Australia urgently needs to develop new ways of delivering health care to cope with the changing needs of patients and the health workforce shortages.
We must move forward by trialling the use of physician or clinical assistants, who have proven very effective in the United States in providing care in rural, remote and other under-served communities.
It seems likely that developing a role for physician assistants – people with qualifications or experience in health and sciences who receive intensive medical training and then operate under doctors’ supervision – will help overcome rural workforce shortages as well as helping to retain doctors and other health professionals.
Physician assistants are not substitutes for doctors or nurses, but help to extend our reach. Traditional professional boundaries or turf issues should not be allowed to inhibit the development of such new models of care.
I hope the Summit’s health stream will seriously look at how Australia can move forward in developing new models of care such as physician assistants.
I am optimistic that a pilot study involving about a dozen PAs from the US will go ahead in Queensland later this year. In the meantime, specialist colleagues and I at our practice in Brisbane have begun our own trial of clinical assistants.
As of last week, we are employing nurses, optometrists, GPs and other health professionals to act as clinical assistants, to provide more effective and efficient systems of care in our specialist practice. In my normal consultation day, anything from 20 to 40 per cent of what I do could be done by somebody else who doesn’t have 15 years of training. That is where clinical assistants come in.
This is a pilot project and we will evaluate its impact from the perspectives of our patients and referring GPs.
Australia has a shortage of doctors, nurses and allied health workers. The response has been to train more when really we should be asking – are we using the ones we’ve got now as effectively as we should?
Bill,
I understand that in the next 5 years there will be more than double the number of medical students graduating. It has been identified by all state governements that the current health system does not have the capacity to train these graduates (either as students or junior doctors), and in fact is struggling to create jobs for them.
In light of this current situation, is it really the right time to be added a new health provider to the mix? How will the health system provide training for these new health providers? How will they affect access to clincial training for medical students and junior doctors, which is already in peak demand?
More importantly you mention that they may provide a solution to rural helath workforce problems… why would a Physician Assistant be more likely to practice in a rural area than any other health professional? We can’t attract doctors, nurses, pharacists, physios, etc to these areas, why would Physician’s Assistants be any different?
Hi, Bill. I’m an optometrist in NSW, presently training (at my own expense) to increase what I do in prescribing eye drops for certain conditions. As you know, this mode of practice has been the case in Victoria for many years, and Queensland and Tasmania more recently. I have observed optometrists working in ophthalmologist practices in Sydney for many years, and prescribing in Hobart, including while working in the hospital.
I was in Hobart for the hospital part of my training. I understand no eye department in NSW public hospitals would be involved in this training.
Bill, we need more co-operation in training and less opposition from the specialist colleges (yours included!) The medical model is not the only way. There are other professions with much evidence based and clinically proven treatment. It’s about time the medicos realised this.
I find this a bit rich coming from an ex federal president of the AMA. In WA the AMA have fought tooth and nail to prevent anyone other than doctors from providing much needed medical services in the bush and Indigenous communities. Nurse practioners and other suitably qualified people who could perform the more basic medical procedures have been resisted at every stage by the AMA – god forbid that anyone else should be able to rip-off Medicare like the good doctors. The AMA is as rigid and self-serving as any other union and should be treated as such.
Practical and sensible. I hope the federal and state governments, the AMA and doctors in general support the ideas Bill Glasson is championing irrespective of the ideas summit.