In Australia, surgery intervention is a core capability of the podiatry profession, with a registered speciality dedicated to foot and ankle surgical practice. This was not always the case.
In the 1970s forward thinking individuals developed a vision to align podiatric practice in Australia with that seen in the US. The relationship between the Australian and American podiatry professions can be traced back to formal meetings in 1975, and the birth of podiatric surgery in Australia is directly linked to this collaboration.
A chance conversation
The then President of the Australian Podiatry Council Dr John Pickering was attending the American Podiatry Association (APA) annual meeting in San Francisco. During this meeting he was invited to the upcoming Board of Trustees meeting and asked to define podiatry in his home state of South Australia for his American colleagues.
Dr Pickering described the definition of podiatry under the South Australian Chiropodists Act, which included ‘surgery’ as a prescribed treatment for the management of the foot and ankle. Given this definition had been in place since the late 1950s, the APA executive director, Dr Seward Nyman asked, “So, how long have you been doing foot surgery?”
Dr Pickering replied, “Well, we haven’t started operating yet…” and he now reflects on the response prompted by this statement. “The Americans were astounded and could not comprehend that Australian podiatrists were sitting on the best podiatry Act in the world as far as scope of practice was concerned, and no one was cutting tendons or bones.” In contrast, the American podiatry profession had begun to use surgery as a modality in an organised manner during the 1950s.
Examples in practice
While he was in the US, Dr Pickering visited each of the then five Colleges of Podiatric Medicine. He observed podiatrists performing incisional nail surgery, bone spur removal and soft tissue mass excision under local anaesthetic (LA). This was quick and efficient, and it seemed to provide a long-term solution for pathology, which was at the time being treated by podiatrists in Australia with regular debridement, footwear ‘education’ and padding or silicone shields.