HISTORY OF THE PROFESSION OF CHIROPODY AND PODIATRY IN ONTARIO
posted: Sep 22, 2013.
This information was brought to you by JOHN INFANTI, D.Ch, the former head of the College of Chiropodists of Ontario and the Ontario Society of Chiropodists. A true gentleman and an advocate of foot care in Ontario.
History of Chiropody/Podiatry in Ontario
Podiatry – The history of the chiropody profession is an interesting one in Ontario. Prior to the 1960′s the terms “chiropodist” and “chiropody” were used to describe medical practitioners specializing in foot care. Since that time the terms “podiatrist” and “podiatry” have spread to become the generally accepted terms in the majority of developed countries in the world, such as the United States, Great Britain, Australia, South Africa, and many European nations. Ontario remains as the only jurisdiction in the world that still utilizes the antiquated terms to describe its licensed regulated foot care practitioners who legally can prescribe medications and perform surgical procedures.
Chiropody is one of the oldest regulated professions in Ontario. British trained chiropodists appeared in Ontario in the late 1800′s. Following the establishment of the first Chiropody school in New York in 1911, American trained practitioners soon appeared in Ontario as well. Chiropodists were first regulated under the Drugless Practitioners Act of 1925. In 1944, Ontario introduced the first Chiropody Act, which confirmed chiropody as a self-governing health care profession under Ontario Legislation.
During the late 1950′s into early 1960′s the American schools of chiropody evolved and transitioned to the use of the terms ”podiatry” and “podiatrist” to describe its foot specialists. During this period, U.S trained Ontario chiropodists also began themselves “podiatrists” and the profession as “podiatry”, however, the Chiropody Act of 1944 remained unchanged and the profession was still referred to as chiropody in all pieces of legislation.
During the late 1970′s, the Ontario government conducted an assessment of the foot care needs of the province. As there were no indigenous schools of chiropody in Canada at that time, there were great concerns about the provinces ability to provide ongoing foot care services to a population that was forecasting exponential growth in the number of residents who were entering into the senior years of their lives. The Ontario government made the decision to adopted a Chiropody model of foot care based on the UK chiropody model that existed at that time. A diploma level chiropody program referred to as the Ontario Chiropody Program was established and provided through a partnership involving George Brown, the Michener Institute (then known as the Toronto Institute of Medical Technology), and the Toronto General Hospital. The Michener Institute took over the program in 1993.
The government of Ontario introduced a new Chiropody Act in 1991. Under this act the existing American trained practitioners were allowed to continue to practice as a class of chiropodists termed “podiatrists”. The new Chiropody Act also proclaimed that no new members would be added to the class known as podiatrists. From that date forward all practitioners registered to practice in Ontario would utilize the title “chiropodist”.
Since its exception, the Ontario chiropody program has progressively evolved as has the outdated British model this program was founded upon. Substantive changes to the program have occurred since its inception as evidenced by the many changes made to the curriculum and to the requirements for eligibility to enter to the program. Graduates from this program are accepted for licensure as “podiatrists” in other countries and provinces in Canada, however must still use the antiquated title in Ontario.
Other jurisdictions comparable to Ontario have adopted a podiatry model of foot care. Ontario is the last jurisdiction in North America where chiropody model persists. The College of Chiropodists of Ontario reached the conclusion that the chiropody model of foot care, at least as practiced in Ontario, is outdated, no longer suits the paradigm of health care delivery in Ontario, does not recognize the evolution in the professions competencies, creates obstacles for interjurisdictional mobility for members of the profession and is not addressing the growing and changing demand for foot care in Ontario, particularity within the seniors population.
The College of Chiropodists of Ontario has taken the position that Ontario should follow the example of other comparable jurisdictions by moving to a podiatry model. To do so, substantial amendments to the Chiropody Act, 1991 and other legislation are required. A referral to and a review by the Health professions regulatory advisory committee (HPRAC) is required to initiate such amendments. Accordingly, the College of Chiropodists of Ontario (supported by the Ontario Podiatric Medical Association, The Ontario Society of Chiropodists and other organizations) made a request to the Minister of Health and Long term Care under section 11 of the Regulated health Professions Act to make a referral to HPRAC.
The Minister approved the Colleges request and asked HPRAC to undertake a review of the profession in Ontario. More specifically the Minister asked HPRAC to:The College of Chiropodists of Ontario has taken the position that Ontario should follow the example of other comparable jurisdictions by moving to a podiatry model. To do so, substantial amendments to the Chiropody Act, 1991 and other legislation are required. A referral to and a review by the Health professions regulatory advisory committee (HPRAC) is required to initiate such amendments. Accordingly, the College of Chiropodists of Ontario (supported by the Ontario Podiatric Medical Association, The Ontario Society of Chiropodists and other organizations) made a request to the Minister of Health and Long term Care under section 11 of the Regulated health Professions Act to make a referral to HPRAC.
“Review issues relating to the regulation of Chiropody and Podiatry and provide advice as to whether and how there should be changes to existing legislation regarding these related professions. Include in your review an analysis of the current model or foot care in Ontario, issues regarding restricted titles, and whether the existing limitations on the podiatrist class of members should continue.1“e
HPRAC’s review is currently scheduled to begin in the 2013-2014 cycle.