Podiatric Surgeons Unregulated?

had hallux valgus on both feet. I was only 13 and he shouldnt have operated on me as i hadnt finished growing. he was massively unprofessional, showing me what he planned to do using someone elses x-rays as mine weren't 'available'.

i know i ended up with 3 k wires in each foot one of which got an infection around it.

the whole thing changed the course of my life as i couldnt carry on with my hobbies, one of which was motorsport, due to the pain and discomfort. i now have to drive an automatic car as my left foot hurts when i operate a clutch pedal.

i have spent so much time in hospital since that when i went to visit my grandma recently 2 nurses recognised me and asked if i 'wanted my usual bed'.

i will be actively campaigning for a regulatory body to oversee podiatrists for the sake of patients. Unfortunately I no longer trust anyone other than my orthopaedic surgeon to deal with anything related to my feet but i understand that podiatrists to provide a useful service, sadly theres always a few people that ruin it for the many.

 

I think the group of practitioners to which you refer are PODIATRIC SURGEONS not PODIATRISTS.

Podiatrists do not carry out bone surgery of the type you describe and but are already regulated by a governing body ,The Health Professions Council, to which any registered podiatrist is accountable.

I hope that clarification helps
Best Wishes
Derek

 

I'd have to defer to my colleagues on this one (i'm mainly a biomechanist) but 13 certainly seems ever so early for hav surgery! I've never seen anyone else who has had hav surgery at 13.

Mind you I could tell you some horror stories about foot surgery by orthopaedic surgeons as well.

Steve, (or any of the other surgeons) what say you? Hav surgery at 13?

 

Flightless Fairy seems to have had a bad experience.

Of course it is wrong to say Podiatric Surgeons are not regulated, they are. I`d be interested to know how long ago this operation took place ?

The 3 k wires would suggest an osteotomy, not unusual; an infection about a k wire, not unusual. There are many factors that can give rise a poor outcome, not all within the power of the surgeon.

It must be said that a bi-lateral osteotomy on a 13 year old racing driver is most unusual, Flightless Fairy must have had severe problems !

Can you tell us more.

 

No thanks. Better off over the park drinking alcopops and smoking pot with their mates.
Which raises a serious question: when I went to school skeletal maturity in the foot occurred somewhere between 18-21 years according to the "book of brilliant things", with the youth of today growing up quicker- at what age does the current research suggest that average foot reach skeletal maturity?

 

I had two operations by this podiatrist (not a podiatrict surgeon, and in a very sketchy temporary building round the back of a hospital) about 12 years ago now.

Since then Ive had a further 6 operations by my orthopaedic surgeon and the problem is on going.

the problem wasnt so bad that i couldnt walk, i just fell over a lot. looking back i wish i had been old enough to decide for myself as i would have waited but thats with the benefit of hindsight. my parents thought that the operations could take place in school holidays and not effect my life too much. but apart from not being able to go out for 2 summers, being in a plaster cast at such an important time in my life i then suffered the on going emotional issues assosiated with so much surgery which affected my GCSE's, A Levels and ultimately my university studies.

{name removed}, a very influential orthopaedic surgeon in london was truely shocked that i had been operated on at all. he thought that will appropriate shoe inserts and night splint use i could have put off the required surgery for about 8 to 10 years when the surgery would have then been relatively non invasive and would have taken a lot better.

i understand that accidents happen but i dont really deem this an accident, this could have been avoided if {name removed} had the balls to admit he was in over his head with this.

Also at this point i should mention that this was a halluc valgus but it was because of a deformed cubic bone as opposed to a bunion. not sure if that makes a difference in your opinions. I do appreciate hearing your views on this as i understand {name removed} thinks quite highly of himself in his field and you guys must be a similar level to him. What would you have done if i had been referred to you?

 

Flightless fairy,

I am sorry to hear of your experiences, however, I don't think that this is the correct place to be airing your opinions as this is a forum for discussion between professionals. If you have a grievance, you should take it to a solicitor.

For the record- {name removed} must be a qualified podiatric surgeon to perform the operations you describe.

 

Flightless Fairy, i'm sorry to hear of your foot problems.

