09/21/2023    Bruce Ramsden, DPM

The Sad State of Podiatry in Ontario, Canada (PM News Canadian Subscriber)

On behalf of the Ontario Podiatric Medical
Association I'm writing to correct statements made
in "The Sad State of Podiatry in Ontario"
published in the September 19 edition of PM News.
There were two principal reasons for the Ontario
government opting for a chiropody model of foot
care in the late 1970s. One was that the UK
chiropody model as it then existed was thought by
the government-of-the-day to be a better fit with
Ontario's hospital-centric healthcare delivery
paradigm as it was at the time. While orthopedic
surgeons may have supported that decision, there
is no evidence that such support had a major
impact.

The second reason was that there was an
insufficient supply of podiatrists to respond to
the demand for foot care and no likelihood that
the supply-demand gap would be closed. A cause of
that supply-demand gap was that no podiatry
education program existed in Canada. Having made
this decision to introduce a chiropody model, the
Ontario government committed considerable
resources to setting up a chiropody education
program and funding chiropody clinics in
hospitals.

To address the immediate supply-demand gap, the
government funded the training of nurses to
provide foot care and also encouraged the
emigration to Ontario of chiropodists from the UK.
For about a decade both the chiropody and podiatry
professions practiced in Ontario. The Ontario
government concluded, however, that the chiropody
profession would not take root and prosper as long
as it had to compete with the podiatry profession.
Accordingly, by legislation that came into effect
in 1993, podiatrists were placed in a separate
class with a more extensive scope of practice than
chiropodists, but new members could not be added
to that class after July 31, 1993.

Until 1993, neither chiropodists nor podiatrists
could lawfully perform bone surgery. Podiatrists
may now perform surgery on the bones of the
forefoot. There is no evidence that the
DPM/chiropodist referred to in the piece did what
he did for the reasons ascribed to him. The
publication of misinformation of this nature is
particularly unhelpful at this time when the OPMA,
the College of Chiropodists and the Ontario
Society of Chiropodists, along with other
prominent and influential stakeholders, are
working together with the Ontario Ministry of
Health to remove the prohibition against the
registration of new podiatrists and to convert to
a podiatry model of foot care.

Bruce Ramsden, DPM, President, Ontario Podiatric
Medical Association

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