The Ottawa Citizen reported on a speech given by Premier Dalton McGuinty to the Ottawa Chamber of Commerce.  In the speech, McGuinty stated that the health care challenge today was so complex that work should begin now.  "Reform is necessary and inevitable" and that  "the renewal of long term funding for health care will, without a doubt be one of the most important issues facing government in the coming years".  He went on to cite figures on the aging of our population, and the health care resources required for the larger, older demographic, inlcuding, skyrocketing costs.  Reform is needed for the sustainability of our health care system.  "We should not be shy of demanding that care be based on what worked, not what people wanted".

One would almost think that the premier understands the actual problems facing those of us who deliver the care he talks about.  Does he also believe that the federal government throwing more of our tax dollars at the exsisiting health care model will truly deliver a sustainable public health care system? As everyone should know at this point, we don't have enough money to pay for everything for everybody for every health care service all the time.

Yes, reform is needed.  Reform has been necessary for a good long time.  But, what has been done?  In previous writings, I have outlined the ruinous path that successive governments have followed regarding the delivery of foot health care services in Ontario.  Most harmful has been the prevention of licensing of podiatrists since 1993.  Ontarians should have access in a timely, effective manner to podiatric services, now being denied.

Admittedly, Mr. McGuinty's Liberals did leave intact, the small percentage funding that OHIP allows for certain podiatric services to individuals who normally would not be able to afford the actual costs involved in health care.

The big job has been left undone.  As reported in an earlier blog, the government committee charged with studying and making recomendations to the minister of health had it's budget slashed, so that no work has been done on podiatry care.  This, even though the College of Chiroposists of Ontario recomended the transition to a podiatry model, as in Alberta.

It is not enough to call for reform.  Dynamic leadership must be offered, with a clear vision as to where we need to go, and how we can get there.  The system needs a major fix.  But my view from here, based on the real world, especially as it applies to foot care, is that we are not getting more than a bandaid.

Take 2 aspirins and call me in the morning!

On August 8th, 2011, a Quebec podiatrist, graduate of the podiatry program at the University of Quebec at Trois Rivieres will join Feetdocs.  Pierre Dupont (DPM) is a doctor of podiatric medicine, licensed as a podiatrist in Quebec and as a chiropodist in Ontario (a bizarre quirk, thanks to our political friends - see my blogs for further insight).

Pierre will assist in providing the same high level of podiatric care that is being provided at Feetdocs.  His presence will allow for a more timely and expanded range of services for foot care at our bustling practice. 

Welcome on board!

Recently, a 50 year old construction worker was referred by an area hospital emergency room with a very broad weeping wound on the inside of his foot. Being a diabetic, this man had a high risk situation. The hospital was unable to care for his needs in a timely manner, so he was referred to our office. The heavy burden placed on our hospitals is a well known phenomenon, so it is not surprising that we are seeing more and more patients referred from the places that used to handle these cases themselves.

 We make every effort to see at risk and infected conditions but it is becoming increasingly more and more difficult to accommodate the heavy load. And it will get worse.

The Canadian Diabetes Association recently reported the following:

In 2009, the Canadian Diabetes Association estimated that the rate of diabetes almost doubled from 2000-2010 from 1.3 million to approximately 2.5 million, and will continue to rise from 2010 to 2020 to approximately 3.7 million. While the number of Canadiansdiagnosed with diabetes is high, an additional 700,000 are estimated to have diabetes, but do not know it. Although these numbers are alarming, refinements to these estimates to be released by the Canadian Diabetes Association in the spring of 2011 based on new information indicate an even higher estimated prevalence for diabetes both now and in the future unless action is taken to address this coming tsunami. These revisions will also include the number of people living with prediabetes. About 50% of Canadians with prediabetes develop type 2 diabetes.  The increasing rate of diabetes and its complications are also a burden on our health care system and our economy. In 2009, the Canadian Diabetes Association estimated that in 2010, diabetes would cost Canada’s health care system an estimated $12.2 billion, up from $6.3 billion in 2000. By 2020, diabetes will cost our health care system $16.9 billion in direct health care costs (hospitalization, general practitioners, specialists, and medications), and indirect costs such as lost productivity due to disability and premature death.

Diabetes is only one disease that impacts heavily on the patients we see in our podiatry office. As you can see from the above, we can expect an even greater demand and burden on our health care professionals.

We need more podiatrists not less, as reported in my previous blogs. We need professionals who have the highest level of skills available to treat the patients who are suffering from the wide variety of diseases we see in our office

The result of all of the above is having a terrible effect on my ability to provide podiatric care in a timely manner. New patients now must wait for 5 months before they can be seen, although we try to make exceptions for urgent care, such as infections.

What we are finding is, that because of this delay, patients are attempting other forms of therapy, medications and devices while they wait. This hit and miss strategy is expensive, time consuming and often leads to frustration and ongoing pain.

David Greenberg D.P.M

During my term as a Council member of the College of Chiropodists in Ontario (the professional regulatory body for both Chiropodists and Podiatrists), the College petitioned the Minister for a referral to HPRAC with the objective of removing the podiatric cap and moving to a Podiatry model of footcare based on the Alberta Podiatry model. The College's petition was supported by the Ontario Society of Chiropodists and the Ontario Podiatric Medical Association. The Minister made the referral to HPRAC in June, 2008 and, on it's original timetable, would have been completed by now. Because of the fiscal situation. however, the review has been postponed to 2011-2012.

I know the College has had meetings with Ministry officials and with members of the Minister's staff and there is some sympathy to bringing the HPRAC review forward, primarily because of the interjurisdictional problems the podiatric cap creates. The Premiere's support for bringing the HPRAC review forward would be invaluable.