Position Statement
The Canadian Orthopaedic Association seeks to clarify the respective scopes of practice for orthopaedic surgeons and podiatrists with regard to treating and caring for patients with a wide variety of foot disorders. Moreover, the COA calls on provincial/territorial ministries of health to consult with stakeholders (orthopaedic surgeons, podiatrists, patients and others) to establish uniform standards for foot and ankle care in Canada.

Background
Recent legislation in Manitoba and Saskatchewan appears to expand podiatrists' scope of practice, allowing them to perform procedures using public resources that historically have been the domain of general and sub-specialist orthopaedic surgeons. The formalization of podiatry is necessary and welcome, given the increased demand for foot care and the system-wide shortage of health human resources. However, the COA is concerned that these legislative initiatives were developed without first establishing detailed standards of care, education and CME requirements, ongoing assessment of competence, medico legal coverage and a regulatory body to oversee these important issues. This process has proceeded without consulting local provincial medical and orthopaedic associations who are legislated to abide by these standards required of any profession. A unilateral and fragmented introduction of podiatry into Canada's health-care system is not in patients' interest - or anyone's interest, for that matter - if there is confusion over where to refer a patient and under what clinical circumstances.

The COA believes that clear treatment protocols outlining the roles and responsibilities for family physicians, podiatrists and orthopaedic surgeons, as well as other medical professionals, would go a long way to helping podiatrists integrate smoothly into Canada's health-care system and ensure that the right patient sees the right health professional for the right reasons.

Quebec has a School of Podiatry, and another is soon to follow in Alberta. Thus, there can be no better time than the present for stakeholders to come together to discuss how to work together.

Actions
The COA has scheduled a first meeting with executives of the Ontario Podiatric Medical Association to look at common interests. Also, the COA has formally asked for standing  at hearings of Ontario's Health Professions Regulatory Advisory Council (HPRAC) that resulted from a request made to the Minister of Health and Long-Term Care by the College of Chiropodists of Ontario.

The COA will continue to seek dialogue with the various provincial podiatric associations, as well as ministries of health, on delivery of foot and ankle care.

 A PDF version of this position statement can be found  here