Transforming and Supporting Patient Care - Health Professions ...

164Chapter 7 – Professions of Chiropody and Podiatrythe CCO. Chiropodists and podiatrists deliver patient care within thechiropody scope of practice, that is, the “assessment of the foot and thetreatment and prevention of diseases, disorders or dysfunctions of the footby therapeutic, orthotic or palliative means”. 2 Active membership with theCCO includes 424 chiropodists and 78 podiatrists, for a total of 502members. 3The OMPA is a voluntary association representing podiatrists in Ontario, allof whom are registered with the CCO. The OSC is the professionalassociation for chiropodists in Ontario. Membership in the OSC is voluntaryand includes approximately 120 members.The history of chiropody in Ontario is unique. In 1980, the Ontariogovernment adopted a chiropody model of foot care that was adapted fromGreat Britain. Podiatrists who practised in the province at that timecontinued to practise under the 1944 statute, but the Board of Regents (theregulatory body of the time) discouraged new podiatrist applicants. Whenthe Regulated Health Professions Act, 1991 (RHPA) and Chiropody Act, 1991came into force, podiatrists who were registered under the previous Actwere “grandfathered” into a new class in the chiropody profession. No newpodiatrists could be registered with the CCO after 1993. This came to beknown in the profession as the “podiatry cap”.Foot Care in OntarioThe incidence of foot problems in the population is increasing due tofactors such as an aging population, lifestyle issues such as obesity, sportsor recreation-related injuries, and growth in immigrant populations whoreceived little or no foot care during formative years.The increase in incidence of chronic disease is also making new demandson the need for foot care in Ontario. Diabetes is approaching epidemicproportions and has been identified as a priority by the Ministry of Healthand Long-Term Care. Many studies confirm the importance and efficacy offoot care for diabetic patients. 4 Proper podiatric care may help seniorsremain in their homes and possibly avoid further medical complications.Podiatrists play an important role in treating patients with osteoporosis andobesity, including children. Studies also show that melanoma is a commonfoot malignancy and it is more likely to be missed or misdiagnosed than amelanoma located elsewhere. 5There have been a number of changes in the practice of foot care in Ontarioin recent years. Health human resource shortages mean that there is agrowing decline in health professionals, including physicians andorthopaedic surgeons, who are available to provide foot care. According tothe profession, many hospitals have closed or downsized their chiropody2Chiropody Act, 1991, S.O. 1991, c. 20, s.4.3College of Chiropodists of Ontario. Fall 2008 Bulletin. V.19 (1): 12.4CCO, Ontario Podiatric Medical Association and Ontario Society of Chiropodists Association. Jointsubmission to HPRAC: Review of Non-Physician Prescribing and Administration of Drugs Underthe Regulated Health Professions Act. November 14, 2008: 30.5Ibid.HPRAC Critical Links January 2009