Levels of training for levels of work

[michellet]

been reading the uel thread.

i'm a 60 YO retiree in good health. I have no foot pathology and my general health is good. I used to cut my own nails but i'm finding it harder to get down there. Then my wife did it, by she's getting shaky.

Do I NEED to see a podiatrist, with all their training in the management of complex and difficult foot problems, or do I need to see an FHP with enough training to cut my nails a good deal neater and better than I ever used to.

This FHP has an opinion. Much is complained of by podiatrists that they are not "taken seriously" by the medical establishment. I think this is fair complaint a lot of the time. Perhaps one way you can be taken more seriously is to relinquish your grip on what most would term "social care". How can they take you seriously as the highly trained medical professionals you claim to be (and indeed are) when you are still doing unskilled work which back in the day would be done by nurses or carers.

Doctors need nurses. Dentists have hygenists. If you guys want to be elevated up the medical food chain you need people to fill in behind you. If you don't want to be seen as "the people who cut nails and remove corns", quit doing those things.

{edited by admin for tone}

[seekerofwisdom]

Michellet,

Some possible answers.

I'm a 60 YO retiree in good health. I have no foot pathology and my general health is good. I used to cut my own nails but i'm finding it harder to get down there. Then my wife did it, by she's getting shaky.

Do I NEED to see a podiatrist, with all their training in the management of complex and difficult foot problems, or do I need to see an FHP with enough training to cut my nails a good deal neater and better than I ever used to.


I would suggest neither, get your siblings to do it.

You do not need the Pod and why would you need a Foot Health professional, your foot is perfectly healthy?

Or, to put it another way, if I lost the ability to clean my teeth, would I need to see a dentist every day to do it for me.

Probably not, again you could probably use a sibling.

This FHP has an opinion.

Much is complained of by podiatrists that they are not "taken seriously" by the medical establishment. I think this is fair complaint a lot of the time. Perhaps one way you can be taken more seriously is to relinquish your grip on what most would term "social care".

Interesting point, but one of the problems arises when you try to define 'social care'. The care of dementia patients is considered to be 'social care', as that is the budget it comes out of. At one time we were considered to be front line workers and prided our ability to 'make contact' with patients, by the nature of our jobs we spent a lot more time than GPs listening to patients comments. Many a medical problem unrelated to feet has been recognised by a knowledgable Pod doing a routine task.


How can they take you seriously as the highly trained medical professionals you claim to be (and indeed are) when you are still doing unskilled work which back in the day would be done by nurses or carers.

Again a point of view.

It was the professional in the NHS who originally told nurses they could not cut toenails, I guess that is what you mean by unskilled work, then at a later stage deemed it beneath their dignity to do such work and handed it over to 'volunteers'. Is the NHS really a good model for the Pod profession?

Doctors need nurses. Dentists have hygenists. If you guys want to be elevated up the medical food chain you need people to fill in behind you. If you don't want to be seen as "the people who cut nails and remove corns", quit doing those things.


Again an opinion but you left out one important factor, nurses and hygeinists work under the supervision and control of Doctors and Nurses.

Assuming you are making a case for handing over what you think as 'routine' work to FHPs then the conditions would be very different. FHPs are taught to consider themselves as autonomous practitioners, so not working under any supervision.

FHPs and their course providers insist on claiming to offer in the main the same services as Pods, not an inferior service.

FHPs are dammed when they do and dammed when they do not charge the same rate as Pods.

A monkey which will not let go of one branch can't swing on to the next.

I think you need to recognise there is more than one monkey when you talk about Pods, the NHS employees arguably providing a specialist service to a specific class of patients, usually the 'at risk foot', the highstreet general practicing degree Pod who brings all the knowledge of the NHS Pod to a wider public but able to deal with any emergency and know when and how to refer on,the grandparented Pod where a terrific range of education and experience exists.

I cannot see the latter two willingly 'letting go' of 'routine work' which after all still generates income, to an unregulated sector.

Shy

[seekerofwisdom]

Just a thought folks.

There are a lot of successful grandparented pods working out there, the majority I suspect are members of their related trade associations.

Could those associations not form some sort of mentoring scheme to allow pre qualified and post qualified FHPs to observe and gain appropriate skills?

The SCP has launched a 'return to work' mentoring scheme and the NHS seem to use a probationary year type approach to new graduates.

Shy.

[Admin]

I think that's the best idea I've heard this month. Possibly this year.

And not just for the fhp. Shy mentioned the probationary year in the nhs. This is great (when it happens) but it need not stop at a year. I was lucky enough to be mentored by a really great podiatrist and biomechanist for my first 4 years. More recently I've found several mentors for different areas of practice. Some of them I've met in person. Others I merely go to for advice.

Personally I found the degree to be a lot like driving lessons. I learnt as much after passing my test as I did before. But this would not have been the case without the patient men and women who have taught me, contact I would not have had outside of the nhs!

So, is there a place for a mentoring scheme?


I'd love to hear bill's view on this.

Regards
Robert

[dewdrop]

Shy makes an excellent suggestion in reply 3. regarding a mentoring scheme for FHPs.

Sorry, Shy, but I am just about to rain on your parade.

