New Zealand will soon formally recognise the role of physician associates (often known as PAs). Photo: Supplied/ Unsplash - Nap studio
A newly-regulated healthcare role is hoped to unlock more pairs of hands for medical care, and attract more overseas workers to rural practices.
On Sunday, Minister of Health Simeon Brown announced the government would be regulating and recognising the role of physician associates (PAs), which was common overseas, but not one New Zealanders could yet train in.
Gore Health chief executive Dr Karl Metzler, who had employed physician associates and advocated for their recognition for the past 12 years, called it a "watershed moment".
"It's a new role to New Zealand, but not a new role internationally," he said. "There's probably over 200,000 physician associates now globally, with the vast majority in the United States."
He explained it was a "mid-level role" - the medical paradigm's equivalent of a nurse practitioner - working under the strict supervision of a doctor, helping with various tasks and taking the pressure off.
Regulating the role meant those workers would be recognised as highly skilled, Metzler said, giving them "the kudos and mana that they deserve".
Brown said regulating the role under law "demonstrates the Government's commitment to patient safety and providing high quality care".
There are currently about 50 PAs spread across 29 clinics throughout New Zealand, Brown said, working in general practices and hospitals, "assisting with both clinical and administrative tasks".
Metzler said Gore Health had employed PAs since 2012, and they would not have been able to maintain the 24/7 Emergency Department without them.
All physician associates had moved from abroad, as there was currently no training programme in New Zealand.
But Metzler said he hoped that would change in the next few years, opening up another pathway into medicine.
"I have no doubt that our universities will pick it up and develop curriculum and training programmes."
There had been some resistance to regulating the role.
In December, 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, wrote a joint letter to Health Minister Shane Reti, to forestall him bringing a formal proposal to Cabinet.
ASMS executive director Sarah Dalton said at the time there was no task a physician associate could perform that was not already being done by a locally trained and regulated health worker, and the government should instead provide funding to employ more doctors and nurses, rather than setting up a whole new profession.
But Metzler said in his experience, it was easier to attract physician associates than local doctors to rural practices.
"If I advertise for a New Zealand doctor in Gore, I get zero applicants. If I advertise for a physician associate, I will get at least 20 applicants," he said.
Overseas doctors saw the appeal in the role, more so than locals - "the idea of Te Anau and Milford on their doorstep, and the Great Walks that we offer, and a really cruisy rural lifestyle".
"There are so many rural towns doing it really hard in terms of accessing good healthcare, and I think our physician associates are going to really alleviate a lot of pressure in rural healthcare."
New Zealand Physician Associate Society (NZPAS) regulation chair Lisa deWolfe agreed. "The majority of PAs already working in New Zealand work in rural or underserved communities.
"Regulation opens a pathway to bringing more PAs to Aotearoa and is a solution to health inequities in hard-to-staff and remote areas."
The society said during a 2010-2015 physician associate pilot programme, more than 90 percent of doctors and nurses reported being satisfied with the contribution of PAs in their clinics.
It said across 30,000 patient visits, there were no adverse outcomes, and that standard had been upheld with more than 340,000 patients seen in the past six years. Regulation would help maintain and strengthen that standard of care.
The government said the role would be regulated by the Medical Council of New Zealand, which had estimated physician associates would be able to start registering from 2026.
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