However as Dr Spooner quite rightly said, this is not the area for making these views public. The professionals on this site will not give views against another particular professional, its just not "professional".

Although working in Podiatric Surgery myself i do have to say that Orthopaedic Surgeons also have their fair share of "bad" post operative outcomes, as do any surgeon.

Once again sorry for your ongoing pathologies, however seek legal advice not internet advice.

 

Firstly, I'm not convinced this is a genuine post. If you are a patient who has sought redress then I am sure your solicitor would have cautioned you against submitting your views on a public forum - even with the distress your problematic surgery would have caused. If I were {name removed} then I think I may be inclined to seek advice regarding your own views on a professional forum. No podiatrist would undertake the procedure you mention without having the appropriate training and qualifications on ambulatory foot surgery - in other words, they would be a podiatric surgeon, not a general podiatric practitioner. Whilst I would have every sympathy for someone who has suffered a complication of any surgery, I do not think this is an appropriate forum to which to raise your concerns - as distressing as they may be to you.

Best wishes.

 

Anyone want to explain the relationship between a halluc valgus and a deformed cubic bone to me?

 

Sorry cant have that, certainly if it was with the NHS, the surgeon level MUST have been the operative professional if not ....

As Simon Posted

And Mr Flanagan posted

And finally as Mark Russel posted

There you have it, many years of experience telling you this is not the place to make allegations or seek advice in this or any other public arena.

If your claims are genuine you may have a valid recourse through the legal system.

Please take heed of the advice

Best wishes
Derek

 

A further 6 operations? For what? Why was your first surgery so bad and yet the following 6 were good? Are you any better following the further 6 operations? I'm not trying to criticise any of your surgery or your posting, I am genuinely interested in what went wrong for you and why you have needed 6 operations since then. Personally, I don't operate on children for some of the reasons highlighted in this string of posts (so I wouldn't have performed bunion surgery on you and you would have been offered something along the lines of the conservative treatment that Mr singh has mentioned). Sometimes surgery doesn't work. I'm sure Mr singh has had some surgical failures of his own that he may not have mentioned to you (as have I). What you need to be aware of is that certain people may use you and your unfortunate situation as a political pawn. I'm guessing Mr singh doesn't like podiatrists or podiatric surgeons (if fact some orthopaedic surgeons refuse to use this title and incorrectly call podiatric surgeons 'surgical podiatrists' or whatever they feel like on the day). I would be very cautious to be guided or antagonised regarding your previous and current experience.

Some orthopaedic surgeons do not like podiatric surgeons operating because they are most concerned about their private practice. There have been several published articles regarding relative success rates in both orthopaedic and podiatric surgery and (generally) podiatric surgery comes out very well. Both professions will have their problems. Some orthopaedic surgeons may blow smoke about how podiatric surgeons are unregulated, etc... but the fact remains that they are wrong. The bbc article was not the most balanced piece of journalism you are ever likely to see. Please contact the faculty of podiatric surgery regarding your concerns. Here's a link to a website that will enable contact with them:
http://www.feetforlife.org/about/contact_us.html
If you email someone in their Marketing and Communications department, I'm sure they will be happy to help.

Rather than approach this problem from a negative angle (as in the bbc's program), you would be best working in collaboration with the professional body governing podiatric surgery so that you can ensure that your concerns are heard and real and positive change is made. If anyone has problems with surgery that I perform, I attempt to resolve the problem in cooperation with them. The best way to get a defensive (and potentially very unhelpful to you) response is to attack a profession whilst being guided by a competing 'profession'. Best of luck with it all.

 

I am not here seeking advice i was merely backing up the article that you were discussing that the BBC brought up recently. I was interested to see what podiatrists thought of it hence my post.

I have sought legal action and won because of medical negligence on his part. I want to fight this from the point of view of a patient who has received substandard treatment but i wanted to know if this was the way my case would have been dealt with had i had the fortune of being referred to one of you.

The first operation on my left foot that was fixed with K wires did not fuse. I have had an operation to try and re do this with a permenant fixture using screws on that foot. then the same on the other foot then toe shortening. My issue is not with the surgery since but the fact i was advised to have surgery at such a young age and in such poor facilities. This is the only podiatrist clinic i have ever known, i want to know if others are along the same lines or not. i am not here to argue or ask your opinion on the line of care not the profession who did it

 

I suspect that no-one here will comment any further on your case. Take it up with the health professions council who regulate podiatric surgeons.

