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?

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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