New Podiatry Wage Rates HSU III

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Hi,

The new Podiatry public sector wage rates were released last week after nearly two years of waiting. What bothered me was that in the new wage schedule all professions are now listed separately. What I noticed is that once a podiatrist reaches the level of Grade 2 Year 4 that the next step is then to move to Grade 3 Year 1 - which was always the case across all of allied health. The new wage schedule however no longer includes a Grade 3 Year 1 classification for physios, OT's and Speech Therapists and instead after Grade 2 Year 4 their next step is listed just as Senior Clinician. I have rang the Health Services Union regarding this matter but they have provided me with very little detail on what this difference means. The inferrence I am getting is that it would be easier to argue that you are a senior clinician based on experience than it would be to argue that you should be paid at a Grade 3 Year 1 level as it generally requires that you are doing specialised work within your field.

I am hoping that there may be some other Pods out there who are across this issue who may be able to shed some light on it.

 

I didn't see what part of the world you're from, but I assume the UK or Australia? If I missed it I apologize ( i'm in the US). I find your use of the term " wage, and Allied Health" worrisome for us in the US who are moving toward Universal Health. I'm not sure how podiatrist are categorized "overseas" as professionals ( if you use MD as the gold standard) I would appreciate a lesson. Are Podiatrists categorized like pharmacists , physical therapist and nurses?

 

Robert

Umm. First, let me get the annoyed part of me out - please don't take it personally, its just a gross generalisation.

Why is that almost every US podiatrist that stumbles onto Podiatry Arena needs a serious history lesson on the evolution of podiatry/chiropody (let alone different forms of health care systems) worldwide. Whilst most other visitors from the many other countries that make up this discussion group have at least a rudimentary grasp of these basics...maybe I'm wrong.

But, to answer your question. Podiatry is unique in its professional status only in the USA. Everywhere else in the world it is classed as an "allied health" profession. Think physical therapist, pharmacist, dietitian. IMHO, its a silly derogatory term that actually harms those that choose to be called as such, and just reenforces medical dominance issues.

However the whole "universal health' thing is another can of worms entirely and is being discussed (rather unsuccessfully) over on another thread right now.

The point of this thread is a discussion about a particular Australian state award system for those podiatrists who are employed to work directly by the government in public hospitals and community health centres. Depending on what part of the country you live that may be as little as 5-30% of the entire profession. The rest of us work privately in fee-for-service arrangements. Same deal in the UK and elsewhere, though the proportion of the profession as a whole who are employed in the public sector varies.

Sorry to have a go at you. I'm just a bit tired of explaining this to every new DPM that stumbles in here. It's really not your fault, it's just an American trait I've come to realise.

LL

 

"Stumble upon"is pejorative, as if you have a special invitation to this blog, but we have to stumble upon it! As for it being an American trait, I take offense as a proud American. That's a blatant over generalization. I suspect there's a thing or two you don't know about America, but I wouldn't be so insulting. Asking you about your reimbursement does not show an ignorance to Podiatry's evolution. As you're still considered Allied Health Professionals, it appears you're not as evolved as we are. Robert Bijak, DPM, DABPS

 

Clearly.

Thanks for confirming my generalisations.

If only there were more Kevin Kirby's and Eric Fuller's in the US. What a different world it might be...


LL

 

Ouch! Monofiliments at 20 paces, boys.

 

Yes, LL it would be a different world. You'd be speaking German

 

Okay, I'm sure we need a sticky thread somewhere for newbies as to what Pod's are and how they are employed everywhere but the US. Robert, it is something that is explained to our US colleagues over and over again and your attitude is disconcerting. It scares me to think that the only way a Pod can evolve is to become a DPM.

Anyways, back to the question:

Have you seen the full document of the 2004-2007 agreement. It had all listed separately as well. So that isn't a new feature.

It is my understanding that is was one of the points that was the thing that took the longest to negotiate. Moving a grade required different skill sets, responsibility, research and administration. Not all departments were able to justify this is gain funding for a Grade 3, especially in smaller departments. A senior clinician is more about recognition of years of service and a natural progression and assumption of responsibilities that generally comes with years of service. It is still my understanding though you don't progress from a Grade 2 Yr 4 to a Sen Clinician Yr 1 on your anniversary. It is still something that needs to be negotiated based on job description and job role but it gives staff the more push for grading based on the work that is being done.

