Altimus the new Parish & Bell?

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Two seperate patients in the last week have brought to my attention the way a company called Altimus in the Kensington area of London are practising. Both have been advised they needed orthoses, the first quoted £1500, and the second just over £1000. Then I asked the name of the individual who saw them and checked - they were not on the HCPC register. Looking on the Altimus website it appears they are instead a "highly qualified foot technician".

From memory Altimus posted on here a while ago advertising a job for a Podiatrist for a very low salary. I wondered if perhaps they'd like to come on here and explain/defend the above pricing structure?? Or does anyone else on here have experience of/with them? I also took a look at the "biomechanical assessment form" that they had given out with all the details of what was needed [that's another story] and the breakdown of costs [£98 extra for a met dome?? Really??]

I don't want to judge, but a non Podiatrist led service charging at least 5-fold more for devices than they should.... Sounds awfully familiar....

 

Here is the thread I was referring to where they were advertising a vacancy: http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=67634

It seems the last poster on that thread may have similar opinion to I...

Craig - any way you can make Altimus aware of this thread so they can have a chance to come on here and give their side of the story?

 

This is a difficult one.
On the one hand the potential for damage to reputation that this kind of operation can do to Podiatry is high.
On the other hand, they aren't doing anything illegal, unless they have a FHP and are calling him a Podiatrist.

Clinical negligence is quite another matter.
If this type of operation were to step outside of what would be considered normal treatment parameters and protocols (and they probably will, at some stage), then they may be liable to legal action.

Although these are generally low-value cases, they still get followed up. I haven't seen any of this type of case reach Court - normally liability is accepted by the defendant's insurers, and a settlement is reached. The cases I've been involved with have all been from sales-orientated operations.

 

They must talk some great Poo.
3 years ago, I was on holiday skiing with friends when I heard the sentence of death - 'Speak to Jonathan - he used to fit ski boots'. Normally I duck these situations like a bowl of Plague Soup. But the guy was onto me. You didn't need to be qualified to see he was in agony. when someone is happy standing at -15, on snow in just his socks, 2400 meters up a French mountain you know something isn't right. That evening a quick examination proved his boots were too small and too stiff for his ability. There was little I could do, but take the Chalet Girls sharpest knife and butcher his liner. I suggested that he go see a good boot fitter on his return to the UK – I gave him a a couple of addresses.

A few months later we met up at a dinner party - he was delighted to tell me that he had found a boot fitter locally in Reading - Oh he must of gone to Carter's I thought (a well established ski retailer in Reading). No he had been to Altimus. They told him that his feet were 'over-pronating' and he needed support blah blah - this they could fix with special insoles and his skiing woes would be over.

He knew he needed larger boots so they sent him along to Decathlon to get the next size up (the alarm bells should have started ringing then). He took his new boots back to Altimus who then made him a pair of ‘Special Orthotics’.
I was curious to see how they made his Specail Orthotic as boot fitters consider it a bit of a dark art.

I was shocked to see that they had flipped a Sidas running insole into his ski boots at a princely sum of £800.00 (cost for the insole trade £18.00). I grilled him - 'why didn't you take my advise and go to a renown boot fitter’. He told me that they had convinced him that their solution was best, and that he had had no reason to disbelieve them as they were podiatrists weren't they?

My friend was too embarrassed to take any action. He tried to ski in the boots, still too stiff, still to low over the forefoot. And the £800 Special Orthotics? utterly useless.
To be fair, the insoles weren't badly moulded or cut - just not the right type - Sidas make several types of ski insoles and are leaders in the field - in fact that is where they started out.

Salesmanship - you bet

 

Makes for some fun reading the other thread.

98 pounds for a met dome. Goodtimes, the sad thung people think that is ok.

 

Yep when your in pain - my friend is a sharp cookie, but as far as he was concerned the 'Professional' offers him a solution.

 

Thanks for this - most helpful.

Mark

 

pleasure -

 

[Check4SPAM] RE: URL Attempt

Altimus also have a branch in Reading.

