In just under 7 hours time South Africa will welcome 2009. Will you make a resolution to become a podiatrist? Maybe one of your family or friends will?
Are you sitting with your ‘Matric’ results and not sure what to do next? South Africa has a serious shortage of podiatrists and as I wrote the other day even our new graduates are emigrating. There are fewer than 200 registered podiatrists for our population of about 48 million people.
However, with increasing access to health care and awareness of the benefits of a healthy lifestyle, there is a growing demand for foot care, especially for children and people with foot problems associated with diabetes and arthritis. Nevertheless, many sectors of the South African population still don’t know what a podiatrist is or what we do. As our population changes more people will need foot care.
A podiatrist is really a ‘doctor of the feet’. We diagnose and treat foot disorders and abnormalities. This is done in many ways. Biomechanical examination involves assessing the whole lower limb and its function and then prescribing the appropriate treatment to maintain or restore normal mobility or function.
Many systemic diseases affect the feet and may even be diagnosed from foot symptoms. As a podiatrist you may need to refer your patient to a specialist for further management. A large part of podiatry treatment involves the skilled use of sharp instruments to treat corns or callus or possibly perform detailed corrective surgical procedures on toe nails.
Some of the conditions that Podiatrists treat are fungal infections of the feet and toenails; corns and calluses; ingrown toenails; foot ulcers in diabetes; causes of foot pain in arthritis. Most podiatrists incorporate orthotics and insoles into their treatment when necessary.
The assessment and management of childrens’ foot problems forms an important part of a podiatrists work, whilst some podaitrists are skilled in the managemment of foot problems arising from sports. Nowadays, prevention of foot problems has become very important, so foot health education is also part of podiatry practice.
Although there is no official specialist register for podiatrists, many of us have developed ‘special interests’ in sports injuries, chronic disease, children or the elderly.
The day to day work of a podiatrist is interesting and varied. Giving relief from pain or diagnosing the cause of a foot problem is both challenging and stimulating. You do need to be able to work alone but also need to be a ‘people person’ to relate to the different patients you meet every day. Most podiatrists are in private practice, but we hope there will be an increasing deployment of podiatrists in the State Health services in future. For example Limpopo Province appointed their first graduate podiatrist.
To practice in South Africa you have to register with the Health Professions Council of South Africa.(HPCSA). This means that you become part of the Team of health care professionals providing care to South Africans and that you adhere to ethical standards.(By the way, it is illegal to practice as a podiatrist in South Africa if you are not registered with the HPCSA. So always check the credentials of a podiatrist).
To become a podiatrist in South Africa requires four years of full-time study at the University of Johannesburg. You will obtain a Bachelors degree and be able to go into practice immediately. Although bursaries are limited I believe this is changing as Provincial Health Departments begin to realise the value of foot care. Your entrance is dependent on your Admission Points Score (APS) or your M-score.
There are still vacancies for 2009 enrolment. So why not contact the University of Johannesburg – they reopen on 5th January 2009 – at 011 559 6167 or www.uj.ac.za
However you welcome in the New Year, dancing the night away, taking it easy at home with friends, walking on the beach on an exotic island or if you are unlucky, at work! Enjoy yourself and I wish you all good foot health and happiness in 2009.
TAKE CARE OF YOUR PAIR! SEE A PODIATRIST
Merry Christmas! Happy Holidays! We closed the practice today. Tomorrow I start a short break in Hout Bay with my family. Including my son who is visiting from the UK.
I know that some of you reading this site do not actually celebrate Christmas and so I wish you and your families well over the long weekend. If you are celebrating Christmas, I hope that you too can spend some time with those you love.
Travel safely and tread lightly. You never know when you will need a podiatrist!
Sore feet or sunburn could ruin your holiday. Whether you are going to the coast, mountains or bush, you need to pay special attention to protecting your feet this summer.
As the holiday season gets going, many of us will be exposing our feet to the African sun for longer periods than usual. Remember that if your feet are usually covered by shoes and socks, they will need as much protection as your face and shoulders. (Or your bald head). Despite the fact that we spend a lot of time barefoot or in sandals in South Africa, during holidays the time is often extended.
