chiropody

views updated May 23 2018

chiropody as an area of professional practice within health care concerned with the care and treatment of disorders of the feet, has had both ancient and modern elements in its development. Whilst some health care professions (radiography and occupational therapy amongst others) are products purely of the twentieth century, chiropody, like dentistry, is best understood as an older health-related craft reformed under twentieth-century conditions. The forebears of modern-day chiropodists were the itinerant corn-cutters of past centuries who plied their trade at fairs, markets, and in the streets. Little is known in detail about the history of corn-cutters, but by 1845 Lewis Durlacher, a leading British practitioner, was drawing a distinction between the new professional chiropodist and the humble journeyman cutter.

Durlacher argued that the treatment of foot conditions should become a firmer part of medical practice of his day, and that in particular those with ‘the requisite surgical information’ after examination should be granted a license to distinguish them from untrained corn-cutters. His attempts to create a trained and recognized new class of practitioner did not come to fruition for nearly half a century, when a ‘Pedic Society’ was founded in New York, followed in Britain in 1912 by the Society of Chiropodists. Foot care at this time was becoming a major business area, which may have stimulated these professional responses. The Scholl remedial footwear firm had developed in the US, successfully responding to market needs, and had opened its first London branch in 1910. British doctors of the day were generally not interested in this area as part of their practice, and only a dedicated few served as mentors, patrons, and examiners for the new Society of Chiropodists. However, by 1923 its journal, The Chiropodist, was presenting the new profession as a collateral branch of medicine in line with Durlacher's earlier ambitions, drawing its scientific principles into a neglected but now crucially important area of health care practice.

The ambitions of the British chiropodists were very much influenced in the 1920s by the general position of dentistry. Dentists were trained, licensed surgical practitioners with a ‘body site’ of their own, separate commercial premises under their own control, and amicable relationships with other medical practitioners. Although previously licensed by the Royal College of Surgeons, they had attained self regulation in 1921 — but attempts by chiropodists to follow this example with a parliamentary bill in 1928 was strongly resisted by organized, professional medical lobbyists. The British Medical Association's position was to oppose any other class of practitioner outside the formal jurisdiction of the medical profession. Chiropody was modestly defined in the bill as ‘the diagnosis and medical, mechanical or surgical treatment of foot ailments such as abnormal nails, bunions, corns, warts and callosities but not the performance of operations for which an anaesthetic is required’, but this was not enough to disarm extensive professional rivalries in the inter-war years.

Nevertheless, after further decades of boundary disputes with medicine, chiropody in Britain finally achieved state registration or licensing in 1960, largely within the terms of the above definition. In the meantime, podiatry had developed within chiropody, as a specialized and more surgically ambitious area of bone surgery. The Canadian province of Ontario, for example, now specifically licenses podiatry as ‘cutting into osseous tissues of the metatarsals and toes of the foot, including osteotomies and joint surgery’ including associated diagnosis. This more advanced type of practice is now internationally common and corresponds with the earlier ambitions of the turn-of-the-century professional modernizers and their vision of a collateral profession. As with other one-time medical auxiliary occupations, chiropody training in recent times has been incorporated into higher education, and now holds a secure place in the broad medical division of labour as one of the preventative and remedial health professions. Students are trained on graduate programmes to offer treatments in the area of biomechanics, sports medicine, and bone surgery under local anaesthesia, in addition to the more traditional concerns with corns, in-growing toenails, veruccas, and local injections. The fully-trained professional group suffers, in its own view, from unfair competition from untrained practitioners, and thus like all professions in such circumstances tries to prohibit their practice, but this claim in Britain at least has not so far been legally successful. Arguably it is more likely that chiropody's next phase of development will lie in even closer links with related medical, surgical, and health professional areas, particularly as health policies try both to contain health care costs and to support increasingly aged populations. Developments in podiatry, however professionally important, may remain a relatively minor part of chiropody's future compared with its wider co-operation with GPs, dieticians, physiotherapists, and others working in primary care services.

Gerry V. Larkin

Bibliography

Larkin, G. V. (1983). Occupational monopoly and modern medicine. Tavistock, London and New York.

chiropody

views updated May 18 2018

chi·rop·o·dy / kəˈräpədē; shə-/ • n. another term for podiatry.DERIVATIVES: chi·rop·o·dist / kəˈräpədist/ n.

chiropody

views updated May 14 2018

chiropody (ki-rop-ŏdi) n. see podiatry.