After over a year of deliberation, AHPRA has decided ‘surgical podiatrist’ is a less confusing title than ‘podiatric surgeon’ for podiatrists who perform foot and ankle surgery.
After deeming that the term “podiatric surgeons” confused and misled the patients of podiatrists who performed surgery, AHPRA and the Podiatry Board of Australia have settled on a new title to “provide greater clarity for the public”.
That title is “surgical podiatrist”.
Scope of practice for these clinicians will not change, despite submissions from both the Australian Orthopaedic Foot and Ankle Society and the AMA calling for narrowed scope.
The new title specifically applies to the 42 Australian podiatrists who have a surgical endorsement on their AHPRA registration and will not kick off for another 12 months.
The saga began in October 2023, when mainstream media reporting highlighted the experiences of patients who had complications following foot or ankle surgery performed by a podiatrist.
Many patients assumed that the podiatrists who had treated them were medical doctors or had received specialist training from a surgical medical college. This is not strictly accurate.
While surgical podiatrists do have to complete either a five-year Doctor of Podiatric Surgery through the University of Western Australia or a three-year postgraduate program through the Australasian College of Podiatric Surgeons, they are not trained as doctors.
The media attention triggered an independent review of the regulation of podiatric surgeons in Australia, completed in March 2024.
It concluded that the “podiatric surgeon” title was “confusing and problematic” and that the “confusion and information gaps surrounding the title ‘surgeon’ present significant risks to consumers”, potentially undermining public confidence in regulation.
The suggested alternative titles were “operative podiatrist”, “operating podiatrist” and “surgical podiatrist”; the latter of these was put forward as the preferred option by independent review lead Professor Ron Paterson.
During the consultation, the Australian Orthopaedic Foot and Ankle Society, which represents specialist orthopaedic surgeons, put forward “operative podiatrist” and “operative credentialled podiatrist” as alternative titles.
“The continued use of the term ‘podiatric surgeon’ represents an ongoing risk to patients,” AOFAS wrote at the time.
“The general public has difficulty differentiating between a ‘podiatric surgeon’ and a medically trained orthopaedic surgeon despite the vastly different training pathways and experience, often, sadly to the detriment of their own safety.”
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Former AOFAS president Dr David Lunz told Nine Newspapers on Monday that he felt the new title would still mislead patients.
“The term ‘surgical’ has the connotation of being a surgeon,” he said.
“It’s still a problem.”
Crucially, despite the loss of the ‘surgeon’ title, surgical podiatrists will still be performing surgery.
“The title change does not alter the standard of care provided but will help guide consumer expectations and allow for informed decision-making,” Podiatry Board of Australia chair Dr Kristy Robson said.
During the independent review, the AMA specifically mentioned that a number of medical professional organisations had expressed concern that the activities of podiatric surgeons in relation to two particular procedures, hallux valgus correction and ankle fusion, were potentially dangerous.
AOFAS, meanwhile, pointed out that according to data collected by the peak podiatric surgery body itself, podiatric surgeons in Australia were doing an average of four cases of hindfoot surgery (i.e. ankle replacement, ankle stabilisation and Achilles surgery, and subtalar fusions and coalition releases with plantar fasciitis treatment) per year.
“The numbers of cases performed by Podiatric Surgeons (from their own data) precludes them from obtaining and maintaining core competencies,” the AOFAS submission said.
“The combined activity of the entire cohort of ‘podiatric surgeons’ would not allow even one of them to have the surgical experience to safely undertake an ankle fusion, but they are permitted to do so by the PBA, and the use of the item number 50118 indicates that they are occasionally performing these procedures.”
Ultimately, though, the 2024 independent review found “no basis for a restriction of the scope of practice of podiatric surgeons”.