 

You would not have been referred to a PODIATRIST !!!:bang:

There you have it
Derek

 

Agreed, but

I was wondering this!

Sounds to me like the 1st surgery did not solve the problem... but neither did the other 6!

And

I was gonna ask that! Sounds like a case of "we can't fix it cos its FAR more complex than a bunion" to me.

Anyway. Not commenting.

Robert

 

If this procedure was performed 12 years ago the CPSM was the regulatory body for Podiatric Surgeons, and very effective it was.

However, before a complaint was made suggesting negligence, it would have been necessary for a successful claim for ' negligence with causation', to have gone through the civil courts. Presumably after the successful claim things were left there !

Flightless Fairy, operations are performed as a last resort, outcomes are not always as we would wish. If there was cause for blame, then compensation was received; why continue bashing the first surgeon when the second surgeon was not successful after 6 more operations ? Could the second surgeon have an 'axe to grind' ? What were you told by him regarding the first surgeons ability ?

 

Flightless Fairy

I am sorry to hear of your problems but obviously cannot fully comment on your care without all the records, X rays etc. in front of me. One area which is certainly of concern is the facility which was apparently used 'outside the hospital'. No hospital in which I have worked would allow bone surgery to take place in other than an accredited operating theatre. I am certain that this is the case both in NHS and private hospitals. Did your legal action address this issue as well as the procedure itself?

I have to agree with the majority of my colleagues above. Unless the full facts are forthcoming, no responsible podiatric surgeon can comment on the treatment. These facts should include details of the six procedures carried out by the orthopod, if you will be kind enough to provide them.

W J Liggins

Consultant Podiatric Surgeon

 

i have heard on the grapevine (actually i heard the potential for this to happen a few months ago) that Podiatric Surgeons are being asked / ?forced? to drop the surgeon title and go for Consultant in Podiatric Surgery as oppose to Consultant Podiatric Surgeon. I have no other evidence than hear say at the moment but i've heard that the DoH are proposing this, i work in surgery and can't find anything to substantiate this, has anybody heard anything?

 

Mmmm. Can`t see this getting far.

I`ve been a Consultant Podiatric Surgeon in the NHS for 15 years on MC21 Medical Consultant grade.

I can guess where pressure for change is coming from but from the EU Human Rights Protection of Trade aspect they`ll hit a brick wall.

 

My NHS contract stated (I am semi-retired) that my job title was 'Consultant Podiatric Surgeon' and I continue to use the title in private practice. Even NHS bureaucrats cannot retrospectively change facts!

All the best

Bill Liggins

 

This story has been rehased:

The Express are reporting:
UNQUALIFIED ‘SURGEONS’ LICENSED TO OPERATE

Full story

 

NHS bureaucrats can bend the very fabric of reality to their whim!! I've seen them do it. They live in a shadow world where numbers and reports don't reflect reality, they create reality.

Retrospectively changing facts is the least of their dark gifts!!!

They're like a cross between "the auditors" in terry pratchett books, the aliens in "dark city" and lord voldemort in harry pothead.

 

Dear 'Flightless Fairy',

Please don't be disheartened --- you are not alone ... far from it !!

These 'Consultant Podiatric Surgeons' are exploiting loopholes in UK law that
1) allow ANYONE to perform surgery as long as informed consent is given - which means that humans are even less protected than animals, who can only be operated on by registered vetinary surgeons - registered on the General Vetinary Council's register, and
2) it seems that ANYONE (nurses, physios etc) can now be called 'Consultants'
3) it seems that even the title 'surgeon', quite incredibly, is not actually protected.

Any normal person/patient being confronted by someone in a white coat or a smart suit in a 'medical' setting, calling themselves a 'consultant podiatric surgeon' would very naturally assume that the 'surgeon' was a proper medically qualified surgeon, fully trained as a doctor, full qualified with the Royal College of Surgeons, and registered on the specialist register of the General Medical Council.

