Orthotist John Farmer
What does your work involve?
My job involves providing patients with appropriate devices, footwear and orthoses to give support, correction and accommodation for deformity that may be acquired due to injury or conditions such as rheumatoid arthritis or osteoarthritis. There are a plethora of items that we as orthotists have available and we often find that due to the ever changing nature of such conditions that we have to be innovative and look outside the box. I often find myself as an advisor or link between fellow professionals; it's imperative that as healthcare professionals we collaborate with other professionals to establish a holistic approach to the concerns and needs of the patient.
What do you do in a typical day?
Clinics start between 8.30 and 9.00 am and are always busy; most orthotic clinics have a mix of patients from orthopaedic, rheumatology, diabetes or paediatric services so you are always kept on your toes. Patients often present with complex needs and these require analysis and discussion. Unfortunately there are only a small number of orthotists in the UK and as a result of this our caseload numbers tend to be quite high, seeing a patient every 20 minutes. During these appointment times we often have to take plaster casts of feet or limbs as some deformities require the provision of extra information for the manufacturers to provide the required orthoses. Sketches, drafts, drawings and impression foam models all add to the vital information-gathering exercise. Patients will also be attending for fitting of footwear and inlays and some will be attending for review of their orthoses or shoes. A typical new rheumatoid patient will want to find out more about the service and what provision will be made for them. I spend valuable time explaining our service and about what goals we should set ourselves, as the relationship between patient and professional is a partnership with shared goals. Shortened and non-existent lunches are normal and the need for tea essential. Clinics usually end around 5pm, but there is often paperwork or ward jobs to do after that.
Why did you choose to do this work?
I started life as an engineer and was a frequent helper with what was then called PHAB (physically handicapped able-bodied people). I was fascinated by body engineering or biomechanics and eventually found my way into a post in Sheffield as a trainee orthotist. From there on I studied at Salford University and qualified in 1982. The role is always innovative and interesting.
What’s the best thing about this job?
Without doubt, patient satisfaction. There is nothing more rewarding than knowing your efforts are appreciated. We don’t always succeed but we are a determined bunch and seek the same determination from the patient in order to achieve our mutual goals.
And what’s the worst thing?
Financial constraint. But I appreciate that we don’t have a bottomless pot of money, although orthotic services have always been described as a 'Cinderella' service.
How has research informed the work you do?
Research is imperative in the development of any patient-focused profession. I have attended many conferences and lectures, worked with several universities on product and service development and studied rheumatology masters modules. All of these help me achieve the best possible outcomes for my patients. The work that Arthritis Research UK does and the partnerships it has with professional bodies gives us all scope for betterment. The Standards of Care for the Rheumatoid Foot is one such example.
John Farmer is an orthotist at Hull Royal Infirmary.