Physicians' assistants start work at Middlemore Hospital.
Subject: Hospitals (New Zealand)
Hospitals (Human resource management)
Medical assistants (Practice)
Pub Date: 11/01/2010
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2010 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: Nov, 2010 Source Volume: 16 Source Issue: 10
Topic: Event Code: 280 Personnel administration; 200 Management dynamics Computer Subject: Company personnel management
Product: Product Code: 8060000 Hospitals NAICS Code: 622 Hospitals SIC Code: 8062 General medical & surgical hospitals; 8063 Psychiatric hospitals; 8069 Specialty hospitals exc. psychiatric
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 243451567
Full Text: Two American physicians' assistants (PAs) started work at Middlemore Hospital in South Auckland last month in a one-year pilot to find out if the role has a place in this country's health workforce. The pilot has been funded by Health Workforce New Zealand (HWNZ).

PAs are an established part of the health workforce in the United States and the role is also being piloted in Australia and the United Kingdom. According to HWNZ, the role complements both nursing and medicine, and frees up the time of junior doctors. PAs are not regulated but work under the supervision of a senior doctor, who remains responsible for the care of patients and approves the PA scope of practice. Typical tasks include taking patient histories, doing physical examinations, developing treatment plans and ordering lab tests and X-rays.

NZNO opposed the pilot plan in a submission to HWNZ, raising concerns about the haste and planning of the initiative, and the implications for the senior career path of nurses. NZNO would have preferred a pilot comparing the performance of senior nurse specialists with PAs.

Counties-Manukau District Health board chief medical officer Don Mackie, who is one of the sponsors of the pilot, said ongoing employment of PAs was not a fail accompli--the pilot would end in October next year, and then be evaluated. "But we haven't exactly thrown up our hands in horror about it either," he added.

Mackie said an early evaluation of the pilot was being done this month, and there would be other evaluation milestones during the year. At first, the PAs had a daily review with their supervisors, which was then pushed out to weekly and, after three months, there would start to be a good perspective on how it was working.

The two PAs were working as part of an acute surgical team and the views of all members of that team, including nurses, would be included in the evaluation. As issues or problems arose, they would be dealt with at the time, and also documented for the evaluation, he said.

According to HWNZ, the evaluation would focus on how the introduction of PAs affected workforce dynamics and the roles, tasks and productivity of the nursing and medical professions. The ultimate aim was to determine if the role was suitable for the New Zealand health environment and, if it was, what the implications would be for training and regulation.

NZNO professional services manager Susanne Trim said NZNO was not averse to new ways of working but thought the PA role had been introduced with "undue haste and without good robust development". NZNO expected "a robust and systematic evaluation process" and was keen to participate in that.

An HWNZ spokesperson said it was critical to have the right professional input into the project, which was being overseen by a multidisciplinary steering group, including Auckland District Health Board's executive director of nursing Taima Campbell. The evaluation report would be made public.
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