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Thursday, September 05, 2013

Diabetes and Feet: Why do people not go to the podiatrist?



Australia has a very high number of lower limb amputations and many experts believe most are preventable with greater awareness of the dangers of diabetes in the earlier stages of the disease, and better access to services. Foot problems are a leading cause of hospitalization in Australia which makes it important for those in high risk to be able to access subsidized, regular consultations and services. The health cost is an estimated $612 million each year. ($203 million on hospitalization alone). One visit to a podiatrist can reduce the risk of serious complication by as much as a third. So it makes sense to make a friend of your podiatrist especially if you are trying to cope with a chronic disease like Diabetes.

So why do people not use podiatry services more?

The majority of podiatrists in Australia work in the private sector and a single consultation can cost $90 (or more) which if you do not have private health insurance is an expensive exercise. On average it is not uncommon to attend for podiatrist maintenance every 6- 8 weeks, and more if skin and nail pathologies persist. So that does knock a hole in your pocket.

Currently GP’s can refer people coping with chronic illness such as diabetes to specialist services such as podiatrist, physiotherapist and other health care profession through Medicare. The present system allows up to five consultations per calendar year. However when a person requires the help from several health professionals then you need to share the five visits among them. The immediate benefit to the GP is they receive a professional evaluation which helps them manage their patients in a more informed way. Many people however use their free Medicare referral to cover the most expensive fees, which is perfectly understandable, but does mean they ignore worthwhile preventative services such as podiatry. Australian podiatrists have been lobbying parliamentarians to increase the number of Medicare Subsidized podiatry visits to 12 per year. This would allow greater access to more health professions and allow foot monitoring to continue.

Australian podiatrists with suitable training can now prescribe restricted medicines such as antibiotics as well as refer to diagnostic services. However as the regulations currently stand, prescriptions from the podiatrist are not subsidized by the Pharmaceutical Benefits Scheme (PBS); and referrals to diagnostic testing and medical imaging are not currently covered by Medicare Benefits Schedule (MBS). As a consequence patients are charged in full. This obviously hampers client care and frustrates professionals all at a time when diabetes is a pandemic.

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