 

Dear bug, Thank you for the clarification that I sought initially. Because you folks are so familiar with your own situation you probably can't appreciate how different this seems to U.S. practioners. I have now learned something, which was my initial intent. As you may or may not know, we have nothing similar. Our Dr's are all paid the same from the first day they start their practice (assuming residency completion& board certification in your specialty). I assume your term "Senior clinician" is the last rung of your ladder?? Another thing that surprised me is that "Podiatry Arena" seems to be inclined toward non US practioners. That's not a criticisim. When I first discovered this website there was no indication of this and I thought it was an equal International forum. I was offended that after my FIRST inquiry, I was chastised, and Americans were impuned as to have a certain "trait". I'm afraid the broad freedoms we enjoy here are so natural to us we find it surprising that others in the world are much more regulated. To obviate further incursions into "your space", your suggestion that there be a disclaimer explaining who uses this forum most and perhaps the differences in government regulation be considered. Anyway, I thank you and will not pursue this particular tread but look forward to reading and responding to clinical questions.

 

I would presume Robert, anyone employed in a public role would progress through a series of promotions and this is a similar progression, do residents not get pay rises? Senior clinician is also not the last rung, there is a Grade 4 and then Chief and various Chief grades within the award.

I think one of the main points that LL was making about Pod Arena, is not that it is inclined towards non-US practitioners but that it is the US podiatrist/employment model that is different to all the others. I think it should be of interest to you as a Podiatrist to learn or understand how your profession differs in skill sets around the world. This discussion board, not blog, has a great number of UK and Australian Podiatrists, countries that have similar health care models and public/free service provision of all medical and allied health. Whether or not your agree with free public health and think that it hinders or helps the profession is another debate entirely however.

Another tip is to loop up to the top and check out the thread. This was posted in: Podiatry Arena » Country Specific Issues » Australia New Podiatry Wage Rates HSU III . Sort of gives it away then that it isn't a US thing.

As a long term public sector worker I am committed to this model of service delivery and don't see the broad freedom you describe, of a user pay system as a positive thing. The demographics I work with generally struggle with a user pay system of groceries so their childrens health is the last thing on their priority list.

This is a shared space, not yours or mine, but welcome and hope you can contribute and learn.

 

One becomes acustomed to the paradigm they live in so i believe you don't understand the freedom we enjoy. We have opted to give the best medicine in the world to most of our population as opposed to mediocre service to all. The U.S. is still the gold standard for medical care in the world. If we wax socialistic like the rest of the world, the world won't have the beacon of research, drugs, and care that they have with the US. Capitalism has proven to be the engine that has fueled innovation. Socialism rewards complacency. If it was your child, would you want to wait and guess when empirical testing is available immediately? Good American doctors add hard science to their art. You can listen for horses but it's the Zebras that will bite you in the pants.

 

Lets get back to the original posting here boys...
I am also interested in the origonal post.
We had the HSU guy come around and explain the stuff several times. But I am just more confused.
I liked what he said about easier progression up the ladder so there isn't just one PO2 or Senior Pod in each department. I have noticed with other AH teams at my site that staff turnover is high because people get stuck in the PO1 classification and can't get any further than the PO1 level 7 so they move on to areas where PO2 positions are advertised.
I also like the fact that we are aiming for similar wages across the country.
But the confusion remains. I would like to know what sort of process you need to go through to argue your senior clincian status! If its anything like the current reclassification paperwork good luck to you.

"The inferrence I am getting is that it would be easier to argue that you are a senior clinician based on experience than it would be to argue that you should be paid at a Grade 3 Year 1 level as it generally requires that you are doing specialised work within your field."

 

Re the HSUA. The wages and conditions outcome only applies to podiatrists working in one of the 55 listed organisations in Victoria. There is no change to the classification around grade 3. For Podiatrists it has always been grade 3, for PT/OT always been grade 3/ senior clinician. This is becasuse the physios got grade 3 (and grade 4) before podiatrists.
The only change to the definition was for grade 2 positions, where the "on the recomendation" section was removed

the full determination is here

 

Robert, there is a fine line between medical art and over servicing seeing you are dragging comments from another thread in here. Good Australian podiatrists in public and private add hard science and educated diagnostic skills to their assessments and treatment.

I work in a system that you feel provides a mediocre service but then I work in private as well so maybe that drags me out of the dreaded socialist class you seem to feel we function in. What a statement.....insulting much??

I hope that during your time at Pod Arena, you see that there are some damn fine podiatrists that provide gold standard that are government paid employees and actually don't work in the good ol' US of A. :deadhorse:

 

Robert,

Have you experienced (practiced/received) health care outside of the USA?

Julian

 

Under the new HSU Agreement, I have been promoted to a Grade 3-1. As it is now nearly midnight and I am still working, it hardly seems the .50 cents was worth it!

 

To julian: Was a pt.1 wk in cardiac care in
Venice Italy. Also spent 1 wk in same in Haarlem, Holland and even had an angiogram there. I can say the cae was quite different, but I did survive.

