Contested role boundaries and professional title: Implications of the independent review of podiatric surgery in Australia
29 Oct 2024
Based on findings from the final report of the Independent review of the regulation of podiatric surgeons in Australia, the Podiatry Board of Australia is currently seeking feedback on a proposed update to the protected title for the specialty of podiatric surgery, changing the title from "podiatric surgeon" to "surgical podiatrist."
The proposed change to the protected title was one of the 14 recommendations made to the Board and Ahpra in the final report of the Independent review of the regulation of podiatric surgeons in Australia (the review).
While aimed at reducing confusion, this change could potentially create barriers around professional recognition and access to key resources.
The review aimed to examine how podiatric surgery is regulated, determine whether patient safety concerns exist, and recommend ways to improve public protection. It was initiated in response to concerns, particularly from orthopedic surgeons and the media, about the role of podiatric surgeons.
It analysed the professional tension between podiatric and orthopedic surgeons, using a sociological lens to explore how different professions try to maintain their status - the battle over the professional title "podiatric surgeon" and the competition over roles in healthcare.
A new paper published in the Journal of Foot and Ankle Research (JFAR), "Implications of the Independent Review of Podiatric Surgery in Australia"*, explores this recommendation to change the protected title from "podiatric surgeon" to "surgical podiatrist".
What and why
The main issue tackled by the paper is the ongoing dispute about the professional title "podiatric surgeon" and where podiatric surgeons fit in the healthcare system.
The medical profession, with its significant influence, has raised concerns about the safety and training of podiatric surgeons, often using the media to amplify these concerns.
Key outcomes
The review didn’t find any strong evidence to limit podiatric surgeons' scope of practice. It concluded that their training and education met the required standards.
Despite this, podiatric surgeons are still restricted in some areas—like access to public hospitals and Medicare funding—due to barriers maintained by the medical profession. The medical field effectively acts as a gatekeeper, controlling access to these resources.
The analysis also pointed out the medical profession's role in shaping public opinion through the media, often portraying podiatric surgeons as less qualified, reinforcing its own dominance.
The review confirmed that podiatric surgery is a safe and effective practice and recognised the profession's growth, but noted the challenges it faces.
Recommendations
The review recommended that the Podiatry Board of Australia and Ahpra work with health ministers to explore ways to integrate podiatric surgery more fully into the public healthcare system, particularly by addressing the lack of Medicare funding and hospital access.
It suggested changing the title "podiatric surgeon" to something like "surgical podiatrist" to reduce confusion for patients who might assume a podiatric surgeon has a medical degree.
The review called for mandatory endorsement for scheduled medicines certification (ESM) to advance allied health prescribing and improve patient care.
While collaboration between podiatric and medical professionals was encouraged, the review acknowledged the significant pushback from orthopedic surgeons, which will be a challenge to overcome.
The key barriers, like restricted access to resources and professional title issues, pose a threat to limiting the profession’s full potential.
It called for changes to help create a more balanced regulatory environment and improve access to essential services for podiatric surgeons.
The Podiatry Board of Australia is seeking feedback on this proposed change, and your input is crucial. To learn more and share your feedback, please click here (consultation closes 8 November).
* Borthwick, A. M., Nancarrow, S., Bristow, I., & Bowen, C. (2024). Contested role boundaries and professional title: Implications of the independent review of podiatric surgery in Australia. Journal of Foot and Ankle Research, 17(4), e70007. https://doi.org/10.1002/jfa2.70007
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