Feet fraternity bound in red tape

Feet are notoriously the most neglected part of the human body – and now they're causing a professional stink all the way from Tauranga to the corridors of power in Wellington.

Podiatrists, the foot doctors, are demanding the right to prescribe antibiotics to us, the patients, to save us time, inconvenience, stress and above all money, lots of money.


A man committed to feet – podiatric surgeon Mr Stefan Edwards. Photo by Tracy Hardy.

Tauranga podiatric surgeon Stefan Edwards says 'being nice and gentlemanly about it has passed and it's time to shout. It's time to cut through the red-tape bull****”.

Strong talk, strong language from the traditionally reserved medical profession.

And Stefan is shouting about what he calls: 'This bit of nonsense, this bit of hypocrisy”.

When we go to the podiatrist with our corns, calluses, ingrown toenails and fungal infections they can perform an initial procedure, do an x-ray and give a local anaesthetic – but they cannot prescribe antibiotics, which are crucial to the treatment process.

Then, says Stefan: 'We have to bundle you down the road where the GP clicks the ticket – prescribes antibiotics we have already recommended and then charges you $40 or $60 for the privilege”.

And he claims patients just might get to see a GP 'who's had as much experience with foot surgery as I have servicing the space shuttle”.

The 'nonsense” continues.

'The patient returns to the podiatrist for the surgery and then quite possibly back to the GP for a further course of antibiotics – and, of course, another fee.”

The time, effort, inconvenience – and particularly the expense – is unnecessary according to Stefan. 'We could do everything at one place at one time and not charge them a consultation fee for the antibiotics. It just makes sense.”

A dentist can also prescribe antibiotics, so can some nurses.

'We just want to prescribe penicillin derivatives or fundamental antibiotics so our patients don't have to line up in a GP's surgery for no reason.”

The reason, it would seem, for health authorities, is the issue of public safety as well as process.

Dr Ruth Anderson of the Ministry of Health says health professionals can apply for prescribing rights under the Medicines Act 1981.

But 'the application must meet the threshold for demonstrating public safety and the benefits to clients”.

'It's the same old story,” says Stefan. 'They just say ‘Yes, yes, yes. It's very important and we need to put it in review and audit'. But it's all happened, it's all been done, there is nothing left to do!”

The Ministry says the podiatrists should apply via their responsible authority under the Health Practitioners Competence Assurance Act, which in this case is the Podiatrists Board of New Zealand.

It's watchdog organisation looking after the interests of podiatry patients. And the Ministry would consider the podiatrists' case if and when they receive an application.

But Stefan again says the submissions, work and evidence in support of the podiatrists has been undertaken and completed. It even has the backing of the pharmacologists.

'In my opinion the current Podiatrists Board is, at best, unable to complete what is essentially a ‘lick the stamp and resend' task.”

Somehow, somewhere Stefan says the podiatrists' case is in the system, waiting to be actioned. And it's costing his patients.

Stefan's colleagues in Australia and England have the right to prescribe. 'My international colleagues look at me and say ‘Come on guys, sort it out'.”

Stefan's Tauranga practice alone gives $67,500 worth of trade a year to local GPs.

'They are delighted with the legislation as it is. They would rather have patients rock up and pay $45 for a prescription. They don't want us prescribing. They wouldn't want to lose my business.”

And Stefan says he's even helping the GP's with their work. 'I can pick up the phone and tell a GP my patient has an infection and they will ask what antibiotic I recommend. They will say : ‘Okay, I will send you a prescription'.”

Successive Governments have agreed to sort it out, says Stefan. But not one has taken the leap of faith. 'They are not saying no – they are just procrastinating.”

Stefan admits he's speaking out in a ‘non-standard kind of way' but he doesn't know what else to do. 'I feel like I'm lying face down in a puddle with a whole lot of arrows in my back. And my patients are suffering because of it.”

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3 comments

Wish you well

Posted on 21-02-2015 19:22 | By nerak

Stefan, in your fight for a sensible outcome. GP's not the only ones clipping the ticket, dentists now get to do the same - a certificate of oral health is now necessary for denture wearers making a change, go get checked at your dentist, $50 thank you. Cheaper for the patient to sign a waiver for the technician, but no, a bit more business for dentists, whose patient visits are declining.


feet

Posted on 22-02-2015 00:05 | By sharon69nz

i am a diabetic and i am seen every 3 months as i have no feeling in my feet. with no feeling i had no idea i had a hole in the side of my little toe. if left untreated with out antibiotics i could have lost the toe. i had no money to go to the doctor so i just left it. my podiatrist just put some antiseptic cream and a plaster on it and told me to watch it over the next week or so and to see the doctor the next day as that is all he could do for me. if he could write a script for antibiotics it would have saved me money (if i had gone to the doctor), stress and taking up time that someone else could have seen a dr who may have been in more need than just a script


Antibiotics

Posted on 22-02-2015 22:00 | By GreertonCynic

Are WAY over prescribed now. The last thing we need is more "health practitioners" handing them out willy-nilly.


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