A plan to introduce some physician assistants to the country’s health system has Australian Medical Association president Rosanna Capolingua very upsetabout patient safety, of course. THE head of Australia’s peak medical body has criticised a plan to introduce US-style physicians’ assistants who would carry out less complex medical procedures, saying it puts patients at greater risk and could deny junior doctors training opportunities. Queensland Health Minister Stephen Robertson yesterday released the five sites for a pilot program to train doctors’ assistants, who would perform the procedures under the guidance of a qualified doctor. The pilot is based on a scheme developed in the US and has been trialled in countries including Canada and Britain. Australian Medical Association president Rosanna Capolingua said that, although assistants would work under a doctor’s supervision at all times, their use in surgical procedures could compromise patient safety. “The physician’s assistant understands how to do the task and they may be useful as a ‘tool’ but, for our own junior doctors, they need to have that holistic training and experience as well,” she said. “Patient safety must always be our first priority, not just the delivery of a service to a patient.” Doesn’t sound like Dr. Capolingua is going tomake a great teammate. The nurses aren’t thrilled, either. Beth Mohle from the Queensland Nurses Union said the Government should spend the money expanding the role of existing nursing staff. “They’re not actually testing physicians’ assistants against positions like nurse practitioners,” she said. “If you’re going to have a trial, you should actually at least test those positions against currently existing positions such as nurse practitioners.” Sounds like the beginning of a major turf war.
Australia needs physician assistants. So why aren’t we getting them?
But interestingly it didnt! Why the nurses are so actively against it is interesting but one would have to ask all opposing groups are they interested in opposing for oppositions sake, are they interested in providing health services to patients who currently find it difficult to access them because the workforce is not there, or are they interested in preserving the status quo with siloed health professional practice? The health service and its constituent parts is a very complex organism but every part of it should work together to improve patient care and not work only in the interests of the health professional or have I got that wrong ? The health and social welfare workforce is currently the largest in Australia 1.4 million and like the rest of the population, it is ageing. We will need to recruit about half a million new workers at least to this sector over the next decade a significant challenge that policy makers and politicians do not seem to be fully accepting at present. Where are these new workers to come from? Current recruitment will not achieve these targets so perhaps some innovation is required. Trials of new models of care have been carried out by Queensland Health and the South Australian Health Commission in respect to PAs. These trials, albeit small, did suggest that these new health professionals would be useful across a variety of health care situations. They actually assisted doctors in care delivery, worked together with Nurse Practitioners as part of the care team, and value added to teaching of students rather than impairing it. So why the opposition? Sad to say but may I suggest pure self interest as always wrapped up in cries that the introduction will impact negatively on patient safety and quality, reduce learning opportunities for medical and nursing students and generally speed the dumbing down of health care delivery none of which can be supported by the many trials of PAs in Australia and overseas . Now I have to declare my bias, having introduced the PA program at the University of Queensland in 2009. One of the reasons was that of recruitment, the fact that in the US those joining PA programs do not want to be doctors or nurses. So it adds to the health workforce, and that is what we have to do.