As FHPs are told by the training organisations that they will be "fully-qualified" when they complete the training why would any want to subscribe to this? It would be admitting that they were not fully competent. There would also be a cost implication in this that many would not be prepared to bear, having already spent £xxxx + to become "fully qualified".

In addition I could see resistence to this idea from the training schools, some of whom would like to keep the monopoly on providing CPD.

[seekerofwisdom]

Hi Dewdrop,

You have a point, but I'm not too sure I agree.

Like Robert said the day he left Uni was the day he started learning.

He was 'fortunate' enough to go into the NHS and meet a good mentor. I went into PP but bought a practice so had the previous owner to support me. That and the support of members of my branch, I had been active even as a student, and by buying a practice was not treading on anyone's toes (possible new thread?)

So even though I did come out 'fully qualified' I have never stopped learning.

I would certainly liked my Alma Mater to have been more involved in my post grad years, I think it is an income stream they have failed to tap into.

So down to money? Yes that could be a problem, depends on how the scheme was devised.

My preference of course is for a closed profession, but given that it is not is there not a case for promoting 'good practice' in the unregulated sector?

Note I am not advocating joining in educating them, that is down to their trainers and the conscience of the degree pods who think it is a good idea.

Shy.

[dewdrop]

You make some good points again, Shy.

I think there is a good case for promoting good practice in both regulated and unregulated sectors. The problem is that the regulated sector have clearly defined standards and the unregulated sector do not.

I wonder if JBB would like to engage in this discussion and give her opinion as an educationalist?

[Admin]

Hey all

As FHPs are told by the training organisations that they will be "fully-qualified" when they complete the training why would any want to subscribe to this? It would be admitting that they were not fully competent. There would also be a cost implication in this that many would not be prepared to bear, having already spent £xxxx + to become "fully qualified".

I don't know. Neither, come to that, do you! Are there any FHPs out there (who've not been scared off already) who would venture an opinion as to whether this would be something they would be interested in?

Regards
Robert

[dewdrop]

Hello Robert,
My opinion is based on the fact about a well-known organisation that is involved with supporting FHPs regularly promotes mini conferences nationally. The last one that was held in my locality managed to attract only about 35 delegates despite the fact that there are at least 200 (known) FHPs operating within a 25 mile radius.
That tells me that most FHPs do not want to engage in CPD and/or additional training.

[Admin]

Hmmm

The last meeting of the kent branch of SCP had about 20 odd people there. I don't know how many podiatrists there are in kent but its a lot! Does that mean most Podatrists don't want to engage in CPD?

Actually for a conference 35 out of £200 is a pretty good hit rate!

Irrespective. Allowing that you'll never get everybody (pod or fhp) into such a scheme, does it have merit for those who WOULD use it?

Regards
Robert

[dewdrop]

Hello Robert or Admin - not sure which hat you have on here, ( or that it matters.)

I'm sure we could argue all day about "lies, damn lies and statistics".

The answer to your last question is that I don't know. That's why I was hoping JBB would give her opinion on this.

[Admin]

Yeah, sorry. Sometimes I forget to sign out of admin and into Robertisaacs.

That was all me.

Cheers
Robert

[blinda]

Allowing that you'll never get everybody (pod or fhp) into such a scheme, does it have merit for those who WOULD use it

Of course it would, such mentoring would benefit both receiver and provider as learning on the job and reflecting/explaining our own practice would lead to improvement of practice.

I think it is a fine idea, just not sure who would be in a position to provide this for unregulated practitioners (other than their original trainers ). I have benefited from quite a few private practitioners who have kindly `mentored` me in LA techniques, derm diagnostic tests, etc.

[seekerofwisdom]

Of course it would, such mentoring would benefit both receiver and provider as learning on the job and reflecting/explaining our own practice would lead to improvement of practice.

Now for once I have no argument with this statement. It's like taking your driving test all over again. But when do you trust the trainee with those 'special secrets'?

I think it is a fine idea, just not sure who would be in a position to provide this for unregulated practitioners (other than their original trainers ).

Not sure why you see a problem here, I know it's not allowed under the Society's rules but all of the other organisation are mixed communities. Both Del and David and Bill are in such a position.

If you are concerned about breaching HPC rules as long as you do not confuse the public it should be OK.

I have benefited from quite a few private practitioners who have kindly `mentored` me in LA techniques, derm diagnostic tests, etc.

And if you are not threatening the mentors income then as you say it can be of mutual benefit.

Shy.

[blinda]

Just saw this;

The last meeting of the kent branch of SCP had about 20 odd people there.

Hmm, so how many normal people were there?

Not sure why you see a problem here, I know it's not allowed under the Society's rules but all of the other organisation are mixed communities. Both Del and David and Bill are in such a position

Good point. It is only the SCP that say we shouldn`t fraternise, but in the interests of `good (improved) practice`it would be a positive step towards helping the unregulated observe, learn additional skills and encourage them to continue to learn i.e. have a stab at the degree.

And if you are not threatening the mentors income then as you say it can be of mutual benefit

Also a valid point. Whether an FHP or Pod, I would recommend finding a mentor not too close to home for this reason. It may mean travelling a fair few miles, but certainly worth giving the clear message that you will not be poaching work from the one you are hoping to mentor you!