Australia Top Doc: Physician Assistant Use Too Risky
So why arent we getting them? These articles have been positive about the role of PAs. But we know that a number of groups are on the record opposing or raising concerns about the introduction of PAs, including the Queensland Nurses Union, the Australian Medical Students Association, the AMA and the 2010 Australasian Junior Medical Officer Forum. No doubt others have been working against PAs behind the scenes. If any of those groups or any other PA sceptics would like to contribute to the Croakey series, please get in touch. It would be good to hear your responses to the pro-PA arguments that have been made. Meanwhile, Professor Peter Brooks, director of the Australian Health Workforce Institute, explains below why he believes that Australia needs PAs. (Incidentally, he is also due to speak at at a University of Sydney seminar on May 3 titled Are we training too many doctors?.) Professional self-interest is blocking introducton of physician assistants Peter Brooks writes: Well done Croakey for running these stories on Physician Assistants (PAs). The opposition to the introduction of these health workers mirrors very much what happened in the US some 40 years ago. Strident cries from the American Medical Association that their introduction would end life as we know it. 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.
Health Workforce Australia report gives the nod to physician assistants
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. Or it would be if it wasn’t all about patient safety.
The findings of this report are overwhelmingly supportive of the introduction of the Physician Assistant into the Australian health workforce. A number of concerns were raised by some respondents about introducing a new health professional, such as the competition of training placements for junior doctors and medical students, and potential competition with the existing nurse practitioner role. It is interesting to note that the report could not find any evidence that supported either of these two arguments. One thing the report alludes to is that the acceptance of the Physician Assistant role is based on the level of understanding. The greater the respondent understood the role of the Physician Assistant that more likely it was to be accepted. What does this report mean for Australian Physician Assistants? Firstly, it will stimulate a great deal of discussion, both positive and negative. The report clearly outlines positive impact that the physician assistant will have on the Australian health workforce and the overwhelming support of the rural and remote health sector. To date, most opposition to the Physician Assistant role has been based on a poor understanding of this model of healthcare, which this report confirms. The contents of the report provide a clear and detailed description of the role of Physician Assistant, which should lead to a greater understanding of the position. So, what is the next step? Well the next step is in fact already happening and as can be seen from the recent events in Tasmania, there is a desire in some states to commence the introduction of a Physician Assistant. Whilst the work being conducted in individual Australian states should continue, the Physician Assistant should also be considered at the national level.