12:48 pm today

Health workers say replacing them with physician associates a poor use of money

12:48 pm today
The man's GP believed he was getting counselling for his depression.

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Doctors, nurses, practice owners and their professional bodies are calling on the government to press pause on moves to regulate "physician associates" to fill workforce shortages.

The Association of Salaried Medical Specialists (ASMS), the Resident Doctors Association and APEX, along with the Royal College of GPs, the College of Nurses and the General Practice Owners Association, have written a joint letter to Health Minister Shane Reti to forestall him bringing a formal proposal to Cabinet.

ASMS executive director Sarah Dalton said there was no task that a physician associate would potentially perform that was not already being undertaken by a locally trained and regulated health worker.

"Right now it appears the government is not providing the funding to employ enough doctors and nurses. The last thing we should do is spend time and money setting up a new system of vocational registration for a whole new profession when the government isn't currently spending enough to fund the existing workforces," she said.

"All the signatories to this letter support growing the health workforce and want to ensure primary and secondary health care is staffed to safe levels, more people can train as healthcare professionals, and more patients get timely and equitable access to healthcare. It just makes sense to do that through existing occupations rather than inventing new ones."

Physician assistants - also known as physician associates or PAs - have been part of the health workforce in North America since the 1960s, and in Britain for the last 20 years.

They must be supervised by a doctor, but the supervising clinician does not have to be in the same room or even the same town.

They have been allowed to practice in New Zealand since a successful 2010 pilot as long as they have at least five years' experience and maintain certification in their home countries.

However, the letter notes the small number of PAs working in New Zealand were working "working well outside recognised scopes of practice in the US - where they will not be found working in diagnostics, or in family medicine".

"We also draw your attention to the UK experience where the Royal College of General Practitioners recently expressed their concern "that the deployment of [physician associates] in deprived areas, which often struggle to hire or retain GPs, could lead to inequalities in patient care and outcomes."

The country's healthcare issues stemmed from a lack of staff, "not a lack of professions", they wrote.

Physician associates who wished to work in New Zealand would be better to retrain as nurses, paramedics, pharmacists anaesthetic technicians or doctors.

"We cannot save our way out of our health workforce crisis by bringing in less-experienced and less-qualified staff; allowing patient safety and quality of care to fall by the wayside."

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