Uninsured’s chiropody needs often unmet
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Sep 20, 2013  |  Vote 0    0

Uninsured’s chiropody needs often unmet

Government funding needed to clear community health centre’s chronic chiropody clinic wait lists

Etobicoke Guardian

Etobicoke community health centres are reporting chronic wait lists for uninsured clients seeking treatment in its chiropody clinics.

Each clinic operates with one to three chiropodists and simply cannot keep up with the demand, health centres’ staff report.

In south Etobicoke, LAMP Community Health Centre generally has a 40-50 client wait list, at times as high as 120, reported chiropodist Susan McGuire, the chiropody team leader at LAMP’s chiropody clinic for the past 25 years.

“Is there an awareness in government that there is a need?” McGuire asked. “Is increased funding something they are considering? “All these (chiropodist) positions were funded before the LHIN (Local Health Integration Network) system was put into place. Within months, I realized the need was getting out of hand.”

McGuire estimated LAMP’s chiropody clinic could fill an additional chiropodist’s practice within six months just by clearing its wait list.

Chiropodists assess, treat and prevent diseases and disorders of the foot by therapeutic, surgical or orthotic means, including care for corns and calluses, wound care, biomechanics or gait problems, as well as physical therapy.

This article is the second in a series The Guardian is reporting on existing challenges to the provision of adequate foot care for seniors in south Etobicoke. Last week, an article reported Storefront Humber had reinstated its popular and much-needed seniors’ toenail cutting service after hiring a new nurse.

The Ontario government created 14 LHINs in 2006, not-for-profit corporations that work with local health providers and communities to determine health service priorities to plan, integrate and fund local health services, including hospitals, long-term care facilities and community health centres.

The Guardian contacted the Central Toronto LHIN for comment. A LHIN spokesperson referred The Guardian’s questions to the College of Chiropodists of Ontario.

A college spokesperson, who asked not to be named, said as the province’s regulatory body for chiropodists it does not lobby the provincial government for increased funding for community health centres’ chiropody clinics.

However, she confirmed the college has been inundated with calls from south Etobicoke residents frustrated by the chiropody clinics’ wait lists.

Stonegate Community Health Centre, south Etobicoke’s other community health centre, also has a wait list of approximately 12 clients, executive director Bev Leaver reported.

To receive treatment at a community health centre, clients must not be insured and also not be able to afford private service elsewhere.

“Funding is absolutely a problem,” the college spokesperson said. “There aren’t enough funds. My heart breaks because I have to say to people, ‘I’m so sorry. I can’t help you.’ As a regulatory college, there is nothing we can do. The Ontario Society of Chiropody Association could maybe write letters to MPPs about this issue.”

An official with the Ontario Society of Chiropody Association said Wednesday its board of directors would consider The Guardian’s request for an interview.

A chiropodist for 30 years, McGuire has spent most of her career working at LAMP and heading its chiropody clinic.

Proper foot care is integral to good health and quality of life, McGuire said.

McGuire offers a years-old example from when LAMP’s chiropody clinic cut seniors’ toenails, a service it no longer offers due to increased demand from clients with more medical-related foot issues.

“One woman had given up every part of her social life,” she recalled. “She wasn’t going out. She was having food delivered. She was ordering shoes from a catalogue. Something as simple as her toenails made her a recluse, which is crazy. I saw her just the once and suddenly she could regain her life.”

At LAMP’s chiropody clinic, approximately 60 per cent of clients are seniors, many 90 years old or older, 30 per cent are people with diabetes, the remainder are adults and children, McGuire estimated.

People with diabetes face serious, even potentially fatal consequences if their feet get wounded and infected.

“Not only is it the loss of a foot unfortunately for someone with diabetes. It can become a cascade of system failure,” McGuire said. “The other foot is at risk. You become at risk in general. Statistics show after an amputation, you lose the other foot or leg and within a number of years, there is a loss of life. Foot care is very important.”

The LAMP chiropody clinic’s chronic wait list makes it virtually impossible to take new clients unless the person is an existing LAMP client in urgent need of care, a situation which rarely occurs.

“I don’t remember a time in my 25 years here when there hasn’t been a wait list. There are always people waiting,” McGuire said. “The clients we have, at least two-thirds of them require ongoing care. It’s always a balancing act.

“It’s so difficult to know there are people we can help, but there is no time. There are people who live in the neighbourhood who can’t come to us. It’s very difficult as a practitioner to know you can help, but you just can’t.”

Lorraine Telford, LAMP’s manager of clinical programs, reported its chiropody clinic has approximately 600 ongoing clients, the majority requiring ongoing care.

“On our roster we have either clients who are acute or have chronic, but serious issues. Once someone is a client, we can’t say, ‘you’ve had four sessions. We need to serve other people.’ These clients have a clinical need and it’s unethical.”

Telford reported LAMP is “making the case to the ministry for more resources” with its chiropody program making a report to LAMP’s board of directors.

It is encouraging, she said, that LAMP has received a slight increase in government funding to allow more diabetic clients to attend its chiropody clinic.

Telford agreed with McGuire and the College of Chiropodists of Ontario that the answer to clearing community health centres’ chiropody clinics’ chronic wait lists is increased Ontario government funding to hire more chiropodists.

“The opportunity for advocacy here is good,” Telford said. “Can we build care with more and better services around seniors’ health, including the need for good foot care?”

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