I recently had a patient ask me this question. Immediately I answered her, “About 50 years.”
The history of my profession is interesting. Until the turn of the 20th century, chiropodists—now known as podiatrists—were separate from organized medicine. They were independently licensed physicians who treated the feet, ankles and related leg structures. The first society of chiropodists, now known as podiatrists, was established in New York in 1895—and still operates there today as NYSPMA. The first school opened in 1911. One year later the British established a society at the London Foot Hospital and a school was added in 1919. In Australia professional associations appeared from 1924 onwards.
Practitioners who were educated in the United States obtained a degree Doctor of Surgical Chiropody from the beginning of the Second World War. By the late 1960s all of the schools in the United States had changed their names to podiatry and the degree graduates were awarded was and continues to be a Doctor of Podiatric Medicine (DPM).
Today’s podiatrists in the United States are physicians, surgeons, specialists of the foot and ankle, have a podiatric medical school education and residency, and their licenses allow them to do the following:
- Perform surgery
- Perform reconstructive and microsurgeries
- Administer sedation and anesthetics
- Perform complete medical histories and physical examinations
- Prescribe medications
- Set fractures and treat sports-related injuries
- Prescribe and fit orthotics, insoles, casts and prosthetics
- Order and perform physical therapy
- Take and interpret X-rays, ultrasound, MRI’s and other imaging studies
- Work as valued members of a community’s health care team
In some Canadian provinces like British Columbia and Alberta, the standards are the same as in the United States where the Doctor of Podiatric Medicine (DPM) is the accepted qualification. Quebec, too, has recently changed to the DPM level of training.
Entry-level medical education programs are either undergraduate-entry (most of Europe, Asia, South America and Oceania), graduate-entry (mainly Australia, North America), or both (Australia, South Korea). In the rest of the world, therefore, the terminology for the profession is not the same, and the term chiropodist (ker-OP-po-dist) still exists, causing some confusion.
In the Canadian prairie and Atlantic provinces, the standard is based on the British model now called podiatry (chiropody). That model of podiatry is currently the accepted model for most of the world including the United Kingdom, Australia and South Africa. In many non-English-speaking countries of Europe, the title used may be podologist or podólogo. The level and scope of the practice of podiatry (chiropody) vary among countries.
In the Canadian province of Ontario, the government adopted the UK foot care delivery model in 1980. Since July 1993 no new American-model podiatrists have been registered to practice in Ontario. The majority of chiropodists currently practicing hold a post-secondary diploma in chiropody, although many also have some university level schooling or a baccalaureate degree in the sciences or in another field. Chiropodists in Ontario may not bill OHIP for their services, “communicate a diagnosis” to their patients (or to their patients’ representatives) nor perform surgical procedures on the bones of the forefoot, while podiatrists who are still practicing there may.
In the United Kingdom, podiatrists complete about 1,000 supervised clinical hours in the course of training which enables them to recognize systemic disease as it manifests in the foot and will refer on to the appropriate health care professional. There scope of practice of a podiatrist is varied ranging from simple skin care to invasive bone and joint surgery depending on education and training. In order to perform invasive foot surgery a UK podiatrist must undertake extensive postgraduate education and training, usually taking a minimum of 10 years to complete.
In Australia there currently exist two levels of professional accreditation and professional privilege: General Podiatrist and the specialist – Podiatric Surgeon. Australian podiatrists complete an undergraduate degree ranging from 3 to 4 years of education. Australian podiatric surgeons are specialist podiatrists with further training; a master’s degree must be completed.
In summary, a chiropodist is a term that is no longer used in the United States. There the profession has evolved to the Doctor of Podiatric Medicine, podiatric physician and surgeon, or foot and ankle surgeon. With the exception of British Columbia, Alberta and Quebec, the practice of the profession is very different in the rest of the world. The podiatry (chiropody) model is used, where practitioners have a post-secondary, bachelor’s or master’s degree. For the best in surgical and non-surgical care of your feet, please click below or reach out to our office for an appointment.
References: Ontario Podiatric Medical Association, Wikipedia
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