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Podiatric surgeons urge Medicare Benefits Scheme support to address Indigenous foot health disadvantage

Callan Morse -

Indigenous people, especially those living in remote areas, are missing out on crucial care and suffering painful delays in seeing specialist surgeons, according to the Australasian College of Podiatric Surgeons.

To address the disadvantage the College (ACPS) is calling for better access to the Medicare Benefits Scheme (MBS) to enable them to assist patients suffering acute pain and reduced quality of life.

Podiatric Surgeons are specialist doctors who are trained only to operate on feet and ankles, yet there is currently no Medicare Benefits Scheme item number for podiatric surgery or associated services, including anaesthetics and pathology.

The ACPS says there is a large bank of evidence suggesting up to seventy per cent of affected patients have untreated foot pain, which has a debilitating effect on their quality of life.

ACPS President Dr Rob Hermann said untreated foot pain has a significant impact on First Nations patients, especially those living outside of capital cities.

"Most of us take for granted, the ability to go about our daily lives free of pain and unrestricted," he said.

"But due to the lack of funding and access, that's just not the case for thousands of patients. Issues concerning foot health can have drastic impacts on quality of life. Along with increased pain for patients and higher risk of complications, delayed care could lead to more costly future treatment and long-term debilitation."

The expense of treatment is a significant barrier for patients including Doreen Peterson, a First Nations woman from the Central Coast of New South Wales.

After a number of unsuccessful surgeries by orthopaedic surgeons, Ms Peterson is facing an $11,000 bill for surgery on her ankle after suffering a torn ligament in 2011.

However the cost of podiatric surgery without assistance from the MBS is a prohibitive price tag.

"I have no idea where I'm going to get that kind of money," Ms Peterson said.

Doreen Peterson requires cortisone injections as part of her waiting treatment, yet is still unable to walk. (Image: supplied, ACPS)

"Even with cortisone injections I'm in constant pain. It affects every aspect of my life, the minute I take off my shoes I struggle to walk, and I have no sense of balance."

The ACPS said the high cost of healthcare faced by podiatric patients can be prohibitive to low-income and at-risks groups, and the consequences life-altering.

They say over the past decade the Indigenous Australian community has seen increases in the rate of preventable hospitalisations, with patients living in regional or remote Australia already struggling with reduced access to vital healthcare.

ACPS says this inaccessibility is further compounded by the prohibitive costs associated with vital podiatric healthcare.

"Long wait times lead to an increased complication rate, the risk of future surgeries or even amputation – a particularly high risk for patients with other complicating factors such as diabetes," Dr Herman said.

"This is costly to the patient, and it is costly to the health system."

The ACPS is calling for a prevention over cure approach to be prioritised in podiatry sooner rather than later, saying an addition to the MBS would offer much-needed relief to many First Nations communities and other vulnerable Australians.

They say podiatric availability is a matter not of convenience but of equitable accessibility.

"All areas of medicine acknowledge that prevention is better than cure and lack of MBS access for podiatric patients is treating them like second-class citizens." Dr Hermann said.

The Australasian College of Podiatric Surgeons said various studies in Indigenous Australian foot and lower limb health point to a chronic health issue, with up to sixty per cent of participants affected by foot pain, with forty-nine per cent reporting very or extremely painful injuries that affected walking, activity levels, and sleep.


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