be pressing for one overarching regulatory body with various 'arms' to deal with different professions. Just a shame that we could not be one of them.

All the best

Bill

 

Hi Bill

I wonder if we took figures from those days how infection numbers would be compared to today with all our controls etc coz I don't remember it being a problem then. As far as "Milton" is concerned both my children ( 37 &35 now) had all their baby bottles "steralised" in that fluid. Both healthy and given me 4 grand children so it must have worked ?????

I think that applies across the board Bill not just with the Society everyone had their chance to unite but didn't take the advice ( Common Sense Approach) and yes we are now left out on a limb in a bucket full of holes.

Our day is nearly past it is up to the likes of Twirly & co ( the young bloods) to continue the fight.

But fight the right people, Not your own.

Divide and conquor.... THEY DID

Cheers Fella

Keep turning the wine into water :drinks

Cheers
Derek

 

Question: Is 41 young?
Answer: Depends which side of it you are I s'pose.
How old was I when the 'creaking' started?
When did they start employing 12 year old policemen?
Why is all music crap now? No words, no melody, just boom boom!
(someones buying it though, have you ever seen cribs)?
When did a good book & a hot bath start to become more appealing than a night on the town?
When did I begin to become more interested in the despatch section of the local paper & less inclined to read the hatch & match section?
When did yearning for a Mini Cooper S become part of a mid life crisis?
& finally ......... erm, erm, I forget........................

young bloods, bloody whipper snappers.

 

just to say that in France medical pedicurist was a job before 1985, just after this date a new degree change the profession as 'pedicure-podologue'
so we have medical pedicurist (pédicure in french) and chiroposdist (podologue in french) (they are pedicurist and make the soap for feet troubles).

a pedicurist cuts nails, corns and callus, nails incarnation, autoclaves her instruments and can treat all the little trouble of dermatology on the foot,
but does not paint nails or do foot massages etc.

my consultation is charging 35 € by exemple,

sorry for my english but if someone would like to speak with me I promise I will improve my level.

Arnaud
pedicure podologue
Paris - France

 

Bonjour Arnaud,
Comment allez-vous? Je m'excuse, je ne parle pas le Francais tres bien, j'ais perdu les mots! Votre Englais cette plus bonne!
Mais , je ne comprend pas que dites vous comment le savon?
Cette interestante pour ecoute, il y a deux persons, dans la France que travaille avec les pieds.
Si une person Anglais desiree travaile en France, que fait il?
Merci beaucoup pour votre response.
Dido

( In English)
Hello Arnaud, how are you?
I apologise for my poor French - I don't have the vocabulary! Your English is very good but I don't understand what you say about soap?
It is interesting to hear that there are 2 types of practitioner working with feet, in France. If an English person wished to work in France as a Podiatrist, how would they go about it?
Thank you for your answer,
Dido

 

Dido,

I was about to ask RE: the soap thing too.

I'm impressed by your French & Arnauds English also.

Far braver than me to post in another language.

:drinks

 

no australian posts (apart from this one!)???

 

Nope markjonconley,

Seems all yer' mates have gone bush.

 

Hi Twirly,
Thanks for the compliment but my French is really quite basic! I was just trying to make Arnaud feel at home! Arnaud has a very good grasp of English and I agree that he is very brave to post on an English forum.:good:
I was interested to hear about the two types of practitioners that operate in France. Hopefully Arnaud will come back and tell us a bit more and perhaps explain the "soap" business.
regards
Dido

 

Toujours le Franglais!

Peut etre le Frine (Francais/Australian)?

Un slab (36 tinnies), Une petite slab (24 tinnies for the ladies), Beaucoup de chunder (multiple vomiting in the channel tunnel), Le vegemite (a weaklings marmite - alternatively un ami Australian qui mange pas de viande), un pommie (a cultured Australian).

Happy New Year

Bill

:drinks

 

Beautifully put.

I could't have said it better myself (believe me).

Do you also MC at weddings Bill?

<tittering muchly>

 

Salut Arnaud et les autres Podologues Pédicures, Chiropodists, Podiatrists, Podotherapeuten, Podologos !:santa:



Well, I'm not totally agree with Arnaud.
In France There is ONLY ONE profession which is Pedicure-Podologue.This profession is called Podologue too and pedicure by the elderly (like in UK with Chiropodist-Podiatrist and Podiatrist, there are two words for the same profession, the old one and the new one).

This profession of Pedicure-Podologue (or Podologue )is regulated and we have a national board (I think that it is the good translation for "Conseil national de l'Ordre" )

Ciao a tutti!

Frederic GUIOT
ANGERS
FRANCE

 

Arnaud,

I don't understand what does "soap" mean too. Is it a "soin" in french?


Frederic GUIOT

 

Je regret non

Mais pour vous cherie... peut etre tu? Toujours!


Bill

 

And the Seasons Greetings to you too, Monsieur Liggins! - do I detect that you are extracting the " oui, oui" by any chance ???
regards
Juno

 

Bonjour Frederic,
I think I have become a bit confused and lost something in the translation!
So there is only one type of registered "foot practitioner" in France - just like uk.
En Francais, savon = soap
Lavez = to wash
but what is "soin" in English??
regards
Juno
PS I think we should watch that Liggins chap, he is using the "tu" form of address and therefore getting a bit familiar.........!

 

Hello Dido,

"Soin" can be translated as "treatment"
I know that soap is savon, but I don't understand what does Arnaud want to tell us

In France, only the Pedicure-Podologue (and of course medical doctor too) can treat foot problems like ingrowing toenails, warts, corns, calluses, diabetics problems.... You must have the french diploma (in three years) of Pedicure Podologue. If I understand, in UK you have the Podiatrists, the foot health practionners, nurses... that can treat foot, in France it's only the Podologue (the nurse can't).

We treat foot problems with orthotics but other professions like "pedorthics" can do them too, but our profession do about 90% of them.

We can't treat surgical problems

Mr Frederic GUIOT

 

Please excuse use of translation:

En français:
désolé À INTERUPT MAIS À PIEDS, OUI je COMPRENDS que fRENCH CEPENDANT EST TRÈS LIMITÉ AINSI MAI où je PRIE POUR L'INTERACTION EN ANGLAIS avec TOUS NOS REMERCIEMENTS, PIROUETTES

lol at interpretation of twirls BTW