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Physicians Assistants

Australian Doctor recently posted this article congratulating and supporting recent graduates of a physician’s assistant (PA) program from James Cook University.  

Is it a surprise to anyone that doctors support the idea of a PA over a nurse practitioner (NP)?  The whole reason why doctors support this novel profession in Australia is because:

  1. They perceive they will have greater “control” over the profession as they are accountable to doctors.
  2. They are educated within a medical model, which is something they are familiar with.

The irony being that I have worked extensively with PAs in the United States and the whole “accountability to a doctor” thing is really just a tip of the hat and that’s it.  They are still very much an autonomous healthcare profession.  And of course, the other ironic thing is that the vast majority of Australian NPs are being trained and mentored by medical practitioners – so if anything they should be a bit more comfortable knowing they are at least partially responsible for the education and training of NPs!  

So now they’re calling for “barriers to be removed” from the PA profession so they can practice to their full abilities and scope.  Hmmm.  Sound familiar?  NPs struggle to demonstrate outcomes in Australia because of institutionalised barriers which covertly and overtly limit NPs from practicing to their full scope.  So now doctors are feeling sorry for the struggling PA?  

Listen, I have no issues with the PA profession.  I feel they are a valuable contribution to healthcare in the United States.  But there is a specific historical reason why they were first developed in the US – NPs dropped the ball and a group of medics said, “Ok, we’ll do it!”  On the contrary, here in Australia NPs are not dropping the ball – they are desperately trying to keep hold of it with greased fingers!  But the Australian Government and certain medical-unions-who-shall-not-be-named refuse to come to the table and help change Department of Health policy, which would allow us to operate to our true scopes and maximise our demonstrable outcomes. 

Perhaps its time to remind the Government they have a willing and able workforce who, despite working with greased fingers and bound wrists, are providing positive outcomes in the communities in which we serve.  Imagine what we could do without institutions working against us.