The most vulnerable part of your feet is the skin on top of your arches. However you can also get sunburn on the soles of your feet if you like to indulge in serious ‘sun-worship.’ Obviously any part of your feet that is exposed is at risk. Initially you might not feel too much discomfort from sunburn, but when you put closed shoes on there will be pain.
Usually, sunburn is confined to a patch of inflamed, sensitive skin, which responds to protective after-sun preparations. The end result is skin dryness and peeling after a week or so and little harm is done. In severe cases however, the inflamed area starts to blister and itch. This is when scratching or opening the blisters can lead to infection.
Always apply sunscreen on top of your feet before you go to the beach, shopping or walking. You might need to re-apply after swimming, depending on what you use, or suits you. If you are spending a long time lying face down with bare feet protect the soles. After showering, treat your feet as you would the rest of your body with your choice of after-sun preparation.
Another common holiday foot problem is burning the soles of the feet. Here again it is usually because the soles of our feet are not as tough as we think and so we forget that the beach sand burns. The same thing applies to the patio tiles or paving.
Don’t do crazy things like walking barefoot over the car park. We all know that it’s thought to be very ‘macho’, to run around barefoot on holiday, but there is nothing ‘macho’ about peeling, blistered soles.
Unfortunately wherever you are, at the beach or around the dam your bare feet are not protected from broken glass, cool drink cans, palm thorns, bits of charcoal from the braai, even rubbing from your new sandals! Watch out for those beach thongs rubbing between your big toe and second toe too.
Always wash sea sand off your feet before you walk any distance, because it can chafe and irritate skin between your toes.
You might even get painful feet from all the extra walking that you do. This can be a big problem if you are walking along a beach where the sand is rough, or if you spend time jumping around in the sea on rough sand. It can also happen if you are enjoying the sights of a chilly Northern Hemisphere winter, as you spend more time walking around.
Finally, as you lie on that soft, sandy beach preparing to enjoy the warm Indian Ocean, remember it’s not just the sharks that can get you, look out for sea anenomes, puffer fish and coral!
So just think ahead. Protect your feet and those of your family, but above all, relax and enjoy putting 2008 behind you. Don’t let sore feet or sunburn spoil your holiday, but if it does, go and see a podiatrist.
TAKE CARE OF YOUR PAIR
Regular visitors to the website will have noticed that recent blogs have suddenly disappeared. New visitors will wonder why nothing has appeared for over a month. Well, the administrative cyberstars behind the webmaster decided to carry out a major restructuring of ‘their systems’. As a result, in some remote part of cyberspace concerned with the management of the website the blogs have disappeared. Despite all attempts to find the blogs they seem to have phoned home like ET.
Please be patient and there will be new information up within the next few days.
At present the practice is very busy, which is just as well in view of the recent press release by the registration body in South Africa, the Health Professions Council of South Africa(HPCSA), which basically has recommended that the guideline for fees in future should be the Nationl Health Reference Price List(NHRPL). This is a backdown from the HPCSA position of accepting that a practitioner may charge up to three times the NHRPL.
Since the government took over control of what is usually ‘the Medical Aid Rates’, they have consistently ignored the recommendations of health economists appointed by them to adjust the fees of Health Care Professionals in South Africa.
What this means is continued problems for providers and consumers when dealing with Medical Aids (Insurers). Personally I think that people who value and receive quality healthcare will still be willing to pay for it, IF the financial crisis is not too severe.
Consider this: for spending 30 minutes performing skilled clinical removal of a corn or ingrown toenail,for example, the NHRPL fee is 57.10 SA Rands. Current exchange rates are R1.00 = USD 10.22 and GBP 15.00. Do the maths and see if you can see the value in that. (Of course there are other fees added for consultation and materials), but it is the principle that matters.
I was guest speaker at the graduation ceremony of the podiatry department at the University of Johannesburg, only 5 graduates, the other 12 are deferred until they have finished their research projects. And guess what? The top student is emigrating to Australia!
Look out for Your Career in Podiatry in South Africa, coming to this space soon.
In the meantime if it’s not broken don’t fix it, or you might get beaten by technology!