Workforce evolution to the rescue?
Emerging health professions and extended scopes of practice are being discussed as ways of making the health workforce more efficient and patient-centric.
The Australian Health Care Reform Alliance, for example, has called on governments to confront the “professional boundaries which are based on historical practices and professional political forces rather than clinical evidence or consumer preferences”.
The alliance wants greater use of nursing assistants and allied health assistants, an expanded role for community paramedics and physician assistants, and the creation of specialist nursing roles for endoscopies and anaesthesia.
The alliance believes such reforms could save the public hospital system at least $430 million a year and allow highly skilled practitioners to be put to best use.
In Victoria, this concept was put into practice recently with an expanded role for pharmacists to administer influenza and whooping cough vaccines.
What does this mean for the rural health workforce?
By necessity as much as by design, there is growing recognition of the role emerging health professions and expanded scopes of practice can play in improving access to health services in the bush.
Rural and remote towns often don’t have a large enough population to support specialised health services.
One solution may be to train other health professionals in some specialised services. So while a town might not be able to support a general surgeon, a GP could undertake additional training to perform some routine surgeries.
A physician assistant or nurse practitioner could undertake many services that may be being provided by a GP, freeing up the GP’s time to concentrate on more complex presentations.
Similarly, an advanced allied health assistant can free up an allied health professional’s caseload for more top-of-scope work.
New roles and expanded scopes of practice can also ensure professionals are undertaking more rewarding and satisfying work. This has benefits for job satisfaction, well-being and retention.
Australia has lagged other countries in this area. At present there are only a handful of physician assistants working in Australia, whereas in the United States there are around 100,000. The Queensland Government has been consulting with stakeholders to identify issues impacting on physician assistant practice in Queensland.
While nurse practitioners are now well established in Australia, there is more work to be done on clearly defining their role and training pathways. Meanwhile, in the United Kingdom, the NHS is trialing a new role called advanced nursing practitioners who practise autonomously at the Registrar level.
Let us know your thought on this topic. Do you envisage working closely with some of these new professionals in the future? Or are you hoping to be a physician assistant or nurse practitioner yourself?
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