Autonomy in Podiatric Practice

Professional autonomy is an attribute that is broadly considered to contribute to the attainment of professional status. It is likely to be positively promoted by professional bodies and used as part of professional rhetoric to enhance university programme recruitment. Whilst some aspects of the notion of autonomy have informed studies mapping the professional development of podiatry, it is perhaps timely to explore the contemporary relevance of the concept for podiatry, particularly in light of the changing nature of current practice and career pathways. Most podiatrists are familiar with the claim that their profession offers its members the opportunity of both independent and autonomous practice as well as the option of working within teams. Often the patient/practitioner relationship is considered to be unique and characterised by the autonomy of the practitioner in matters of diagnosis and management. However, failure to define autonomy adequately may give rise to a contradiction between claims grounded in professional rhetoric and those based on reality. This paper attempts to revisit the theoretical basis of professional autonomy and seeks to develop a more applied definition that circumvents the misleading messages inherent in professional rhetoric and dogma, and enables a firmer appreciation of the relative uses of the concept of autonomy in a contemporary context. Of immediate relevance are the factors determining independent clinical decision making as distinct from the collective dynamics of professional power and authority. Thus, there are two key elements that when separated, offer potentially different insights into the role and authority of podiatrists, the power of the profession, and the authority of the individual practitioner.