Financial characteristics and security of podiatry work in Victoria: the PAIGE cross sectional study of Australian podiatrists.

BACKGROUND: Podiatrists' earnings have an important influence on workforce dynamics. This includes the profession's ability to attract and retain workers so the population's healthcare needs can be met. This study aimed to describe financial characteristics of podiatry work and factors relating to a sense of financial security. METHODS: This was a cross sectional study using data from Victorian podiatrists who participated in Wave 1 of the Podiatrists in Australia: Investigating Graduate Employment (PAIGE) survey. Demographic and financial characteristics were described. The outcome measure, financial security, was collected through a self-reported belief based on current financial situation and prospects, respondents' perception of having enough income to live on when they retire. Univariate logistic regression was used to determine associations with rural or metropolitan practice locations. Multiple ordered logistic regression was performed to explore associations between factors relating to financial security and retirement prospects. RESULTS: There were 286 Victorian podiatrist (18% of n = 1,585 Victorian podiatrists) respondents. Of these, 206 (72% of n = 286) identified as female, 169 (59% of 286) worked in the private sector and the mean (SD) age was 33.4 (9.5) years. The mean (SD) annual gross income was $79,194 ($45,651) AUD, and 243 (87% of 279) made regular superannuation contributions. Multiple ordered logistic regression analyses identified factors associated with podiatrists' perception of having adequate retirement income. These included being an owner/partner of their main workplace (adj OR = 2.70, 95% CI = 1.49-4.76), growing up in a rural location (adj OR = 2.27, 95% CI = 1.38-3.70), perceiving a moderate overall health rating (adj OR = 2.03 95% CI = 1.51-2.75), not having financial debt related to education and training (adj OR = 2.02, 95% CI = 1.24-3.32) and regular contributions to a superannuation scheme (adj OR = 4.76, 95% CI = 2.27-10.00). CONCLUSION: This is the first known study to explore podiatrists' earnings and perceptions regarding financial security. Findings suggest modifiable ways to improve financial security of podiatrists including support and education about personal and business finances including debt management, understanding the importance of contributions to superannuation when self-employed, and developing skills and supports for podiatrists to run their own businesses. This research is exploratory and is relevant for understanding the impact that income and financial security have on workforce dynamics.

Implementing a podiatry prescribing mentoring program in a public health service: a cost-description study.

BACKGROUND: In the management of diabetes and high-risk patients, timely treatment with scheduled medicines is critical to prevent severe infections and reduce the risk of lower extremity amputation. However, in Australia, few podiatrists have attained endorsement to prescribe. The aims of this study were to identify the costs associated with developing and implementing a podiatry prescribing mentoring program; and to compare the cost of this program against potential healthcare savings produced. METHODS: This was a cost-description analysis, involving the calculation of costs associated with the development and implementation of a mentoring program to train podiatrists to become endorsed prescribers. Costs were calculated using the Ingredients Method and examined from the perspective of a public health service provider, and the individual learner podiatrist. Breakeven analysis compared the cost of training a podiatry prescriber for endorsement against the potential benefit (savings) made by averting complications of an infected foot ulcer. A sensitivity analysis was conducted to allow for uncertainty in the results of an economic evaluation. RESULTS: Total start-up cost for the podiatry prescriber mentoring program was $13, 251. The total cost to train one learner podiatrist was $30, 087, distributed between the hospital $17, 046 and the individual learner $13, 041. In the setting studied, a podiatry prescriber must avert 0.40 major amputations arising from an infected foot ulcer through prescribing to recover the cost of training. If in-kind training costs are included, total cost increases to $50, 654, and the breakeven point shifts to 0.68 major amputations averted. CONCLUSION: The economic benefits (savings) created by an endorsed prescribing podiatrist over their career in a public health service are likely to outweigh the costs to train a podiatrist to attain endorsement. Further research is required to help understand the effectiveness of podiatry prescribing in reducing diabetic foot related complications and the potential economic impact of podiatry prescribers on this health condition.