OPMA

History of the OPMA

“Before we can decide where to go, we have to know where we’ve been”

Originally, the term or title applied generally to the specialization in foot care was “chiropody”. Over the past half century the term “podiatry” spread and today is the generally-accepted term in the majority of developed countries. In Ontario, the two professional titles reflect substantive differences in education and scopes of practices.

In Ontario, chiropodists appeared as a distinct specialization in the late 19th Century. As might be expected, their training was received in Britain . In the United States , chiropody was taught indigenously as a branch of medicine.

The first association of chiropodists in North America was established in New York in 1895, which was also the year in which the profession became regulated for the first time – again in New York State – as a separate profession.

The first school of chiropody in North America was established in New York in 1912, with a medical doctor as president and with most faculty members trained as physicians.

Regulation for chiropodists in Ontario first occurred in 1925 under the Drugless Practitioners Act.

During the Second World War, the supply of British-trained chiropodists dried up. Since there was no indigenous chiropody school, the gap was met by U.S. trained chiropodists migrating to Canada in increasing numbers. The Chiropody Act, which confirmed chiropody as a stand-alone, self-governing health care profession in Ontario , came into effect in 1944.

The U.S. continued as the predominant source of new practitioners after the War and pursuant to regulations passed in 1950 and 1955, chiropody in Ontario became essentially the U.S. model.

In the early 1960’s, U.S trained Ontario-based chiropodists, following the lead of their colleagues in the U.S. , began calling themselves “podiatrists” and the profession as “podiatry”. In 1970, Ontario podiatrists were given OHIP billing privileges.

Podiatry In Ontario

Date: 7/10/2007

In Ontario, podiatrists are a class of members of the College of Chiropodists of Ontario. The College is the professional regulatory body for both podiatry and chiropody under the Regulated Health Professions Act, 1991 and the Chiropody Act, 1991. To be eligible to practise as a podiatrist in Ontario, one must hold a "Doctor of Podiatric Medicine/DPM" degree from one of the eight Colleges of Podiatric Medicine in the United States, or from the podiatry program offered by the University of Québec at its Trois Rivieres campus. No podiatry school has yet been established in Ontario, or elsewhere in Canada. Entry to any of the podiatry programs in North America requires a baccalaureate (BA) degree in the sciences and successful completion of the Medical College Aptitude Test (MCAT). The podiatry program consists of four years of clinical and didactic study, followed by at least one year's residency or internship in a hospital. Health Professions Act, 1991 podiatrists

Are one of only six professions legally authorized to "communicate a diagnosis" [1] to their patients and to their patients' representatives identifying a disease or disorder of the foot;

may perform surgical procedures on the subcutaneous tissues of the foot and the bones of the forefoot;
may administer injections into the feet; and
are authorized to prescribe drugs.

Under the Ontario Health Insurance Act, podiatrists may bill OHIP for assessments and treatments provided to patients.

Under the Healing Arts Radiation Protection Act, podiatrists may operate x-ray machines for diagnostic purposes.

Podiatrists practise primarily in private clinics in the community, although a few also act as consultants in community and teaching hospitals. Podiatrists also provide foot care services in some long-term care homes, in some retirement homes and some podiatrists make house calls to patients who are homebound.

To locate a podiatrist in your area, contact the OPMA at 416-927-9111 toll free in Canada 1-866-424-6762 or email the office contact@opma.ca

[1] In addition, practitioners of Traditional Chinese Medicine are authorized to communicate a traditional Chinese medicine diagnosis and naturopaths will soon be authorized to communicate a naturopathic diagnosis.

Our Mission

The objective of the Association is to continue to be recognized as the single, credible voice of podiatry and podiatrists in Ontario.
The principal duty of the Association is to serve its members effectively and to be accountable to its members
The goal of the Association is to advance the podiatry profession and the interests of its practitioners in Ontario, by supporting the continuous development of individual practitioners and the profession generally, by promoting the profession and by advocating to government and to other stakeholders on behalf of the profession.
The Association also recognizes a duty to serve and protect the public of Ontario, in particular to ensure that the public of Ontario can access highest-quality footcare when and where it is needed and to protect the public against fraudulent practices or incompetent practitioners.
The Association will pursue its objective and goals on its own, but also by establishing collaborative relationships with other provincial and national organizations that have shared goals.
In conducting its activities, the Association will at all times act diligently, honestly and in good faith in the best interests of its members.

Podiatry And Chiropody

Date: 7/10/2007

One of the questions the OPMA and individual podiatrists are most frequently asked is "What is the difference between a podiatrist and a chiropodist?". We are the first to admit that there is justification for confusion given that both are regulated under the same College, but in fact there are important differences between podiatrists and chiropodists. The distinction is important.

Confusion between the two professions originates from the fact that the term or title generally applied to the profession specializing in foot care was originally "chiropody". Over the past 40 years, the professional title "podiatry" and the additional competencies associated with it spread and today are generally accepted in North America and in the majority of developed countries.

In Ontario, practitioners who were educated in the United States and had obtained a degree “Doctor of Surgical Chiropody” provided most of the specialized foot care services in Ontario from the beginning of the Second World War (when the supply of British trained chiropodists dried up) to the late 1960s. There were a few UK trained chiropodists providing foot care. By the late 1960s all of the schools in the United States had changed their names to podiatry and the degree they were awarded was and continues to be a "Doctor of Podiatric Medicine (DPM)".

The problem was, however, that there weren't enough podiatrists to meet the growing demand for foot care services in Ontario. Accordingly, in 1980 the Ontario government introduced a new foot care delivery model, with accompanying changes to the applicable legislation. The major elements of the new foot care policy were

· The introduction of chiropody, based on the UK chiropody education model, to be provided primarily in hospitals and in other health care institutions on a salaried basis;

· continuation of podiatry and podiatrists to provide services, including surgical procedures, as before in their clinics, primarily on a fee-for-service basis under OHIP; and

· greater reliance on surgeons, particularly orthopedic surgeons, to provide surgical management of foot disorders.

The major differences between podiatrists and chiropodists in Ontario today are:

Education: Podiatrists are required to have a "Doctor of Podiatric Medicine/DPM" degree, which is a post baccalaureate, four-year degree. The majority of chiropodists currently practising in Ontario hold a post-secondary diploma in chiropody, although many have some university level schooling or a baccalaureate degree in a non-related field as well.

OHIP coverage: Podiatrists may bill OHIP for their services. Chiropodists may not.

Services: Podiatrists may "communicate a diagnosis" to their patients and perform surgical procedures on the bones of the forefoot. Chiropodists may do neither.

X-rays: Podiatrists may own and operate x-rays. Chiropodists may not.

Since July, 1993 no new podiatrists have been registered to practise in Ontario in order to encourage the development of the chiropody profession. However, the gap between the demand for foot care services and the supply of regulated foot care professionals continues to grow. Chiropodists have been unable, on their own, to satisfy the demand and there is a growing shortage of orthopedic surgeons. Nurses and other regulated and unregulated health care professions have moved into the vacuum by offering a range of foot care services for relatively minor ailments.

The College of Chiropodists of Ontario made a request to the Minister of Health and Long-Term Care in January 2006 for the Minister to ask the Health Professions Regulatory Advisory Council (HPRAC) to examine whether a reversion to the podiatry model would not better respond to the demand for foot care services in Ontario than the current chiropody model. By letter dated June 28, 2007, the Minister asked HPRAC to “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 of foot care in Ontario, issues regarding restricted titles, and whether the existing limitations on the podiatrist class of members should continue.”

OPMA Disclaimer

Date: 7/5/2007

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