HPRAC: Your Feedback is Needed! Published on Wednesday,12 April, 2017
HPRAC’s report was released on March 07,
2017 – marking almost 10 years since the Council began its work to update and
modernize the role of chiropodists and podiatrists. Unfortunately, not only is
the Society disappointed by the length of time it took for the report to be
completed and released, we are also extremely disappointed in its contents.
Rather than repeating the Society’s
concerns about key components of the HPRAC report, I would like to start by
reminding you that HPRAC is only an advisory body. As a result, the Government
of Ontario is not bound to adopt any of the recommendations contained in the
report – a position we heard loud and clear when the Society met with a senior
advisor to the Minister of Health and Long-term Care.
The Ontario Society of Chiropodists
would like to state our position which may help guide you in your feedback to
We are in full support with the
submission from the College of Chiropodists of Ontario.
The OSC believe we should have a unitary
profession with the title podiatrist, which is consistently used around the
world and Canada to define a foot specialist. We agree in the use of title,
Podiatric surgeon for those who have achieved additional bone surgical skills
The podiatry cap would have to be lifted
should we all become "Podiatrists". Podiatry cap in the Chiropody
Act, 1991 reads as follows, "No person shall be added to the class of
members called podiatrists after the 31st day of July, 1993."This
prohibition against the registration of new members of a regulated profession
is unique and unprecedented in Ontario.
The cap has been the most obvious
impediment to the natural evolution of the chiropody profession in Ontario. The
Podiatry Cap must be removed, otherwise we will not be called podiatrists.
We believe there should be one scope which
includes the list of new and expanded authorized acts stated by the College of
"The practice of podiatry is the
assessment or diagnosis of the foot and ankle and the treatment and prevention
of diseases, disorders or dysfunctions of the foot, ankle and structures
affecting the foot or ankle by therapeutic, orthotic or palliative means.”
We support the College of Chiropodists
proposed new and expanded authorized act as they reflect national and
The OSC believes that engaging in the
practice of podiatry, a member would be authorized, subject to the terms,
conditions and limitations imposed on his or her certificate of registration,
to perform the following proposed new and expanded authorized acts as per the
College of Chiropodists of Ontario.
Chiropodists should have their scope of
practice expanded in the following key ways:
a. Communicating a diagnosis identifying a
disease or disorder of the foot or ankle as the cause of a person’s
symptoms(Currently authorized to members of the podiatrist class only);
b. Performing a procedure on tissues below the dermis to treat conditions of
the ankle or foot (currently authorized with respect only to the foot)
c. Setting or casting a fracture of a bone or dislocation of the joint, in the
foot or ankle (Not currently authorized for either chiropodists or
d. Administering, by injection, a substance in the Regulations (Currently
authorized for both chiropodists and podiatrists, but limited to injections
into the foot).
e. Applying or ordering the application of a prescribed form of energy (Not
currently authorized for either chiropodists or podiatrists).
f. Prescribing, dispensing and selling a drug designated in the Regulations
(Chiropodists and podiatrists are currently authorized to prescribe, but not to
dispense or sell).
g. Order prescribed laboratory tests (Not currently authorized for either
chiropodists or podiatrists) under the Laboratory and Specimen Collection
Center Licensing Act and Regulation 682 there under and the Medical Laboratory
Technology Act and regulations
h. Operate radiographic equipment, prescribe radiographs within the podiatry
scope of practice and be designated as "radiation protection officers”
under the Healing Arts Radiation Protection Act or its successor. (Currently
authorized for members of the podiatrist class and for DPM chiropodists).
The Ontario Society of Chiropodists
would like to focus our feedback submission on chiropodists professional
competencies which are not currently recognized and need to reflect the
advances in the chiropody educational program. We believe the four main core
changes should reflect the competencies we believe chiropodists already have or
would be easily acquired with additional training, upgrading and continuing
Communicating a diagnosis identifying a disease, disorder or dysfunction of the
foot or ankle. We are not asking to diagnose systemic conditions as the HPRAC report
alluded. Chiropodists have the competencies to formulate a diagnosis and a
differential diagnosis, as well as ability to communicate it to other health
care providers of the foot and ankle. This is supported by the following
documentations: PES report, Michener Courses Competencies, College of
Chiropodist Core Competency Profile document.