I used to work in the NHS in that area so i did have a lot of people coming to me with OTS insoles that had cost them £500-800 but i knew only cost £15-25. These patients generally were previously asymptomatic and had become symtomatic or simply could not afford the prices quoted and came to me as a result.

One day, a couple of years back, after a run of patients with expensive insoles and painful foot problems i was a little bored and decided to do a bit of digging. Their website then mentioned examination and fitting by a podiatrist (it has been changed now). I called them up explained who i was and asked to have a chat with their podiatrist. The assistant answering the phone informed me that he was busy, so i asked for his name. I checked his name on the HPC register. Guess what, is was not on there! :boxing:

Further discusssion ensued with the shop minion regarding the profession of the person in question and i was informed (after a chat with the manager and advising them that i was looking at the HPC register as i was talking to them) that the main person fitting and prescibing their insoles was not a podiatrist, but they did have one up in head office that did train and advised them.

This is their website
http://www.altimusonline.co.uk/biomechanics.aspx#examinations

I particually enjoyed the definations and examination part and would be interest to know what others experiance or opinion is.

I eventually did get to speak to the foot health professional in the shop and he was a very nice chap who seemed to know a bit about what he was doing, but could not explain why some patients were being advised to purchase insoles when they did not have any problems, just saying that was what they were taught to do. The insole price did include fitting and a free check and adjustment of the insole i gather. :wacko:

I would really love to hear from them about how they practice now.

Edd

 

On the website under the heading of 'About Altimus' is the following:

Whether you’re looking for assistance with mountaineering, skiing, camping, trekking; the staff always exceed expectations. As well as specialising in outdoor clothing and equipment, Altimus have a unique speciality in diagnosing foot problems and providing comfortable solutions for feet and customised footwear.

What they fail to add is that they manage to do all this on a horse, wearing a mask and with a flintlock pistol in their right hand. Now that would be a 'unique speciality'!

 

What follows are 3 emails I have received since enquiring about peoples experience of Altimus on Twitter. I have anonymised all of them, but have permission to reprint them here:

 

This is an interesting thread. I agree they way over charge for what they are selling, but for me the insoles have worked really really well - I have seen various excellent podiatrists (Ian here , and Anne-Marie), so I am not really worried about misdiagnosis.

I can now run, cycle, row, exercise after a few years of injury and I do associate some of that to the insoles. They have worked well for me.

Can anyone suggest where I can get the exact insoles Altimus puts together from a respectable podiatrist/shop at a reasonable price?

Let me know if you have any questions.

Thanks

Ali

p.s. photos attached

 

Wow. Just... wow.

Whats it made of, platinum?!

 

If it was made of platinum it would easily be worth £4350.

When I see these threads it makes me feel quite strange. I've asked it before on here (and I am in no way condoning any company or individual ripping people off) but I'll ask it again - what is a fair price to charge? In surgery, you are partially governed by insurance companies and their agreed fees. In law, you generally pay by the hour for the expert's time (and their hourly rate is usually higher based on experience, etc... although it always seems very arbitrary to me). What do you base your fees on as podiatrists in private practice? What is fair and what is unfair?

How much do you charge for:
- nail surgery
- orthotics
- biomechanics exam
- new patient assessments
- review appointments

What do you base your fees on?

 

Depends if it was solid or hollow

I think it's fair to charge anything you see fit for your expertise. It's worth what you say it's worth and what people are willing to pay for it. But insoles? I have a real problem with people setting a base price the charging for "extras" like having a met dome. It's sort of like selling a car for £1000 then charging an extra 500 each for the wheels.

It's not "wrong" it's just... Sharp. IMO.

 

If it is hollow, it will probably need some sort of struts to reinforce it since it will be attached to an insole and therefore subject to bodyweight - so easily worth at least £3781.

You are right Robert. One of the things that has always puzzled me about 'professional fees' is how seemingly random they are and how there is some sort of weird taboo about discussing them.

