Health Reform - where to from here for podiatry?

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The debate following the NHHRC report is intensifying in the medical profession.

Medical websites are buzzing with the prospect of 'change', which has never been a strong suit of the AMA and others. There are outraged postings basically all with a similar vein - "how dare nurses and other health professionals try to do what we do...we won't clean up their mess....let's revolt!....GPs are being screwed over...etc"

Somehow when the shoe is on the other foot, it is a very new and humbling experience for medical practitioners...an erosion of power, ego and clout over all other health workers.

Curiously, the non-medical professions (outside of nursing) have been rather quiet about it all.

Take this article from the Australian Doctor:

One of the forum posters had this today about the article:

Last week, the head of the Pharmacy Guild, Kos Sclavos, had a lot to say about a greater clinical role for pharmacists, raising the ire of medico's;

Meanwhile, nurse practitioners and midwives legislation is being debated in the Senate, with the AMA attempting to maintain some level of control over the situation here:

In an important concession:

My question is - this could be the greatest shakeup ever to enhance the roles and responsibilities of non-medical health professions. Why are we not debating it!

LL

 

At the end of the day, Doctors have had a monopoly on patient care in this Country for far too long.

I congratulate the Victorian Podiatry Association (and significant others) on achieving the passage of legislation with respect to S4 prescribing rights (and duly note thanks to the Greens).

I recently raised the prospect of Podiatrists prescribing S4 drugs in NSW with a friend of mine whom is a final year Medical student. He informed me, that he and his colleagues would do everything in their power possible, to ensure that Podiatrists in NSW were not given prescribing rights. He is 23 years of age.

I questioned him further to examine the foundations of his argument. His framework of thought seemed so incredibly entrenched by the culture of the AMA, to "protect the power of Medical Practitioners at all costs". He did not seem to have much regard for the standing of allied health professionals.

I again congratulate the Victorian Association of achieving such a tremendous outcome, especially in the face of such opposition.

 

Hi LL and surfboy,

I have to say that i think a lot of the angst within the medical profession comes from the very real prospect of them lossing some/a lot of their "power".

And i don't think that, as a profession, Podiatry should blindly agree or think they are warrented with their concerns regarding issues of safety when we treat Pt's using modalities primarily used by medical practitioners just because they THINK so.
Since when did diplomacy mean blanket agreement with everything they say? I think we should be debating these issue more now than ever.

LL, how would you advise we debate these issues? Can you give us a push in the right direction?

Thanks

Sal

 

The AMA are a "trade union". The role of any trade union is to protect the interest of its members. Would you expect otherwise? Similarly, the APodA's are there to protects its member interests. Would you expect otherwise?

 

Well.

Any talk and discussion is better than complete silence. Which is about all I have heard from non-medical groups (aside from the Nurses Union).

GPs and the rest of medicine are going ballistic about all of this. Internet forums such as Australian Doctor and 6minutes are in heated and spirited debate about nurse practitioners and midwives in particular. GPs seem to percieve that this is a nail in the coffin towards their incomes, status and public health care generally.

I would encourage all podiatrists to read these comments, such as here.

I know I for one have written to my local MP to voice my support to the federal Health Minister of nurse practitioner and midwifge MBS and PBS reform. Naturally I explained about how podiatrists could also be better utilised.

Many things are about to change in a hurry. For eg, Divisions of GPs and going to become Divisions of Primary Care - with non-medical practitioner on the Boards for the first time! That means local podiatry input on health matters in regional communities. We need capable leaders from our profession on those Boards, stat.

I guess I get p*ssed off with the apathy of our profession. Does no-one really care if podiatry doesn't reach the professional status of some of our international colleagues? There is about to be (most likely) the greatest shake up in health care roles in a number of generations, and clinicians, academics and other groups in our profession are generally oblivious to the ramifications.

Where are the press releases, position papers and associated propoganda from our side of the fence? Or at least a bit of spirited argy bargy on Podiatry Arena?


LL

 

A 23 year old final year medical student would have much more on their mind than "doing everything in their power possible" to ensure that Podiatrists in NSW will not get prescribing rights!!!