However, this is just not so. A 'consultant podiatric surgeon' is a completely made up job title -- it's not officially registered or regulated by any official statutory or regulatory body (except their own society, ie. themselves!). These individuals are actually officially registered as podiatrists / chiropodists (means the same thing). However, about 15 or so years ago some UK podiatrists started training themselves up in surgery and they then set up their own 'faculty of surgical podiatry' - and the good old NHS (blindly eager in it's frenzied lust to get waiting times down) started employing them.

The whole thing's an absolute disgrace.

Thankfully, however, the true message is finally beginning to get out there ---- this is not just some kind of petty 'turf war' between orthopaedic surgeons and podiatrists, this is an issue of fundamental importance encompassing patient safety and patient choice.

Please would you get in touch --- there's a lot more than I'd really like to discuss with you ....

stevieking2010@hotmail.co.uk

BW

SK

 

Hi Stevie

Welcome to the Arena .

As a new poster you should be aware it is not a good idea to post personal details ( email addys) on a public forum

If the the "edit" time out has passed on your post , if you contact Admin it will be removed.

If you want to contact any member you can do so via this site on Private message or email. Click on the members avatar and the options are there.

Hope that helps

Cheers

Derek

 

Flightless Fairy

Regrettably, the post by Stevie King is so riddled with errors and half truths that it cannot be relied upon by you, or any other contributor.

If one were to follow his/her philosophy then the mouth and teeth would be a continual source of agony because dental surgeons would not be allowed to practice.

Informed consent is always taken- and that means that the patient knows exactly what procedure is to be carried out and, importantly, who is to carry out the procedure.

A consultant title is what it states - (in this case) a practitioner who does not carry out their professional activities as a primary practitioner but is referred patients by a primary practitioner ie. they consult. This is not a 'made-up' title - complete or otherwise - but a title which is earned through examination - now by the two Royal College of Surgeons in Scotland, rigorous training as a junior and finally appointment by an appointment committee accredited by the NHS.

The longevity of podiatric surgery is far in excess of that indicated and the original body who dealt with podiatric surgery was the Podiatry Association some 40 years ago long before Stevie King could attack the NHS with his attempts at hyperbole.

I can clearly claim a great deal more knowledge than Stevie, and just from the information above, you should be able to deduce that the current drive against podiatric surgeons is simply the latest in a long line of attacks by Orthopods which will go away and then re-surface in due course. Patient safety and crucially, choice are indeed fundamental, and that is why these factors should be protected at all costs.

I will still be interested to hear from you the details of the six procedures carried out by the Orthopod that you mention but which you have not shared. In the meantime, beware of Orthopaedic Surgeons bearing gifts, especially those who post using inflammatory and questionably literate language, such that they may be assumed to be an ill informed member of the public.

W J Liggins

 

Stevie

Your diatribe is yet another rehash of a theme that has been fully discredited.

Whatever you motivation it is unworthy, inaccurate and mischievous

 

Stevie King, having noticed your comment on the Express Newspaper website following the sham reporting on Sunday. I don't really believe you are in a position to comment regarding professional training when in fact you are not a medical professional and actually a disgruntled IT support manager who had the misfortune of an undesirable post operative outcome.

 

Maybe it would save some confusion if the medically trained surgeons continued to be referred to as Doctor, rather than using the term Mister. Then at a glance we would be able to see who is who.

Or would this be too simple......

 

You want to tell them?

 

Why are surgeons in the UK called Mr or Miss or Mrs, rather than Dr?