It is non-sensical that we must
formulate a diagnosis and a differential diagnosis but we can't communicate
that diagnosis to the patient, yet require informed consent from the patient to
agree to the treatment plan. The fact that our current scope allows us to prescribe
drugs, to inject drugs and to do surgery, yet we are not able to communicate a
diagnosis, makes no sense and must change.
other three core competencies we believe chiropodists have already acquired, or
would be easily acquired with additional training, upgrading and continuing
education course are|:
*Applying or ordering prescribed form of energy (ultrasound, MRI)
*Ordering prescribed laboratory tests (C&S, Histopathology, Blood, Tissue,
*Prescribe radiographs within the podiatry scope of practice
These authorized acts
are diagnostic in nature which complement and reinforce our diagnosis. We would
like to eliminate circular referrals to the physician to assist in providing
comprehensive care. Referring our patients back to the primary care physician
delays timely care and increases costs for the Ontario health care system. We are not trying to diagnose a systemic
condition and we are not asking for all tests but only those specific to the
podiatric scope of practice. The care
would be immediate and comprehensive. There will
be no increase or overuse in testing as we are currently requesting these tests
through the primary care physician. There would be no duplication as the
patient is seeing us for their foot condition. We would fully
support a mandatory reporting to the physician of any tests performed, to avoid
Chiropody education has evolved in
Ontario as the entry requirement at the Michener Institute for chiropodists is
an undergraduate degree with a 3 year chiropody program; that is 7 years of
education which is comparable to the DPM program. We are no longer a post-high
school diploma of 2 or 3 years.
86.5% percent of the chiropodists since
1993 have undergraduate degrees.
need to remind the government that chiropodists presently have controlled acts
which have a much greater risk of harm then ordering diagnostic tests such as
lab work, x-ray, or forms of energy.
*Cutting into subcutaneous tissues of the foot.
*Administering, by injection into feet, a substance designated in the
*Prescribing drugs designated in the regulations.
*Administering, by inhalation, a substance designated in the regulations.
Did you know that 94 percent of
chiropodists perform surgery?
Did you know that 73 percent of chiropodists prescribe oral medications?
The College has proven they can regulate
and protect the public by regulating chiropodists and podiatrist who are
performing these invasive controlled acts: injecting, surgery and prescribing
drugs. It makes no sense that the ability to diagnose or order diagnostic tests
would be of higher risk of harm, then what we already competently do.
I hope this helps clarify OSC's position
and you can use some of this information as you discuss this with your
colleagues, other health care professionals, your patients, your local MPP or
in your written feedback submission to the Ministry.
Please take time over the next
few days to share your thoughts with the Minister.
With your help, we can
communicate these core positions to the Ministry of Health and Long-term Care
by April 20, in order to make sure the Minister and his team better understand
the indispensable role we play across the province. The Ministry of Health and Long-Term Care
public consultation on the report and recommendations.
The Society hopes that the
positions will help outline the OSC's views at this critical time, and that you
will take the opportunity to share the value of the profession with other
health care professionals, your patients, your local MPP or in your written
feedback submission to the Ministry.
HPRAC Report Published on Wednesday, 8 March, 2017
HPRAC Report is Now Available!
Dear OSC members and friends,
It is my great pleasure to share with you the news that the Ministry of Health and Long-term Care has just released the HPRAC report into the future of foot care in the province.
As you will remember, HPRAC - the Health Professions Regulatory Advisory Council - launched a consultation process in 2007 designed to update and modernize the role of chiropodists and podiatrists. The OSC was actively involved in this process, both on our own and in collaboration with the College of Chiropodists of Ontario and the Ontario Podiatric Medical Association.
Now that the report is out, stakeholders will have 45 days to offer their feedback, before the Ministry adopts a final set of regulatory changes.
Working with our public affairs consultants at Santis Health, the OSC will be preparing a summary of the HPRAC report that we will share with all of you over the next few days. Once we have formulated our response to the report’s recommendations, we will also be meeting with the office of Dr. Eric Hoskins, Minister of Health and Long Term Care to share our advice and feedback.
We look forward to sharing our initial feedback and to hearing YOUR thoughts over the coming weeks.
To make sure your voice is heard, join the OSC today!
