A Podiatrist's Perspective

A Podiatrist's Perspective

I am a musculoskeletal specialist podiatrist. In 2020 I completed my PgCert in Medical Ultrasound, to allow me to scan the foot and ankle as part of my practice. Podiatrists and Sonographers have something in common, there’s not many of us about and most people have no idea what we do! ‘No, sonographers don’t just scan babies’ or ‘No, podiatrists don’t just cut toenails’ can be daily conversations in the work place (or the pub). There are benefits to being a small community though, as I discovered when I left my NHS role this year to set up as an independent practitioner.

Rules around using ultrasound as an independent podiatrist are different compared to being an NHS-based podiatrist but after two years of refining my skills in sonography I was determined to continue using ultrasound in private practice and decided to buy a machine. Not only did I not want to lose my skills, but the thought of not being able to offer a patient an ultrasound scan that would undoubtedly benefit them and influence my treatment plan for them was worse than the idea of chopping off my own arm!  To me, ultrasound has become a natural extension of my practice and an essential part of the holistic service that I provide.

The reality of practising ultrasound independently, however, has been a steep learning curve. Choosing a machine, getting my own cloud-based Picture Archiving and Communications System (PACS), planning for audit and QA have been the first hurdles. The next steps are negotiating the requirements of the Care Quality Commission so I can practise independently in England.  It's been a whirlwind of a few months but the support I have had from BMUS and some friendly, independent MSK sonographers, has been amazing. I’m not sure I would have got this far without them.

Podiatrists have POMs annotation (prescription-only medicines) on our HCPC registration, as we administer local anesthetics. Many podiatrists complete additional training to offer other interventional procedures, like cortisone injections.  Once we have our ultrasound qualifications, it is then fairly straightforward for us to go on to offering guided interventional procedures.

I have been impressed by the MSK sonographers I have met, from a radiology background, and the efforts they have gone to to develop their musculoskeletal knowledge and understanding of the mechanisms of injury and management of conditions. Foot and ankle anatomy still tests my brain and I have been studying it for over 15 years!

With more time, scanning and mentoring I will continue to develop as a competent musculoskeletal podiatrist and foot and ankle sonographer, eventually able to offer guided therapeutic treatments to my patients. I won't get there without support from the ultrasound community and the podiatry community, but from my experience so far it feels achievable. We can all benefit from multidisciplinary working and supporting each other and I would love to see more podiatrists and sonographers working together in future, exchanging skills and experience.  It's fantastic what can happen when we reach out to each other.

Article by Musculoskeletal Specialist Podiatrist, Emma Barnes