The patient podiatrist relationship - contextualising professionalism within the clinical encounter

Abstract

Introduction Patients are the key resource of health care practitioners, and much emphasis is laid on partnerships of care, with the patient being informed, autonomous and empowered. Many questions arise from current practice - are podiatrists fully embracing this model of practice? Do patients fully engage with their practitioner? How do podiatrists feel that patients perceive us? Research in nursing and occupational therapy stresses that practitioners must 'connect' with patients, and at times act as chameleons, changing to match the environment of each patient encounter (Aranda and Street, 1999; Rosa and Hasselkus, 1996). This study aimed to explore podiatrist's perceptions and experiences of the relationship they hold with their patients. Methods A phenomenological approach, informed by Gadamers's hermeneutic philosophy for gaining meaning and understanding was utilised, with the researcher's influence as 'native' being accepted in co-construction and interpretation of data from 8 Podiatrists in Central Scotland (4NHS, 4 private practitioners). Corec and QMU granted ethical permissions. Results Six categories of meaning emerged: relationship, engagement, role, image, reward and personal development. This fed into one overarching theme - Professionalism. Discussion Theories of dramaturgy (Goffman, 1959) and Liminality (Turner, 1969) are used to interpret and explain the findings. Baldwin's (2006) model of professionalism is utilised to demonstrate that phronesis (practical wisdom) and tacit knowledge are important and undervalued aspects of professionalism, alongside episteme (knowledge) and techne (profession specific skills). The study findings suggest a model of professionalism which focuses on the individual patient - practitioner interaction, with phronesis being a more important element of professionalism than traditional models have accepted.