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review is not reassuring
this review does not show that most podiatric surgeons are practising unsafely ”.
To doctors , that will sound more like an absence of evidence than evidence of absence . They will also note that having “ most ” practitioners in any field of healthcare not practising unsafely is hardly a reassuring threshold .
He says limiting scope of practice for podiatric surgeons — as suggested by some — would be “ inconsistent ” with how other health professions are regulated in Australia .
Ultimately , the headline recommendation from his report is for a name change so patients do not assume they are being operated on by a proper surgeon .
He refers to a trawl through the websites of current podiatric surgeons where they have described themselves as a “ foot and ankle surgeon ”, “ specialist foot and ankle surgeon ” and “ expert in foot and ankle surgical reconstruction ”.
He quotes an orthopaedic surgeon who told the review : “ I take umbrage at the term ‘ podiatric surgeon ’. They are podiatrists who operate .
“ Patients are consistently surprised to hear that the person who operated or is planning to operate on them is not medically qualified .
“ The recent legislation to protect the title ‘ surgeon ’ is ridiculous as it only limits medical health professionals from using the term .
“ This conveniently allows podiatrists who operate to continue to inappropriately use ‘ surgeon ’.”
Symbolic capital
Professor Paterson however is wary : “ Issues of power and prestige are at play when different craft groups use a well-recognised , symbolic title such as ‘ surgeon ’.”
He notes that professional titles function as “ symbolic capital ”.
“ Privileging the use of the title to one group — medically qualified surgeons — with a long historical claim to the title tends to shore up the power and prestige of that group .
“ It may also have the anti-competitive effect of shutting out a competing craft group performing similar tasks .
“ Thus , there needs to be a strong justification for restricting the use of the title ‘ surgeon ’.”
Persuaded that a strong justification can be made , however , he suggests going back to ‘ surgical podiatrist ’ — what they were originally called back in the 1970s — as the fix for customer confusion , along
with some additional publicity material from AHPRA and for the podiatry board to explain to the public the differences .
It may have been better simply to suggest that the patient on consulting a podiatric surgeon signs a piece of paper declaring that they understand that the practitioner is
Not an actual patient . not a doctor or a specialist surgeon with a recognised medical college fellowship and is not on the medical register .
But while he goes on to make 13 other recommendations , it is clear Professor Paterson rejects most of the complaints made by doctor groups , including those
NOW PBS LISTED FOR CHRONIC KIDNEY DISEASE 2
claims by the AMA that discussion of podiatric surgery is “ always plagued by a lack of evidence and an incomplete knowledge of podiatric surgical practices ”.
He quotes what he describes as a “ nice summary ” about the challenges facing the incorporation of other
Chronic Kidney Disease
to reduce the risk of kidney disease progression in adults with chronic kidney disease §
Boehringer Ingelheim Pty Limited , ABN 52 000 452 308 . 78 Waterloo Road , North Ryde , NSW 2113 Australia . Copyright © 2024 . ELI4742 . PC-AU-103939 . Prepared April 2024 . health practitioners in teams traditionally led by doctors .
“ First , a population ’ s growing health needs … will not be met by doctors alone . Better , more compassionate care requires team members to contribute in their different ways .
“ Second , any new professional group able to influence
*
JARDIANCE ® is indicated for : 1
Type 2 Diabetes
to prevent CV death in patients with T2D and established CV disease † ; Glycaemic control in T2D
BEFORE PRESCRIBING , PLEASE REVIEW THE FULL PRODUCT INFORMATION AVAILABLE FROM BOEHRINGER INGELHEIM AT WWW . BOEHRINGER-INGELHEIM . COM . AU / PI OR BY SCANNING THE QR CODE .
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NSW 2000 , Australia . Copyright © 2024 .
patient care needs appropriate and clear regulation .
“ Third , it is important to respect professional colleagues and resist tribalism .”
AHPRA : Independent review of the regulation of podiatric surgeons in Australia : Final report ; March 2024 bit . ly / 4cY3tc1
Heart Failure
treatment of symptomatic HF independent of LVEF ‡
†
CAD , PAD , MI or stroke on top of standard of care . 1 ‡ As an adjunct to standard of care therapy . 1 § CKD Stages 2 and 3A with urine ACR ≥30 mg / g , or CKD Stages 3B , 4 and 5^ irrespective of urine ACR . ^Due to limited experience , it is not recommended to initiate treatment with JARDIANCE ® in patients with an eGFR < 20 mL / min / 1.73 m 2 . 1
PBS Information : JARDIANCE ® : Authority Required ( STREAMLINED ). Type 2 Diabetes . Heart Failure with Reduced Ejection Fraction ( LVEF ≤40 %). Heart Failure with LVEF > 40 % ( including Heart Failure with Preserved Ejection Fraction ). Chronic Kidney Disease . Refer to PBS Schedule for full Authority Required Information .
JARDIANCE ® has a consistent and established safety profile across T2D and CKD indications . Very common adverse reactions : hypoglycaemia ( combination with metformin and an SU ; insulin ). Common : hypoglycaemia ( combination with metformin ; pioglitazone with or without metformin ; metformin and linagliptin ); hypoglycaemia ( T2D patients with HF ); UTIs ; increased urination ; vaginal moniliasis , vulvovaginitis , balanitis and other genital infections ; volume depletion ( T2D patients aged ≥75 years ); thirst ; pruritis ; serum lipids increased ; constipation . Precautions include patients with type 1 diabetes ; ketoacidosis ; surgery ; not recommended to initiate treatment in patients with eGFR < 20 mL / min / 1.73 m 2 . Please refer to the full JARDIANCE ® Approved Product Information for information on other precautions and adverse reactions .
Abbreviations : CAD , coronary artery disease ; CKD , chronic kidney disease ; CV , cardiovascular ; eGFR , estimated glomerular filtration rate ; HF , heart failure ; LVEF , left ventricular ejection fraction ; MI , myocardial infarction ; PAD , peripheral artery disease ; T2D , type 2 diabetes ; uACR , urinary albumin to creatinine ratio .
References : 1 . JARDIANCE ® Product Information . 2 . Pharmaceutical Benefits Scheme . Available at : www . pbs . gov . au . Accessed April 2024 .