A ROW has broken out between orthopaedic surgeons and specialists in foot care over the use of the title of consultant.
It takes a doctor as long as 15 years to become a consultant after completing a five-year medical degree. It is the highest rank in the career ladder for hospital doctors and surgeons — so any patients referred to a “consultant podiatric surgeon” might well believe that they are seeing a leader in the field. Not so: there are at least 50 such surgeons practising in the NHS with no medical qualifications at all.
The use of the title by podiatrists has long rankled with orthopaedic surgeons. Now the British Orthopaedic Trainees Association has declared open war.
“The public is being deceived,” said Matthew Freudmann, a committee member of the association and a specialist registrar in orthopaedic surgery (the rank below consultant) at Hereford County Hospital. “It is illegal to pass yourself off as a medical doctor, but there is no similar protection for the word consultant. The public automatically assumes that anybody with this title is not only a doctor but an extremely well-qualified one.
“We see patients every week who have been operated on by ‘consultant podiatric surgeons’ and without exception they are astonished when they find these people have no medical qualifications.”
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The podiatrists argue that orthopaedic surgeons took no interest in foot problems before they came along and that, without them, thousands of patients would not get treated at all.
Tom Galloway, a consultant podiatric surgeon and Dean of the Faculty of Surgery of the College of Podiatry, says there is “absolutely no danger of the public being confused”.
To be clinically effective it is not necessary to be clinically trained, he said. “We wouldn’t pretend to be experts in anything else but feet. We don’t want to have a battle.”
David Jones, president of the British Orthopaedic Association, denies this.
“People going for operations should be properly informed,” he said. “We have repeatedly complained but we get no help from the General Medical Council and absolutely none from the Department of Health either.”
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Mr Freudmann and colleagues carried out a survey by stopping a total of 355 people in the street, giving them a list of job titles, including consultant orthopaedic surgeon, physiotherapist, consultant respiratory surgeon, chiropodist, occupational therapist and consultant podiatric surgeon, and asking which they thought were medically qualified.
“The results are shocking,” Mr Freudmann said. “We found 95 per cent of the public think that consultant podiatric surgeons are medically qualified doctors.” He added: “The Department of Health thinks podiatric surgeons are wonderful because they are quick to train, cheap and take patients off orthopaedic waiting lists. But our overriding concern is for the welfare of patients and ensuring informed consent and choice.”
Mr Freudmann said that the training needed to become an orthopaedic consultant was far more demanding than that for podiatric consultants. Doctors usually need three high-grade A levels to get into medical school, take five years to qualify, pass exams set by the Royal College of Surgeons and train for a total of 9 to 15 years before qualifying for a consultant post.
Podiatric surgeons do a three-year university course to qualify as health professionals. They can then train as surgeons through the College of Podiatry’s Faculty of Surgery, taking five years to become fully qualified.
Relations between the professions soured recently when Yorkshire Podiatry Services claimed on its website that podiatric surgeons “are the physicians best-qualified” to deal with foot problems. Use of the term physician by medically unqualified people is illegal and the site has now been changed after what was said to have been “an oversight”.