In most other parts of the world all medical practitioners, physicians and surgeons alike, are referred to as ‘Dr’ whereas in the UK surgeons are usually referred to as Mr, Miss or Mrs. This is because, from the Middle Ages physicians had to embark on formal university training to gain possession of a degree in medicine before they could enter practice. The possession of this degree, a doctorate, entitled them to the title of ‘Doctor of Medicine’ or Doctor.
The training of surgeons until the mid-19th century was different. They did not have to go to university to gain a degree; instead they usually served on apprenticeship to a surgeon. Afterwards they took an examination. In London, after 1745, this was conducted by the Surgeons’ Company and after 1800 by The Royal College of Surgeons. If successful they were awarded a diploma, not a degree, therefore they were unable to call themselves ‘Doctor’, and stayed instead with the title ‘Mr’.
Outside London and the largest cities the surgeon served an apprenticeship like many other tradesmen, but did not necessarily take any examination. Today all medical practitioners, whether physicians or surgeons have to undertake training at medical school to obtain a qualifying degree. Thereafter a further period of postgraduate study and training through junior posts is required before full consultant surgeon status is achieved. Thus the tradition of a surgeon being referred to as ‘Mr/Miss/Mrs’ has continued, meaning that in effect a person starts as ‘Mr/Miss/Mrs’, becomes a ‘Dr’ and then goes back to being a ‘Mr’; ‘Miss’ or ‘Mrs’ again! :wacko:

Training to be a Podiatric surgeon
After a 3 year BSc Hons degree course in podiatric medicine, graduate podiatrists must complete a minimum 1 year post registration year before commencing a Masters degree course in the Theory of Podiatric Surgery. This course is joint validated by the Royal College of Surgeons, Edinburgh. After completing the post graduate certificate section of this course which includes Masters degree modules in Anatomy, physiology, medicine and pathology, podiatric biomechanics and diagnostic imaging. Candidates may then complete an Objective Assessment of Professional Skills Test at one of the five designated UK centres. This is often referred to as the passport to surgical training and allows the candidates to attend national interviews where if successful they may be offered a surgical training post in one of the three ‘Schools’ of Podiatric surgery.
The three schools are the West Midlands, East Midlands and the South East. A minimum 2 year training post will see the candidates rotate through a number of NHS department of podiatric surgery in their chosen school where they will gain a comprehensive experience in foot surgery under the direct surpervision of an NHS Consultant Podiatric Surgeons. During this period of training, the surgical trainees will undergo regular assessment of knowledge and practical skills and will keep a detailed log of their experience. Candidates will also continue with their Masters degree university course, completing modules in clinical pharmacology and research methods, leading to a research project in a surgically related field. This project must be of a sufficiently high standard to be published in a peer reviewed journal. Further practical exams in clinical diagnosis and surgical treatment planning are also completed during this period which culminates in a Fellowship exam when the candidates’ surgical ability and clinical experience is examined by two senior fellows of the Faculty of Podiatric Surgery. During this exam candidates must perform a comprehensive range of foot surgery on a number of patients.
Once awarded Fellowship of the Faculty of Podiatric Surgery, the podiatric surgeon is entitled to apply for Specialist Registrar in Podiatric Surgery posts in the National Health Service. These are generally 3 year posts when the podiatric surgeon will further develop their podiatric surgical skills and experience. Again their experience must be recorded in a log book which will facilitate reflective development. At the end of the 3 year Specialist Registrar post, the podiatric surgeon must submit their log book to the Faculty of Podiatric surgery for the award of the Certificate of Completion in Podiatric Surgical Training (CCPST). The CCPST allows the podiatric surgeon to apply for Consultant Podiatric surgeon posts in the NHS. All such posts are awarded by a carefully assembled appointments panel in keeping with the high standards of clinical governance demanded by the UK National Health Service.
The minimum training period for UK podiatric surgeons is 10 years and at least 2 post registration years in clinical practice. The whole process is extremely competitive with many more candidates than there are surgical training places, but it is well recognised that this element of competition ensures the highest standards of clinical practice.





Does this not class as 'regulation'?






Kind regards,



Mandy

 

The loophole that allows this debate to continue is that neither the Faculty, nor the society are a regulatory body. The HPC is the regulator, and in someones wisdom is seemed a good idea not to keep a separate register of pod surgeons, or even annotate the registration of properly educated and qualified pod surgeons. So it could be argued the title podiatric surgeon (or anything above Chiropodist/Podiatrist) is effectively not regulated

So this means that someone looking at the registration of pods on the HPC website cannot determine whether a practitioner is a clip and chip specialist, who does the minimum of cpd every year or a highly skilled and extensively trained pod surgeon, who has devoted many years of their life (as detailed in the previous post) to their professional development, who takes part in peer review, mentoring, research and audit year in and year out.

 

Agreed.