 

I imagine it with some sort of lattice, like the inside of bird bones.

 

Or one of Mr Kipling's exceedingly good apple and blackcurrant tarts?

 

He really does make exceedingly good cakes.

 

I base my fees on an hourly rate of £100. Thus nail surgery is estimated at £400 (pna)- £550 (tna) incl post op dressings. Orthotics charged at cost plus examination & follow-up consultations - total fees approx £280 - £580 depending on devices. Consultations are at hourly rate thus new patient assessment of 45 mins or an hour is £75 or £100 respectfully.

I would have thought that some form of national fee structure (with appropriate variations) would be advantageous to both the public and the profession alike but I'm sure there is equally another argument that suggests otherwise.

 

A few years back I went to Altimus in London to check out a pair of walking boots.
A SA approached me as I was looking at the boots on display. He got me a pair of boots in my size. He fitted the boots, which incidentally I found out later on were too small, despite using a Brannock measuring device. As he fitted the boots he pointed out various 'problems' with my feet, which I didn't understand (he used lots of jargon).
The general drift was that there was a big problem with my feet (he did a lot of measurements), which he thought could be 'genetic'. He made me walk around a bit.
To cut a long story short, from simply going into the shop to buy a pair of boots, I was swiftly moved through to the point that orthotics were made for my feet. I stood on a machine and a mould was made of my feet. I nearly fainted when he told me that the cost was over £1000. I can’t recall exactly how much it was now, but I think it may have been a few hundred more than that.
It all ended there. I didn't have the money to pay for them, and he never told me what the total cost would be before he made them. I left the shop.
All in all it was a nightmare. I felt like a right mug.
I later saw my GP and an NHS podiatrist who made corrective orthotics for my feet. No mention of the 'genetic' problem or anything else.
A responsible company would surely have said there might be an issue with my feet – check with your GP or a podiatrist, rather than make a pair on the spot.

 

I was interested to see the name Altimus in the thread title as in the last two weeks, their practice has been brought to my attention on two separate occasions by two different patients.

The first patient came to our department last Tuesday. He has grade III hallux limitus. He had been referred to us by his GP. Prior to the referral, he had gone to see this practitioner in the aforementioned shop/practice. The practitioner (who the patient had informed me was a podiatrist) had told him that the orthoses on offer would repair the damaged cartilage in the joint and would resort the osteophyes from around the joint. Said orthoses were going to cost £1700.

I saw the second patient this Tuesday gone. I operated on her hallux vagus 16 weeks ago. She is now asymptomatic and wants the other foot corrected. Due to work commitments, she was going to defer surgery for another year and sought a conservative measure to keep her going until then. So she happened to come across this ski shop and the same man (again, the patient told me she was under the impression he was a podiatrist) told her that the surgery I had done had been a complete waste of her time and effort because his insoles correct bunions. She was advised to make sure she did not have the contra lateral foot operated on and instead buy these orthoses at a modest £700 this time. It is apparently just a shame that she didn't see him sooner before I "chopped her foot open" so that she could have avoided all the scars!! All one of them that is.

I have phoned this place twice this week stating who I am and why I was calling and am still waiting for my call to be returned....
I was going to say I will get back with the outcome of the conversation but I suspect I will be waiting a while. I don't live too far from Kingston so maybe I'll pop along some day and see what he has to say for himself.

Ryan.

 

well i missed this one the first time round, we have had clients call us asking prices and being shocked when we have told them a semi rigid custom device was less than £100 from what i have heard they have a competition in store to see how much they can charge for the product. the other thing i have heard directly when i called then was that the fitter was a trainee pedorthist and was overseen by a podiatrist, not only is the podiatrist not on the HPC but a trainee pedorthist is just a footwear fitter who has not done the required training, internship and exam to be a CERTIFIED PEDORTHIST currently there are only 6 people in the UK who have certified in pedorthics (C.Ped) i am one of them and 3 if not 4 of the others are not practicing as they have let their cert lapse i am all for business and being commercial but this takes the piss