Foot health Month. Expanding skills amongst health professionals
It is difficult to know who is who in a hospital. When is a doctor a doctor and when is a surgeon called a surgeon. All females are not nurses and some males are nurses. Not all those carrying stethoscopes are doctors. CONFUSED?
As a podiatrist I am not a doctor but I am a specialist because I have added to my training substantially and am registered to perform treatment at a higher level. All podiatrists hold a basic three-year qualification. All podiatric surgeons in England hold a fellowship; those recently qualified will have a second degree within a post graduate training of a further 10 years. As with many clinicians some have a PhD and so are entitled to use doctor of philosophy even though it may be in science. British podiatrists who practise in foot surgery will explain this to patients if they hold a PhD to avoid confusion with the term ‘medical doctor’.
Many of the websites are very helpful in providing such information. Broadly there are three groups of people in medicine: medically qualified and trained doctors, nurses and allied health professionals (AHPs). Dentists fit somewhere between doctors and AHPs. Some dentists go onto specialise in surgery and medicine i.e reconstruction to the face (maxilla-facial or max-fax surgeons). There has been much consternation about dentists using the term doctor. The Max-fax surgeons became double qualified i.e too medical degree but use the older historical title Mr that the barber surgeon used. Throughout the world you will find most countries use doctor for surgeon, but not in Britain! We do like to be different…
AHPs include psychologists, physiotherapists, radiographers, occupational therapists and operating department practitioners as well as podiatrists. There are over 20 professionals which make up a very large group of clinicians who provide a variety of treatment, keeping the nation fitter. Here again some will use the prefix doctor but this will be taken to mean doctor of philosophy, not associated with medicine. As the natural educational standards rise and more responsibility is assumed by many professionals, overlap inevitably arises. Many regulated professionals other then doctors and dentists can provide medicines related to the conditions that they treat. In 2014 Independent Prescribing licenses gave podiatrists an extension to their role in helping to treat appropriate conditions.
All podiatrists study medicine as part of their qualification so that by the time we qualify we know the function at cellular level to macro-level, anatomy of muscles and diseases of the heart for example. To learn more about podiatry please link to www.feetforlife.org
All podiatrists have to be registered in British law to practise podiatry. Unqualified people who use the term ‘podiatry’ are breaking the law. The register is held by the Health Care Professions Council (HCPC) charged with similar powers to the General Medical Council in that they protect the public where clinical staff fall below the expected standards of care. Please note that Foot Health Practitioners may be registered but not under the HCPC but have a narrower scope of practice.
Regulators in healthcare
In the UK only podiatric surgeons and some orthopaedic surgeons are ‘wholly’ dedicated to elective foot and ankle surgery although orthopaedic surgeons may not practise on the foot and ankle surgery exclusively. Please note that the orthopaedic profession’s opinions are not necessarily shared by the podiatric profession although members of both professions do try to work closely over a wide range of health concerns. Podiatric surgery is recognised by the Department of Health as providing a valuable contribution to health care in the UK although curiously is not separately annotated presently. However to reassure the public this is coming within the next 2 years.
The podiatric surgeon works on the foot and associated structures which can include the tendon achilles. We deal with skin trauma due to pressure and fixed deformities as well as diagnose and manage pain.
If confused always ask your consultant what his qualification is and who his regulator is.