* The report is profoundly disappointing - there are serious flaws in both the process that led to the report and its content
* As currently written, the report’s recommendations will lead to more duplication, poorer service for patients and higher costs
* However, it is important to remember that HPRAC only offers advice to the Ministry of Health and Long-term Care; it has no formal power to make any changes to how health care is practiced in Ontario
1. The Society will be meeting with the OPMA and the College ASAP to identify areas of shared concern and potential joint positions
2. We have started to prepare a formal letter to the Minister outlining the Society’s positions and our concerns with the report
3. We have already heard from Ian Chesney in the Minister’s office that he wants to meet with the Society to hear our feedback, and we will be arranging that meeting to coincide with the completion of our letter
Sonia Maragoni, President
Ontario Society of Chiropodists
Guidelines for LASER Published on Tuesday,28 February, 2017
Don't Tax My Health Benefits Published on Wednesday, 1 February, 2017
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Bill 87 Amendments to the RHPA Published on Tuesday,31 January, 2017
Bill 87 – RHPA amendments
PROPOSED CHANGES TO THE REGULATED HEALTH PROFESSIONS ACT
FURTHERING PATIENT PROTECTION AND ACCOUNTABI...
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Happy New Year! Published on Friday,13 January, 2017
Happy New Year!
For those who don't know me, my name is Sonia Maragoni, I am a wife, a
mom, a podiatric practitioner, and in my extra spare time I volunteer
as the president of the Ontario Society of Chiropodists .
I thought I would write this as I reflect back on 2016 and what I see for the future in 2017 for the OSC.
First I want to say a BIG thank you to all of the Board of Directors who
have been dedicating their free time and passion to the profession. We
welcome any of you wishing to get involved and giving back to the
profession by volunteering with the OSC and appreciate your continued
support by renewing your membership.
In 2016 the OSC hired a new association management firm and even though
we may have had a few bumps in the transition, we continue to be
impressed with Carol Ford, the OSC manager, on her skills to help
increase the efficiency of the OSC.
We have also launched the new website, which allows the public to find a
local practitioner. The website also features a members site separate
from the public site.
We have actively met with many MPPs as well as senior policy
advisors with the Premier and Minister of Health to advocate for the
change to the podiatric title, increased scope and controlled acts.
We have increased our continuing education events with 3 workshops and
one conference, to which over 350 practitioners attended.
We have also partnered with the practitioners in the public sector to help with the request of pay equity and evaluation.
We have introduced preferred partnership programs with Perkopolis, CAA and others.
We have created a mediation program to aid in dispute resolution between patients and practitioners.
Wow! It's been a busy year!
We are just so grateful for support we are receiving as we end the year with 265 OSC members!
The door is wide open and we are gladly welcoming new volunteers to join
the OSC, we want you to be involved! We have many items in our wish
list but need your help and will be hosting an information session in
the new year! If you are interested email me at firstname.lastname@example.org
Another goal this year will be to build bridges between the other
provincial and national associations to work on common goals like
promoting the profession during Foot Health Month, Insurance issues,
Foot Wounds & Diabetes.
We will continue to represent chiropodists' interests as we
attend meetings on your behalf with the Coalition of Regulated Health
Professional Associations, the College of Chiropodists and the Ministry
We also will be launching our new fee guide and coding with a unique practitioner stamp.
We have planned four workshops: acupuncture, how to set up an in-office
orthotics modification lab; a learn and play golf/spa day; as well as
surgical cadaver workshop and our annual conference scheduled for this
We will be exhibiting and educating physician, pharmacists, nurse
practitioners, nurses and other health care practitioners as we attend
the PriMed , CAWC, Canadian Diabetes, and Nurse Practitioner
2017 looks awesome! Please join us in welcoming the new year!
We wish you all healthy and happy new year everyone!
Yours in Health,
Proud to be a Member Published on Thursday,22 December, 2016
Log in and get a copy of your OSC Membership image to use on your website, social media, etc...
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Keynote Speaker Announced for OSC Conference! Published on Sunday, 6 November, 2016
The OSC is very happy to announce that Dr Kevin Kerby as the Keynote Speaker for the Annual Conference on May 05-06, 2017 in Toronto!
Kevin A. Kirby, DPM
Dr. Kevin Kirby graduated from the California College of Podiatric Medicine in 1983 and completed his first year surgical residency at the Veteran's Administration Hospital in Palo Alto, California. He spent his second post-graduate year doing the Fellowship in Podiatric Biomechanics at CCPM where he also earned his M.S. degree.
