Perspectives on a Divided Profession: Podiatry and Chiropody in Ontario

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Perspectives on a Divided Profession Podiatry
and Chiropody in Ontario

• Dr. Alan M Borthwick Mr Brian Cragg
• University of Southampton Research Liaison Lead,
  Executive Committee
• Southampton Canadian Federation of Podiatric
  Medicine
• UK Markham, Ontario, Canada

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Chiropody and Podiatry in Ontario ( Canada)

• Key Provincial and Federal Issues
• Access to titles
• Mutual recognition freedom to practice (legal
  and regulatory)
• Accreditation and harmonization of education
• Inter-Provincial mobility (across Canada)

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Canadian Provinces and Territories

• 10 Provinces
• 3 Territories

YK
NV
NW
BC
NF
AB
SK
MB
QBC
PEI
Ontario
NB
NS
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Chiropody and Podiatry in Canada

• US DPM model recognised for licensing in
  British Columbia, Alberta and Quebec
• UK, Australian and equivalent models recognised
  for licensing in Ontario, Saskatchewan, Manitoba,
  New Brunswick Prince Edward Island

(No licensing requirements for Nova Scotia,
Newfoundland, Yukon, Northwest Territories or
Nunavut)
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Chiropody and Podiatry in Ontario

• Chiropody Act (1991) established 2 classes
• of foot care professions
• Podiatrists (DPM from USA, registered in
  Ontario before July 31st 1993)
• Chiropodists (Ontario DCh, UK, Australian,
  South African and any USA DPM registered after
  31st July 1993 the podiatry cap)

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Medical influence and Government policy

• The Committee on Healing Arts (1970)
• Ontario will never attract as many recruits into
  chiropody as are needed ifthey must undergo a US
  DPM training period services requiredcan be
  provided by British-type chiropodists
• Ontarian Chiropody Programme established in 1981
  by Ministry of Health

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Study Design and Method

• Study conducted in 2 phases
• Phase 1 422 questionnaires distributed to
  practitioners in Ontario (353 chiropodists, 69
  podiatrists) (nb. podiatry cap in Ontario)
• Phase 2 Face-to-face and online interviews with
  key actors derived from professional and
  regulatory bodies and legislature in Ontario (and
  across Canada) and a documentary analysis of
  available literature

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Summary of Findings Phase 1

• Chiropodists
• favour new model university accredited BSc
  education (ie not the diploma education of
  Michener)
• seek opportunities for MSc PhD surgery
  (optional)
• grandparenting with shared title with upgrading
  opportunities to new model level
• Podiatrists
• DPM favoured recognised in North America
  gold standard and allows NAFTA labour mobility
  across North America (inc. Canada, USA Mexico)

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Study Conclusions Phase 1

• Cultural perspectives influence attitudes
• Podiatrists view Canada as part of a North
  American culture universal recognition and
  NAFTA labour mobility
• Podiatrists view UK/Australian/European links as
  foreign and not relevant to North America
• Chiropodists view Canada as distinct and separate
  from the USA, with a British heritage and links
  to the Commonwealth professional and educational
  influences from UK and Australia

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Study Phase 2

• Interviews
• OPMA executive committee members
• CFPM executive committee members
• College of Chiropody of Ontario (regulatory body)
• Ontarian legislature
• Documentary analysis (examples)
• OPMA correspondence to Ontarian Government
• Canadian Institute for Health Research (workforce
  data)
• CoCoO Annual reports Competency Framework
• OPMA submission to CoCoO (2002)
• Podiatry in Ontario (OPMA to Ontarian Govt, 1977)

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Thank you for your attentionNiagara Falls,
Ontario, Canada, November 2006
Thank you for your attention Niagara Falls,
Ontario