To cylie: The operative adjetive in your post is "Good" Australian Podiatrist. I don't doubt for a inute there are excellent practioners overseas. My point is because we havaen't had govt/. restrictions in the past we didn't worry about a cost ratio in deciding to run lab tests.

 

Hi Backdoorpod, do you mind if I ask if you work in a hospital or community health? Also what part of the new agreement or your work made it possible for you to be automatically promoted to Grade 3?

 

Robert, I have never worried about about government restrictions on ordering tests IF they would be useful, assist in the diagnosis or medically appropriate. I don't know of any doctor or allied health that would in the first instance order blood work for something as simple as posterior heel pain in a child. I'm sure if it was ongoing and atypical then it would be. I only work with kids, I'm not sure any would come back if this became standard practice for toe walking, DCD, gait disorders relating to ASD etc.

Maybe in this country our population place a greater trust in the practitioners rather than the amount of tests they can order. If there is any restriction on rontine blood work I don't know of it. See Dr, Dr thinks it is appropriate, Dr orders - simple. Besides, lab work is just another tool like an x-ray, ultrsound, MRI etc. I use plenty of those, does that raise me a peg? A tool is only good in the hands of the person using it.

Oh, bit of Australian medical information: Podiatrists can't order blood work. We can order pathology testing on skin/nails etc. We can order x-rays, ultrasounds that can be free of charge to the patient and done same day or within the week through the hospital or external non government funded service provider.

Backdoorpod - also interested in how that happened??

 

To cylie, You really have me confused now. You say you have no govt. restrictions on ordering lab tests than you say you're not allowed to order blood tests (by law). As a degreed specialist in Laboratory Medicine (besides being a Podiatrist) you'll understand my incredulity. If the heel pain and toe walking is as simple of a dx as you say, why would you be asking for other opinions? This is getting silly. Had I known your laws forbid you to order blood tests I would have just said refer to an MD. Over and out, I think.

 

Fair enough. however mostly our MD's have referred to us, without blood work. I hope in your time here is both thought provoking and educative.

 

Robert:
I think you are outnumbered!
No one coming to your defense?

I've learned, as I'm sure you will, that it really does not pay to start being too political here at the Podiatry Arena.

For the most part the medical side of it is very interesting and can be quite a learning experience no matter what level of practice you are at, but when you begin throwing around "capitalism" "freedom" "Free market" "socialism" etc....... you open the proverbial can of worms.

When I began the thread Government Run Health Care - Good or Evil it quickly deteriorated (perhaps "changed" is a better word) into a discussion on the role of Government and, for me at least, how the U.S. is perceived; how the media in other parts of the world apparently portray us, our life style, our politicians, our majority views and our relationship with our government.
Quite disappointing from what I perceive as reality.........And I live here!!!!!!

Let's face it, we are the ULGY AMERICANS regardless of our self image.

Stick to advice on Verrucae, orthotics and bunionectomies and be happy with your private insurance coverage, your middle six figure income and Monday Night Football!

Steve

 

I've tried to end this now I have to challange one of my own countrymen. Speak for yourself that you feel you're UGLY! I & America are not UGLY AMERICANS,
we're just ENVIED. I make no excuses for our success through capitalism. What's wrong with you? What do you think you're doing everyday? "To compromise is to doubt your own convictions" (Richard Widmark in the "Bedford Incident"). It took many posts making clinical suggestions until I found out Pods in Austrailia can't even run blood tests! I think that's the rationalization for not doing them. Perhaps being a political "gadfly" may incite a revolution and subsequent evolution of Podiatrists in the rest of the world. If a profession is as fragmented as I've learned here, it won't be taken seriously by the rest of the medical community. We see that in the US with different state laws governing different scopes of practice. And, as you know, US Podiatry is not without its own challenges. robert bijak,dpm,dabps

 

Hey Robert:
You may have a way of jumping to conclusions.......
I NEVER said I felt we WERE ugly, nor was I making any excuses.
Please reread my post in the sentiment in which it was written.

I'm on YOUR side, both in these posts and on the Atlantic.
Steve

 

Robert:

I & America are not UGLY AMERICANS, we're just ENVIED.

I and America? Aside from the obvious, how do you speak for all of America - of the roughly 300 million you, dear sir are just one voice and one opinion.

I make no excuses for our success through capitalism. What's wrong with you? What do you think you're doing everyday? "To compromise is to doubt your own convictions" (Richard Widmark in the "Bedford Incident").
That's just a convenient excuse to reject any and all criticism, and not based on a mature worldview....Thou doth protest too much!


