By Marlie Cappel, HealthCasa Chief Chiropodist
One of the questions I am most frequently asked is “What is the difference between a Podiatrist and a Chiropodist?” The simple answer is that there is no significant difference between Chiropodists (pronounced: ‘ker-ro-po-dist’) and Podiatrists in Ontario. Both professions are regulated by the College of Chiropodists of Ontario and both must pass comprehensive board exams and provincial licensing exams to be licensed to practice.
The difference in title is determined by which country the Chiropody or Podiatry degree was obtained. A Podiatrist practicing in Ontario will have graduated outside Ontario (usually in the US) and will have moved to Ontario before 1993. All Podiatrists who moved to Ontario after 1993 are registered as Chiropodists in the province of Ontario. Therefore, in an effort to promote the profession of Chiropody in Ontario, there have been no new Podiatrists registered in Ontario for the past 25 years.
In Australia, the title “Chiropodist” was replaced with “Podiatrist” in 1977, while in other countries such as the UK, the designation “Chiropodist” is still used today.
Training and education
Podiatrists and Chiropodists are often referred to as “foot doctors” or “foot specialists”. Podiatrists are required to have a “Doctor of Podiatric Medicine/DPM” degree, which is a four-year, post-bachelor’s degree. Remember, although they have the title “Doctor”, they are not medical doctors. The majority of Chiropodists currently practicing in Ontario have studied for 7 years - they hold a post-secondary diploma in Chiropody and most also have a bachelor’s degree or university level education in the sciences or in another field.
Some practitioners also enroll in additional training and courses; I recently completed a diabetic educator course which expanded my knowledge in the management and prevention of diabetic foot conditions. I love educating patients, helping them better understand their condition, and providing them with the knowledge and preventative tools to live a healthier, more enjoyable life. Here’s a short video with me talking a little more about why I love what I do!
Treatment of foot conditions
If you suffer from a common foot condition such as plantar fasciitis, bunions, ingrown toenails, flat feet, calluses, corns or warts, both a Chiropodist and Podiatrist can help. Podiatrists and Chiropodists help individuals of all ages and with a wide range of health conditions. They have trained extensively in the assessment, management and prevention of many types of foot conditions. They are also specialists in the prevention and treatment of foot injuries, foot trauma and wound care.
Prescriptions of drugs
Both Podiatrists and Chiropodists are allowed to prescribe drugs used to treat various foot conditions and disorders. These include topical (creams, lotions, ointments), oral (pills, tablets) and injectable medications. Some of the most common drugs that I prescribe for foot-related conditions are anti-fungals, cortisones and antibiotics. My patient’s health and safety is my highest priority, and to ensure that all drugs prescribed are appropriate for your health, your HealthCasa Podiatrist or Chiropodist will always review your medical intake form and will discuss any concerns with you.
Orthotics
Custom orthotics can help to alleviate pain and discomfort associated with a variety of foot conditions such as flat feet, plantar fasciitis, over-pronation, diabetic feet, bunions and neuromas. Although some Chiropractors and Physiotherapists also dispense orthotics, Podiatrists and Chiropodists are the only regulated health professionals in Ontario, aside from medical doctors, who can prescribe custom orthotics. Seeing a foot specialist such as a Podiatrist or Chiropodist for your feet is the logical choice.
Surgery
Both Podiatrists and Chiropodists can perform soft tissue surgeries, skin surgery and nail surgery. However, Podiatrists trained in the US before 1993 have a slightly expanded scope of practice that includes bone surgery in the foot. It’s important to note that in Ontario, most patients choose to see Orthopedic Surgeons for foot-related bone surgery since the associated costs are covered by OHIP. Podiatrists can also order and take x-rays of the foot, while Chiropodists cannot.
Healthcare professionals…not just foot specialists
Remember, no matter what title they use, both Podiatrists and Chiropodists are primary healthcare professionals specializing in the assessment and treatment of lower limb disorders. They have both trained extensively and are highly knowledgeable in the anatomy, physiology, pathology and biomechanics of the foot. While your family doctor or another healthcare provider may be able to address some of your foot concerns, it makes sense to see a Podiatrist or Chiropodist for your foot health since they’re specialists in that field.
It is also important to remember that we have also studied the rest of the human body. Since we’re qualified to perform potentially invasive nail, skin and soft tissue surgical procedures and prescribe drugs, we need to have a thorough understanding of your personal medical history before we can assess and treat you. Your patient intake form is the best way for us to get a comprehensive picture of your health and for this reason, we ask that you complete your intake form prior to your appointment. This ensures that we have enough time to familiarize ourselves with your health conditions and medications or discuss your health with your family doctor if necessary.
My story
Now, a little bit about myself. I became a Chiropodist after doing my prosthetics and orthotics program at George Brown College. I’ve always had a passion for athletics - I’ve taught swimming and skiing and have worked with adaptive skiers as well, so I have a thorough understanding of biomechanics (the study of the body’s structure and function). Above all I really enjoy helping people.
One patient stands out in my mind. John was an avid golfer and squash player. After a severe left ankle injury several years prior to seeing me, his ankle healed improperly, forcing him to give up golf and squash. After a thorough assessment and several detailed conversations with John and the lab, John and I worked together to create a special custom orthotic that specifically addressed his left foot. The end result was that John was able to start golfing and playing squash again. I’m lucky to have the opportunity to practice a profession that allows me to give people the ability to resume their daily activities and hobbies.
With over ten years of clinical experience as a practicing Chiropodist, I’ve seen many patients who, for a variety of reasons, were house bound. These patients, who often have debilitating health conditions, don’t have many options when it comes to health care, and often give up and ignore their symptoms to the point where they become serious. Those patients were my primary focus when I started doing in-home consultations. Over the years I’ve also started working with busy, working professionals and parents with young children, who simply don’t have time to visit a “traditional” foot clinic. With HealthCasa, the Foot Clinic now comes to you!
I’m so thrilled to be a part of the HealthCasa team and have the opportunity to provide convenient in-home or in-office appointments for my patients.
Be assured that you will receive optimal care whether you see a HealthCasa Chiropodist or Podiatrist!
Marlie Cappel Chief Chiropodist
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