In any case at the end of the day the decision relies on more people than just the AMA - who as Craig point out are merely a Trade Union (even though they will adamantly deny they are, but that's a whole other story for a different thread!)

Tony you are 100% correct - why is this not being debated in public forums more! This IS the greatest shakeup of healthcare this country has ever seen - for better or for worse we are yet to see. Sad that some people are not taking any notice.

One of my patients is a nurse practitioner (one of the first ever qualified) and works in Paediatric emergency in a major Sydney hospital. I am gobsmacked every time I have discussions with her about these issues about how knowledgeable she is and how poorly she is treated in the patient management ladder. I am appalled that someone with such experience and academic education becomes a minion to and RMO 20 years her junior. Makes you really wonder how poorly nurses are generally treated.

Does anyone have any lead writers/editors for major reputable papers? Surely one of us has a contact that would eat this story up!

 

LL,

Im navigating my way to those forums right now, and i will do everything i can to make my local MP aware of my support also.

This is the greatest shake up and i would love to be a part of it in any way possible.

Cheers for the advice, LL.

Sal

 

Hi all, on a slightly different note of reform.
Can not remember the years but there was a time when Pods and allied health workers could work form the Community Heath Centres privately. I think this died due to complications associated.
BUT ALAS it is back on the agenda. Does anyone know how to prevent the local CHC from setting up a private clinic? Where does one go for moral, legal, ethical support on this issue. Should we resist this.?? If we don't then are precendents set. Where does that leave us? :--((
Of course as we know all their necessary items are supplied via us the tax payer? There fore the fees can be reduced whilst the allied health professional makes easier $'s than those of us who have to fund ourselves!?!
I look forward to some assitance and guidance,

Cheers )

 

I guess I get p*ssed off with the apathy of our profession. Does no-one really care if podiatry doesn't reach the professional status of some of our international colleagues? There is about to be (most likely) the greatest shake up in health care roles in a number of generations, and clinicians, academics and other groups in our profession are generally oblivious to the ramifications.

Where are the press releases, position papers and associated propoganda from our side of the fence? Or at least a bit of spirited argy bargy on Podiatry Arena?


LL, I could not agree with you more. The apathy amongst some practitioners I have met in my travels, truly amazes me.

I will be navigating to the doctor's forum shortly and informing them of my views.

The tide is beginning to turn. Let's organise !!!

 

Heather, great post. Of course we should resist this at every opportunity.!!

As it is, there is already a monopoly forming with a number of private, national companies providing contract Podiatry services to ACF's, day therapy centres, medical centres, etc.

We must stop the CHC's from operating private Podiatry clinics. But what you say is so true: Where do we go for moral and legal help with this???

You are right! - If we do not act now, a precedent will be set.

If only our union/association would take a more aggressive stand on things. Look at the pharmacy guild for instance - they don't take **** off anyone!!!!!

 

As one of the profession meeting the community need by going rural I can tell you thet CHC's are already set up to be your direct competitor. They are grabbing and keeping every gold card, EPC referral and health insurance holder they can get and squeezing them for every dollar, it is happenning here and now in Lakes Entrance......I work there as a competitor to myself and it is starting to seem a bit stupid of me. I was the first pod they had there for 4 years and I was doing two days a week, now they have a new grad for 4 days and me for one day, way over what the population actually needs to meet it's CHC role, but here they want to provide everybody in the community with an $8 consult unless they can get more from some one else, but not the patient. It's going to make private practice in rural areas even less viable, gold cards, EPC's and health insurance were supposed to make private practice the pathway for the holders of those things, the rest were meant to be too poor to afford it....pensioners, unemployed,....and they go to community health.
Things are really changing.
regards Phill

 

Wow Phill, that sounds pretty alarming mate. Especially at lakes entrance, I would have thought that was a very safe house for practice.

I don't think we've got as big a problem in NSW with the CHC's poaching patients (at the present time) for reduced cost, but I could be wrong.

What's the go in rural areas in NSW folks ?? Any problems with CHC's posing a commercial threat ???

My reading of the situation in rural NSW is that there is plenty of work at the moment. Even Wagga Wagga doesn't have a public podiatry clinic at the hospital, all the high risk work is generally farmed out under EPC's to the local private pod's.

Please advise further folks.