In the lead up to AHP Day on Monday 14 October 2019, we are sharing an interview a day from some of our Allied Health Professional staff.
Today's features Suhail Ainarkar, from the Community Podiatry Team in North Manchester. Suhail was fascinating to talk to; as well as being an Advanced Podiatrist, he’s also a Vascular Specialist Podiatrist, which is pretty new.
What got you into feet?
I accidentally found myself in podiatry. I originally applied for radiography but then realised I wanted more interaction with patients. In podiatry you can assess, diagnose and treat the patient – the full journey – you can be autonomous.
Podiatry is very diverse in terms of the demographics as we work with anyone who needs us. Though the majority of people we see are adults, we will see children who commonly have problems such as in-growing toenails and pain from the way that they are walking. With older people, they generally have long-term conditions which can put them at higher risk of ulceration, infection or amputation from things like loss of feeling, diabetes and poor circulation.
A lot of our work is preventative. Foot treatments reduce the risk of ulcers, which can form when a person is not mobile or has too much hard skin. Quite often our appointments may be as simple as cutting nails, reducing hard skin and corns to help with their balance, keeping them mobile and independent.
People joke that we must have a foot fetish but they certainly wouldn’t say that if they saw the feet that we see!
A podiatrist is a specialist in the lower limbs (feet and legs). Podiatrists used to be called chiropodists, which people wrongly pronounce “sheropodists”. There’s no difference between the two – it is similar to Marathon bars being renamed to Snickers or Opal fruits changing to Starbursts!
Taking podiatry one step further
I’m an advanced podiatrist, working as part of the high risk foot team and a vascular specialist podiatrist in the leg circulation service. There’s a small group of vascular podiatrists in the UK but it is growing. Manchester and Salford were the pioneers of vascular podiatry in the UK. It saves so much money and so much time. If a patient presents to the GP with calf pain, the GP used to refer them to an expensive vascular surgeon. Now, there is another layer of triage, which sends patients for a vascular podiatry assessment in the first instance. Quite often surgery isn’t required – exercise and medication (lifestyle changes) will improve outcomes and this can be provided effectively by a podiatrist.
This relatively new intervention is doing really well so we are training and supporting other podiatrists to grow, both within our own team and across the UK.
What are the unexpected skills you need to be a podiatrist?
You need to be quite agile as you can spend a lot of time on the floor. Fine motor skills are also essential – half a millimetre here or there makes a big difference when you’re working with toenails and layers of skin.
There is a huge amount of patience, communication and listening required in podiatry as a lot of the time, the patients have many of the answers and clues; you just need to be able to draw them out. We build up a good relationship with patients as we see them regularly and discuss their lifestyles, which impact on their health and feet. We are serious multitaskers – you’re asking questions and listening at the same time as assessing and treating their feet.
Multi-disciplinary working is essential to keep someone healthy – if any piece of the jigsaw is missing, it can all fall apart. No one profession holds all the answers. We connect in with district nurses, occupational therapists, physiotherapists, GPs, the Macmillan team, diabetes specialists, infectious diseases doctors – you name it! We need to be in touch with almost all services as so many health conditions can have an impact on a person’s foot health.
People attend regularly so we are uniquely placed to get to know patients well and can be the only person they see. We are able to signpost patients to help reduce falls, review medication with their pharmacist, take up exercise and quit smoking – we can refer on to most services.
I am currently involved in providing training for private and NHS podiatrists around vascular assessments, wound assessments and infection/sepsis to make sure we all have the correct skills to recognise conditions early and refer on appropriately to ensure best outcomes for patients.
The impact of podiatry on patients
You can prevent early death by detecting risk factors for heart attack and stroke
Preventing foot ulcers - 80% of people with a foot ulcer will die within 10 years
Reducing risk of amputations
Signposting to other services
Optimising people’s journey through our services
Improving people’s quality of life and independence
We try to get people healing as quickly as possible by choosing the best clinical interventions to help them remain healed/intact.
The best bits
My favourite thing about my job is knowing that you are making a difference to people’s lives. Sometimes it doesn’t feel like it at the start but you get there in the end. It is hugely rewarding. Patients are usually very complimentary and look forward to coming back and seeing their podiatrist – we build up a relationship and patients come to trust us. For some patients, there can be instant relief. A tiny corner of a nail that’s digging in or a small corn can cause a huge amount of pain and have a knock-on effect on the person’s body. There aren’t many professions where you can provide instant treatment and relief. Ultimately I am proud of being in a profession where we save limbs and lives.