Podiatric Surgeons were registered as such under the old Professions Supplementary to Medicine Board and this continued initially under the HPC. However, after 3 years, some civil servant in their wisdom decided this was no longer necessary. However, I repeat, a civil servant cannot remove a qualification (FPodA in this case) and this is the assurance of quality. Mandy has explained the current situation very well.

Bill Liggins

 

I quote from a letter from the Privy Council to the Royal College of Surgeons in 1993:

Under section 4 of the CPSM Act , the Board, the CPSM and the Privy Council have to be satisfied that a qualification will ensure that the holder has sufficient knowledge and skill to practice the profession in question’.]

The only qualifications in Podiatric Surgery that met these criteria were Membership and Fellowship of the Podiatry Association. Under the HPC Act these qualifications could be listed but the HPC decided only to oversee 1st degrees, not postgraduate qualifications.

As things stand, holders of F.PodA and M.Pod.A are so protected and recognised in law and of course are subject to the HPC should they decide to 'take it on'. Those holding the Society surgical qualification are really 'out on a limb' and cannot claim protection. However, the HPC view is that foot surgery is carried out at 1st degree level. What nonsense.

That said, the HPC, with it`s generic therapy approach is totally unsuited for any sort of invasive surgery. A separate regulatory body is needed !

 

Indeed, I was going to bring this up when Bill posted regarding FPODA being a "barometer" for quality. Since the podiatry association doesn't exist anymore, the contention that the qualification assures quality seems questionable. Since the awarding body no longer exists and as such cannot be auditing the quality of their fellows, how is one to know that the "fellow" is still up to scratch?- Devil's advocate Bill, but can you resist the contention? If I were a fellow of the Royal College of Surgeons, presumably they could remove the fellowship granted to me. But since the podiatry association no longer exist, presumably their fellowship cannot be removed even if I cut the wrong toe off of a patient on multiple occasions? Which begs the question: can one even be a fellow of an organisation that doesn't exist? Isn't this like me calling myself a SRCh (state registered chiropodist)? None existent, anymore.

 

The fact that the awarding organisation no longer exists does not negate the awarded degree; there are certainly many degree holders out there whose awarding college is extinct.

I know of no Fellow who does not have some form of re-validation and annual appraisal, employment would be difficult without it.

The PA qualifications are recognised as being of an acceptable standard by the state, a starting point, like any other it requires maintenance in an appropriate way.

 

ps.

Simon

'If I were a Fellow of the Royal College of Surgeons, presumably they could remove the fellowship granted to me'.

Not so long ago the RCS intended to chase up those using FRCS but not paying annual subs. Their lawyers advised that if it came to court they would lose as FRCS was obtained by examination.

Membership of the Society can be removed but any qualification gained by examination ? I suspect the same principle would apply.

 

It's a contentious issue in the UK definitely. As a side point it's amazing how many pod surgeons there are in the UK who have only a brief knowledge of biomehanics. I would have thought that they went hand in hand. There are some very talented pod surgeons though.

Podtiger

 

Thanks for your posts guys. It's been interesting reading. Also Simon love the pics. You must enjoy triathlons mate?

 

Hello Simon

Sorry not to have returned your query -I've been away.

Rosherville has largely answered the point which you raised. Because a body which awarded a (state) recognised qualification no longer exits, that cannot negate the qualification. Every podiatric surgeon who enjoys admitting privileges to hospitals (both NHS and private) is required to undergo stringent annual review in order to maintain those privileges. So essentially, the qualification having been accepted, the acceptance is continued despite the examining body being merged with another, or otherwise ceasing to exist. I am sure that you must have come across this in your academic career when examining bodies merge or otherwise become conjoined.

Your point about the Royal College of Surgeons is actually as illusory as Stevie King's naive belief that all medical practitioners are Doctors (and I know that you hold a Doctorate). The RCS have an advisory role to the DoH, as did the Podiatry Association. The point is that the RCS, like the medical profession as a whole are extremely powerful and manage to create a belief that some of their bodies are regulatory when this is totally fallacious. Ignorant (in the true sense of the word) people such as Stevie are then misled by malicious journalists (who presumably derive some benefit) writing lies and half truths.

All the best

Bill