Research on Foot Pain’s Connection to Obesity and Mental Health [Interview][Transcript]

Presenter: Wayne Bucklar

Guest Bio: Paul is the course co-ordinator of the Podiatry program in the School of Health and Human Sciences at Southern Cross University on the Gold Coast. Paul joined SCU in January 2012. Paul qualified as a podiatrist at La Trobe University in 1997 and has a Master’s degree from Curtin University in 2008.

Segment overview: For our Health Academy Series today, Dr. Paul Butterworth FFPM RCPS from the Southern Cross University School of Health and Human Sciences is here to share valuable insights on the topic of podiatry. Paul is also a fellow of the Faculty of Podiatric Medicine, Royal College of Physicians and Surgeons of Glasgow. Paul works as a podiatric surgeon at Southport Day Hospital and is due to complete his PhD this year. Dr. Butterworth’s interests are on foot surgery as well as conducting research on systemic foot pain obesity and mental health.


Health Professional Radio


Wayne Bucklar: You’re listening to Health Professional Radio with Wayne Bucklar. And today my guest is Dr. Paul Butterworth. Now Paul is a specialist podiatrist, he’s based on the Gold

Coast in Queensland and he’s here to talk to us about his practice and what goes on. Welcome to Health Professional Radio Paul.

Dr. Paul Butterworth: Thanks Wayne.

W: Now Paul tell us a bit about your practice?

B: Well I graduated around three and half years ago with my surgical qualification and I’m a registered foot and ankle specialist and surgeon with the Australian Health Practitioners Regulation Agency. So basically my scope of practice is anything to do with the foot and ankle so I’m able to provide advice on the conservative treatment options and perform surgical procedures where indicated.

W: Now Paul I notices you’ve got quite a website up. Is that kind of a routine amongst surgeons or is that unusual? I haven’t noticed one before?

B: Yeah look I think with the a lot of orthopedic surgeons they’re starting to look at developing website and there are certainly some out there. I think websites are good way to provide information to patients. Patients are pretty tech savvy these days and so being able to have a website that provides information on conditions, contact information for where they can seek your service and so on. It’s relatively important in today’s world I think.

W: And that’s a if you’re interested in having a look. is that website. And as you say Paul it provides information about conditions and processes I notice on therefore other professionals looking to refer patients to you. Does it get a lot of traffic?

B: Yeah, it does. I’m actually updating the website currently and it should be ready within the next sort of 5 or 6 weeks. So yeah, look it certainly does get some traffic, I’m certainly get some inquires through there and certainly being a useful tool.

W: That’s interesting because it’s kind of a bit for many industries I guess it’s routine these days but in health it’s probably a bit at the leading edge of technology, so it’s nice to see.

B: Yeah I think it depends on the practitioner and where they’re working and so on. But I think certainly in dentistry and podiatry probably rather than medicine I think it’s probably website utilized more because our referral pathways are a little bit different. So I think we tend to, someone like myself I tend to get patients coming to me who either can’t get into see an orthopedic surgeon because there’s such a waiting list or perhaps they’re looking for a second opinion. And so I think that’s were having a good website enables for that referral pathway to occur.

W: And what is the, I guess from a patient’s perspective more than from a clinician’s perspective – what is it the decision point between an orthopedic surgeon and a specialist podiatrist surgeon like yourself?

B: Oh look, I think there’s a number of different factors. I think that at the end of the day patients often will choose a specialist depending on how they get along with that person. You can’t please everybody. So often I’ll get patients that want a second opinion maybe they’ve sought off an opinion previously and perhaps didn’t want to go down that path and so typically it comes down to the patients, how they connect with practitioner I think at the end of the day.

W: Yeah. I think that’s still pretty much universally across medicine, that it’s the human connection that decides the difference whether its good doctor or good patient or not. It’s that human connection make difference. Paul is there a categorization of your patients? Do you see a lot of sports people, do you see a lot of aged people? How does your work breakdown?

B: Well it’s a bit of everything from young kids to the elderly. I’d always say the majority of my patient are females somewhere between the age of sort of 35, 40 to sort of 70 typically with forefoot deformity so bunions, hammertoes, Morton’s neuroma, things of that nature. But up here I certainly see a lot of surfers who have particular problems and I see lots of kids who have got bony deformities as well. But typically females tend to have more foot problems than men and partly that can be explained by female foot wear. And also females tend to be more susceptible to getting certain foot problems more so than men. So one example is a condition called “Hallux Valgus” which is which is a bunion and it’s certainly men get it as well but it’s certainly common in females and they tend to be the patients that I consult with more often than not.

W: Feet are one of those things that I think most of us are happy to ignored until they go wrong.

B: Essentially, yeah look foot pain and deformity. And look most people you know is sited down in there and you don’t pay too much attention to them until there’s a problem. But I think using a condition like a “bunion” as a prime example that is a condition that is highly correlated with an increased risk of falls and balance problems once we get older. And often patients will ask me “Should get this fixed now or should I later see how it goes?” There’s no right or wrong answer. But certainly you know with an aging population and I think we spoke last time about the rise of overweight and obesity that there are more foot problems out there.

W: Yeah. So Paul most of our audience as you know are clinicians in acute setting. What would you like them to know about your practice?

B: Oh, look I think the main thing is that there’s an alternative option for patients who perhaps are waiting for long periods to get into an orthopedic specialist. And so because I’m a podiatrist specialist I do tend to have the ability to look pretty closely at what conservative options patients can try prior to considering surgical interventions. So I think that’s one of the benefits of my service and that I like what I do, I think I’m pretty good at it. But the option is there for patients who need it.

W: Yes, that’s interesting. And referrals to you can just follow a no GP referral process or is there something special about it?

B: GP referrals are most welcome, they’re not essential because our service are covered under Private Health Colorado that Medicare. So it’s a little bit like dentistry that patient can refer themselves, they can come in without a GP referral and if they’ve got private health cover then they’ll be covered. Uninsured patients are welcome but obviously they’re out-of-pocket without cover.

W: That’s interesting. Paul, now every industry has its misconceptions and I was going to make a joke about pediatric and children here but I’m not even gonna try and do that. What’s the greatest misconception about your practice that drives you nuts and keeps you awake at night?

B: I think the misconception out there that perhaps we’re not as well trained as orthopedic specialists and that’s really frustrating because I had over 2,800 procedures in my log books before I graduated in close to 500 medical rotations both here in this country and in the US and UK. So in the UK podiatric surgeons are well established within the public health system and in the US podiatric surgeons are performing over 80% of all elective foot surgery. I think in Australia we’re a little behind our overseas colleagues and I think that just takes time. So that could be difficult but because we’re regulated by the same regulatory body that regulates medical practitioners I think patients can be well assured that we have to jump through the same sort of hoops with maintaining our accreditation. So yeah, that can be frustrating.

W: You’re listening to Health Professional Radio. I’ve been talking this morning with Dr. Paul Butterworth about both his website at and his practice as specialist podiatrist. Paul it’s been a pleasure to have you once again on Health Professional Radio. If anyone’s missed the interview this morning, we have a transcript on our website and an archive on SoundCloud and on YouTube and that’s at

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