Dear Member

As you know, the College of Chiropodists has revised its Standard of Practice on orthotics and has asked the professions to comment.

The OPMA has prepared a first draft of our response to the College and has embedded in the text of the actual draft Standard smaller editorial comments. Both of these documents can be reviewed in the Members Forum on the OPMA website. I encourage you to do so and to make comments and suggestions for improvement of the submission. Please make your comments by no later than September 8 to give us time to review and consolidate everyone's comments and finalize the submission to the College by the October 2 deadline.

Thank you for your cooperation and assistance I look forward to your comments.

James Hill, DPM,

President

I would disagree with the idea of not having to recast a patient if the time frame is within 2 years. We should be recasting the patient for a second set if it is more than 6 months later or circumstances have changed with the foot structurally. 2 years later would be far too long. I also understand the rationale with the practitioner dispensing and fitting the orthotics , as it is both maintaining the continuity of care and it elevates us as practitioners over a patient simply going and ordering something online. As the treating podiatrist we should be the  ones casting the patient, doing the biomechanical exam / gait analysis, etc , and  the 5 minutes it takes us to fit and dispense the orthotic a few weeks later is professional and makes us different than non-podiatrists. We should also be following up every patient in person as part of our case fee for the orthotics regardless of whether it is a bit inconvenient for the patient and takes an extra 5 minutes for us as the treating doctors

Jim..your response is very well written and I think your have raised some very important facts that I hope the College will address. 

I would still like to have the statement below in our Standard as it protects us and allows some flexibility at times with our patients. To be pigeon holed is no way to practice medicine!!! 

"The College of Chiropodists of Ontario recognizes that there can be exceptions to these standards where all of the above conditions cannot be met (i.e. physical and/or psychological limitations of the patient or uncooperative patients, especially young children). In these situations, an explanation should be given to the patient or guardian as to why all the criteria were not met in prescribing and dispensing the orthotic devices and this explanation should be noted in the chart."