Another View On Scope Of Practice Challenges

I recently read the article, “Scope of Practice: Where Things Stand” (see page 36, May issue). I had to refrain from laughing when I compare the problems with scope of practice in the United States to what the situation is in Ontario. Indeed, a brief historical overview of the situation of podiatrists in Ontario is warranted so your American readers can appreciate our frustration.

   In July of 1995, the Ontario government imposed a cap on all future podiatrists from entering and practicing in Ontario. Since that time, no new podiatrists have been allowed to practice in the province. The podiatrists who have returned are practicing as chiropodists. Some of these podiatrists have completed either a two- or three-year surgical residency program.

   The current law in Ontario only allows podiatrists to perform bone surgery from the bases of the metatarsals going to the toes. We cannot perform digital amputations. We cannot operate in hospitals. All of our surgeries are performed in our own offices under local anesthesia. Implants and internal fixations are all done in offices. As podiatrists, we cannot order blood tests, MRIs or bone scans. We have to call the patients’ general practitioner to arrange for these tests.

   In spite of what most of your readers may surmise or think after reading this, we are all doing quite well in spite of these restrictions. You learn to work around them and practice what you know is best for the patient. Our patients still get the type of podiatric care they need.

   Only four of the 10 Canadian provinces have podiatrists. The remaining provinces have chiropodists. Currently, Alberta and British Columbia have the best podiatric laws. In the province of Quebec, the Podiatric School at the University of Quebec at Trois Rivieres will be graduating the first Canadian trained podiatrists next year. This school is working closely with the New York College of Podiatric Medicine.

   While the concerns that podiatrists in the southern states have are quite valid, they are truly minor in comparison to the situation here in Ontario.

   I am sure that some of your readers may wonder why I returned to Ontario knowing what I know. I was born and raised in Canada. I chose to come back to Canada, Ontario in particular, in order to return to my home. It was a personal choice. I have no regrets.

— Kel Sherkin DPM, FACFO
Immediate Past President
Ontario Podiatric Medical Association (OPMA)

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