Dr. Kirby has authored or co-authored 26 articles in peer-reviewed journals, has authored or co-authored five book chapters, and has authored four books on foot and lower extremity biomechanics and orthosis therapy, three of which have been translated into Spanish language editions. He has invented the subtalar joint axis palpation technique, the anterior axial radiographic projection, the supination resistance test, the maximum pronation test and the medial heel skive and lateral heel skive orthosis techniques. He has also created and developed the Subtalar Joint Axis Location and Rotational Equilibrium Theory of Foot Function and has co-developed the Subtalar Joint Equilibrium and Tissue Stress Approach to Biomechanical Therapy of the Foot and Lower Extremity. He has lectured internationally on 33 separate occasions in China, Spain, Belgium, New Zealand, Australia, England, Dominican Republic and Canada over the past 23 years on foot and lower extremity biomechanics, foot orthoses, and sports medicine. He has also lectured extensively throughout the United States.
Dr. Kirby is a member of the editorial advisory board for the Journal of the American Podiatric Medical Association and a manuscript reviewer for the Journal of Biomechanics, Journal of Foot and Ankle Surgery, Medicine and Science in Sport and Exercise, and Journal of Foot and Ankle Research. He is currently an Adjunct Associate Professor in the Department of Applied Biomechanics at the California School of Podiatric Medicine and has a full time podiatric biomechanics and surgical practice in Sacramento, California.
Join or Renew Your OSC Membership Today! Published on Saturday, 1 October, 2016
You are part of this awesome profession! The OSC is made up of people just like you, practitioners with a passion for the profession who volunteer their time. Our goals are to provide continuing education, advocate for the profession to key stakeholders and educate the public, as well as increase an array of membership perks and benefits.
Join or renew today so that we can continue to meet and exceed our goals!
You are part of this awesome profession! The OSC is
made up of people just like you, practitioners with a passion for the
profession, who volunteer their time on the OSC. Our goals are to provide
continuing education, advocate for the profession to key stakeholders and
educate the public, as well as provide an array of membership perks and
Join or renew today so that we can continue to meet and to exceed
In the last year we have had 358 practitioners attended OSC
Continuing Education Events!
See what is coming, OSC Continuing Educations for 2017:
March 03-04, 2017 Acupuncture
May 05-06, 2017 OSC
Annual Spring Conference
Summer 2017, date TBA soon for Learn and Play Golf/Spa Seminar
Fall 2017, date TBA soon for Surgical and Injectable
Workshop on Cadavers
Upcoming Professional & Public Promotion and Advocacy
Canadian Diabetes Association Professional Conference
November 03,04,05 Canadian Association of Wound Care
MPP Campaign since end of August has created and continues
to provide the opportunities for OSC Members and Board of Directors to meet and
discuss the need for "One title, One Expended Scope”.
Ontario Society of Chiropodists Procedure Codes and Fee Guide Update Published on Friday,12 August, 2016
Ontario Society of Chiropodists Procedure Codes and Fee Guide Update
The OSC has been working on updating the Chiropody Suggested Procedure
Codes and Fee Guide and hope to finalize and release it in the fall.
The OSC Chiropody Suggested Procedure Codes and Fee Guide is intended to
serve as a reference to enable the development of structured,
standardized procedure codes and fees in order to create and maintain
consistent lines of communication between chiropody offices and the
insurance companies processing patients' extended health care claims.
* The Society has no interest in regulating what individual
chiropodists charge for various procedures. Cost or price decisions can
be left up to individual clinicians working across the province. One
that is fair and reasonable to both the patients and to the
practitioner. The fees listed within OSC fee guide are not mandatory,
only suggested, and each practitioner is expected to determine the fees
which will be charged for the services performed.
*The Society's ability to articulate and demonstrate the value of
the profession of chiropody to the Minister of Health and Long-term Care
and other key stakeholders has been undermined by a comprehensive lack
of data. We have struggled to be able to easily answer questions
relating to who is doing what, how often, where, why and for whom.
* To address this "data gap" the Society is proposing to introduce
a coding system that we can all use to ensure that we're all describing
apples as apples and oranges and oranges - and so the Board will have
access to an expanded array of evidence we can use to articulate why
investing in chiropody is money well spent.
* To increase access to electronic billing and EDI transactions.
Insurance companies write programs to read and process the billing codes
hence why a standard coding system is required. This would allow you to
offer your patients additional value and lower out-of-pocket expenses
by submitting their claims on their behalf. It provides a direct link
between patients and insurers to streamline claims processing and
shorten reimbursement times for providers resulting in increased client
satisfaction and loyalty due to fewer out-of-pocket expenses; your
clients pay only the portion not covered by their group insurance. It
would provide real-time confirmation of claim payments as a web-based
claims service providing faster claims processing and increased
If some of you are particularly concerned and would like to volunteer
and provide input working with the OSC Fee Guide Committee, please
forward your email to email@example.com