How P.E.I.'s new podiatry regulations are changing footcare on the Island

This sign on John Johnson's clinic door used to say Johnson Podiatry. There was also a 'Dr.' in front of his name. The sign was changed recently.  (Steve Bruce/CBC - image credit)
This sign on John Johnson's clinic door used to say Johnson Podiatry. There was also a 'Dr.' in front of his name. The sign was changed recently. (Steve Bruce/CBC - image credit)

There may be no greater sign that P.E.I. now has podiatry regulations in place than the actual sign on John Johnson's clinic door.

It used to say Johnson Podiatry. It now says Johnson Footcare, and he is described as a "foot specialist."

The head of the Canadian Podiatric Medical Association is happy to see it.

"That name is protected — podiatry, podiatrist, podiatric surgeon. So if someone is calling themselves a podiatrist, they need to go through the college to register," said Howard Green, the CPMA's president.

Howard Green, President of the Canadian Podiatric Medical Association, believes the fact podiatry is not regulated on P.E.I. makes it easier for a podiatrist to work in the province without any formal credentials.
Howard Green, President of the Canadian Podiatric Medical Association, believes the fact podiatry is not regulated on P.E.I. makes it easier for a podiatrist to work in the province without any formal credentials.

Howard Green, president of the Canadian Podiatric Medical Association, has been pushing for P.E.I. to bring in regulations. They finally took effect Oct. 1. (Ryan McLeod/CBC)

The college he's talking about is the P.E.I. College of Physicians and Surgeons. Under P.E.I.'s new rules, which took effect Oct. 1, the college is now the regulator of podiatry. That means it is responsible for screening and registering anyone who wants to work as a podiatrist.

The key requirement, according to the regulations: "The successful completion of a post-secondary program in podiatry approved by the [college]."

Norman Kew, a semi-retired podiatrist who works five days a month on P.E.I., is relieved to see rules in place.

"I'm actually grateful in that it removes anyone who's unqualified for the position," he said.

Activities were unregulated

P.E.I. is among the last provinces to bring in podiatry regulations.

The need for rules was highlighted in July, when a CBC News investigation revealed John Johnson was calling himself "Dr. John Johnson, DP" and treating hundreds of patients' foot problems, allegedly without even completing high school.

Johnson has never responded to those allegations, or provided proof of any credentials.

Concerns surrounding his practice led provincial health officials to take a closer look at all of the podiatrists working on the Island (there are only a few). That highlighted another problem: For years, some were doing medical procedures they weren't allowed to do in the province.

Under P.E.I.'s Regulated Health Professions Act, activities like diagnosing disorders, injecting drugs and cutting into the skin are off-limits in health professions that aren't regulated.

Podiatrist Norman Kew, who works five days a month on PEI, says he's 'grateful' to see regulations in place. He's currently looking into the registration process.
Podiatrist Norman Kew, who works five days a month on PEI, says he's 'grateful' to see regulations in place. He's currently looking into the registration process.

Podiatrist Norman Kew, who works five days a month on P.E.I., says he's 'grateful' to see regulations in place. He's currently looking into the registration process. (Norman Kew )

So Kew said that while he himself is more than qualified to do all those things, a lawyer for the P.E.I. government told him this summer he had to stop until regulations came into effect and he registered with the college.

"That's now led us down the path where I'm not able to provide my full services for the clients coming through the door. And we had to cancel many procedures we had on the books," said Kew, who is now looking into the registration process.

"Anybody who called, we were telling them: 'Sorry, there's no sense putting you on the list. Once we know there's legislation in place and we're registered, you can give us a call again.'''

Complaints-based enforcement 

That's not to say the college is planning to actively enforce the podiatry rules with proactive inspections.

"We will be approaching this on a complaints basis, as we do with the physicians," said George Carruthers, the college's registrar. "If we were to become aware of podiatric services being offered [by someone not registered], we would then investigate and act accordingly."

While P.E.I. does not have podiatry regulations, there are rules limiting what unregulated health professionals can do on the Island. Among other things, they're not permitted to do procedures under the skin, to diagnose diseases or disorders, or prescribe medications.
While P.E.I. does not have podiatry regulations, there are rules limiting what unregulated health professionals can do on the Island. Among other things, they're not permitted to do procedures under the skin, to diagnose diseases or disorders, or prescribe medications.

With regulations now in place, podiatrists who are registered will be allowed to cut into the skin, inject medications and diagnose disorders. Podiatrists weren't legally permitted to do those activities on P.E.I. when the profession was unregulated. (Ryan McLeod/CBC)

While John Johnson has taken the word "podiatry" out of his clinic's title, it's not clear what footcare he's now offering.

In late July, his clinic said in an email to CBC News: "We are here strictly doing orthotics for the time being."

CBC News reached out again recently to ask about the status of the clinic and how it's been affected by the new regulations, but didn't get a response.

I think the college could look into it to make sure someone saying they're practising footcare is not drifting into podiatry, and providing care they really shouldn't be. — Howard Green, president of Canadian Podiatric Medicine Association 

At last check this week, a framed certificate was still hung on Johnson's clinic wall — visible from outside.  It says "Dr. John Johnson" has "met all the requirements of registration" in the P.E.I. Podiatry Association and is "hereby admitted a full member of the association with all rights and privileges."

Johnson's father, Brian, is listed online as the president of that association. The two other practising podiatrists on P.E.I., one of whom retired this week, were not a part of the group.

The elder Johnson has never responded to questions about the association's status, or how his son became a member.

Calls for more active enforcement 

Charlottetown Police Services confirmed to CBC News that it has received complaints about Johnson and his clinic, and is investigating, although it doesn't have the authority to shut his business down or change how it operates.

Green, the head of the national podiatric medicine group, thinks the P.E.I. College of Physicians and Surgeons should play more of an active role to ensure rules are being followed and anyone calling themselves a podiatrist — or effectively working as one — is registered.

"On the Island, where the population is smaller, the number of practitioners is smaller, I think the college could look into it to make sure someone saying they're practising footcare is not drifting into podiatry, and providing care they really shouldn't be," Green said.

Kew agrees.

"There probably should be more of an active look," he said. "I mean, take the instance of John Johnson there. If somebody had looked into his practice before now, we would've been aware before now there was an issue."

Podiatrist Dr. John Johnson says he is 'very confident there is going to be no risk to the public and everything we have been doing has been safe for all Islanders.'
Podiatrist Dr. John Johnson says he is 'very confident there is going to be no risk to the public and everything we have been doing has been safe for all Islanders.'

CBC News reached out to John Johnson to ask about the status of his clinic and how it's been affected by the new regulations, but didn't hear back. (Aaron Adetuyi/CBC)

To date, the college says no one has actually registered to work as a podiatrist on the Island.

With long-time podiatrist Keith Bettles retiring this week, it appears Kew is the only trained (though unregistered) one left in the province.

Green is hoping the new regulations will be an incentive for another podiatrist to set up shop on P.E.I.

"I think having the regulations in place will actually be a positive for someone who wants to come there in, hopefully, the near future. They can say, 'Oh the profession's regulated. Great. I'm going to go and apply for [a] licence, open my practice, and practise as I'm trained to do.'"