It took many posts making clinical suggestions until I found out Pods in Austrailia can't even run blood tests!

We assuredly can run blood/pathology/radiology tests etc, it is just that only some of them are part of the government subsidized Medicare scheme - so in most cases we do not refer as patients can access these same tests via the GP/Specialist either fully subsidized or heavily subsidized. Australian pods work in the private and public sector, Pod Surgeons have made significant inroads into the medically-dominated landscape of care here, thankfully inroads continue to progress.

Yes we have a socialized health care system here, and there are some significant issues, we also run a private health care system in tandem, and it has issues as well.

Julian

 

She says you can't run blood test. You say you can.. but in some cases you refer out. You have govt insurance, but you also have private insurance. What a mess of inconsistency. You criticize me for not having a Worldview! The world I'm reading about here is very confused. Besides, except for a few religious views, who says a worldview is the best view? Where's the evidence? As for me being one voice and not being representative of America, I wouldn't walk into an American Bar and start using the term UGLY Americans. I think you'd find I do represent the majority of SANE Americans. Can we end this one upmanship? It really will be difficult to make clinical suggestions not understanding your limitations in carrying them out.

 

"There is tremendous diversity in age, race, gender, language, location (worldwide) and most importantly, in the scope of practice of podiatry in different countries. Please respect those differences."

Worth repeating!

Let's move on.

Steve

 

Thank you for your kind offer, likewise, if/when you also require clinical suggestions please feel free to ask.

 

I work in a regional community health service. I was promoted to Grade 3 for a large variety of reasons. Mainly to do with increased clinical supervison hours and research opportunities. If yu have anymore questions you may PM. I do not think I shall return to this thread.

 

With regard to the Australian system of healthcare- God bless Medicare and all the public health systems that go along with it. My hubby has been battling B-ALL leukaemia now for nearly all of this year, and the vast majority of his treatment has been free of charge. With 3 kids under 10 and me only working on a very casual basis (full time Mum,carer etc) I can only say how grateful I am that I live here in Oz. The care from the Alfred hospital in Melbourne has been top notch, staff, docs everyone is just superb!!!

 

To All My International Podiatric Colleagues:

Please don't take Robert Bijak's comments as being representative of the majority of podiatrists here in my country. He is in the minority, thankfully, for our country's profession.

 

Kevin,

No need to worry, I (we) don't!

I think the point at which he referred to not mentioning topics in a bar was the 'clincher'.

 

Dr. Kirby has just substantiated what American Podiatrists have stated in a different blog that attacked biomechanics as NOT being a real science. In the Podiatry Arena Blog he anecdotally states I don't represet the majority of Podiatrist. The reality is he has nothing to substantiate his claim. In fact, it was precisely a debate among Podiatrist in the"Podiatry Mangement " blog that questioned the lack of science and efficacy of arch suports. I came in later as another one questioning . He teaches arch support technology so you can see where his BIAS is. "Cushioning' & heel spur types of arch supports make the majority. (Reference major labs). The majority of DPM's aren't to impressed with arch support biomechanics. Most check the box "lab to evaluate post to cast" . Of course Dr. Kirby makes money teaching about arch supports, so his BIAS is obvious. My only interst is the TRUTH.

 

Yes well, as a wise man once said, "The truth is out there".

Can I also help with some terminology?
A blog is a monologue of a single persons thoughts on a subject. Others may comment and the user may or may not choose to their comments be seen.
A forum is a collective of diverse people discussing things.

 

Robert:

I don't make money teaching about "arch supports". I only get paid to teach surgical biomechanics, foot orthosis biomechanics and sport medicine about 4 times a year which makes up about 0.2% of my total income at about 1/10 of the hourly rate I would make if I simply stayed in my very busy practice and saw patients. I still teach surgical and orthosis biomechanics and sports medicine and always have taught these subjects for the benefit of the podiatry students, not for the money. And who determines, in your opinion, what is the truth?

Robert, why don't you spend your time here on Podiatry Arena with your considerable accumulated knowledge doing something positive for yourself and others by teaching and maybe learning a thing or two. Instead, from what I have seen from your postings here, you have made a point of continually insulting your international podiatric colleagues. I don't understand the point of this exercise in futility. I would think that being more friendly and helpful to your international colleagues would be a much better use of your time. In addition, you might actually make some friends on this site, like nearly everyone else has who has been more polite.

 

Excuse me, you're the one who wrote about me. I happened to get the email of your thread this morning. Certainly I'm not going to let you unilaterally run from the "Podiatry Management" blog where there are opinions against your beliefs, while you look for comfort in the Podiatry Arena site. Save your platitudes, and global kumbya for your student captive audience. Dr. Kirby, your ego is showing.