Exploring the role of physician associates in Aotearoa New Zealand primary health care
Albert Andrew
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Handling Editor: Felicity Goodyear-Smith
Abstract
New Zealand’s health care system faces significant shortages in health care workers. To address workforce challenges and meet the population’s health needs, health care systems around the world have introduced new clinical roles, such as physician associates/assistants (PAs) into existing health care teams.
This article aims to examine the benefits, challenges, and broader implications of regulating PAs in the context of New Zealand’s primary care sector, with a specific emphasis on how it may impact general practice.
A range of literature surrounding the role, impact, and perception of PAs were selected and included in this article.
The PA profession can significantly strengthen New Zealand’s primary care workforce, improving patient access and continuity of care. However, the global deployment of PAs has faced scrutiny due to concerns about its potential risks to patient safety and the overall viability of such a role.
If regulated, the PA profession can reshape New Zealand’s primary care, offering a partial solution to current medical staff shortages. Trained under a generalised medical model similar to doctors, PAs possess the necessary skills to perform both routine and non-routine medical tasks. This dual capability can significantly improve primary care service provision, reduce existing workloads, and allow for a more efficient deployment of doctor expertise. However, medico-legal issues and the supervisory burden can impede widespread integration into general practice. Despite challenges, the success of the PA role relies on mutual trust, respect, and support from other clinical team members within primary health care.
Keywords: family health care, general practice, general practitioners, health services, models of care, physician assistant, physician associate, primary health care.
References
1 Lewith G, Peters D, Manning C. Primary care is the cornerstone of our NHS. Br J Gen Pract 2016; 66(653): 604.
| Crossref | Google Scholar | PubMed |
2 Shi L. The impact of primary care: a focused review. Scientifica 2012; 2012: 432892.
| Crossref | Google Scholar | PubMed |
3 White F. Primary health care and public health: foundations of universal health systems. Med Princ Pract 2015; 24(2): 103-116.
| Crossref | Google Scholar | PubMed |
4 The Royal New Zealand College of General Practitioners. The Workforce Survey: Overview Report. 2022. Available at https://www.rnzcgp.org.nz/resources/data-and-statistics/2022-workforce-survey/ [accessed 22 November 2023].
5 Forbes S. South Auckland’s ‘disturbing’ GP shortage highlighted in report to Parliament. 22 March 2023. Available at https://www.stuff.co.nz/national/politics/local-democracy-reporting/300836908/south-aucklands-disturbing-gp-shortage-highlighted-in-report-to-parliament [accessed 23 November 2023].
6 Medical Council of New Zealand. Possible regulation of physician associates under the HPCAA. 2023. Available at https://www.mcnz.org.nz/about-us/news-and-updates/consultation-regulation-of-physician-associates-under-the-hpcaa/ [accessed 25 November 2023].
7 Oberzil V. Physician associates as a potential win for the Aotearoa New Zealand healthcare workforce. N Z Med J 2023; 136(1583): 95-97.
| Google Scholar | PubMed |
8 Hooker RS, Hogan K, Leeker E. The globalization of the physician assistant profession. J Physician Assist Educ 2007; 18(3): 76-85.
| Crossref | Google Scholar |
9 Rosen R, Palmer W. Physician associates in the NHS. BMJ 2023; 382: 1926.
| Crossref | Google Scholar | PubMed |
10 Curran A, Parle J. Physician associates in general practice: what is their role? Br J Gen Pract 2018; 68(672): 310-311.
| Crossref | Google Scholar | PubMed |
11 Malone R. The role of the physician associate: an overview. Ir J Med Sci 2022; 191(3): 1277-1283.
| Crossref | Google Scholar | PubMed |
12 Williams L, Adhiyaman V. What do physician associates think about independent prescribing? Future Healthc J 2022; 9(3): 282-285.
| Crossref | Google Scholar | PubMed |
13 van den Brink GTWJ, Hooker RS, Van Vught AJ, et al. The cost-effectiveness of physician assistants/associates: a systematic review of international evidence. PLoS One 2021; 16(11): e0259183.
| Crossref | Google Scholar | PubMed |
14 Grzybicki DM, Sullivan PJ, Oppy JM, et al. The economic benefit for family/general medicine practices employing physician assistants. Am J Manag Care 2002; 8(7): 613-620.
| Google Scholar | PubMed |
15 Drennan VM, Halter M, Joly L, et al. Physician associates and GPs in primary care: a comparison. Br J Gen Pract 2015; 65(634): e344-e350.
| Crossref | Google Scholar | PubMed |
16 Hooker RS, Moloney-Johns AJ, McFarland MM. Patient satisfaction with physician assistant/associate care: an international scoping review. Hum Resour Health 2019; 17(1): 104.
| Crossref | Google Scholar | PubMed |
17 Jackson B, Marshall M, Schofield S. Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach. Br J Gen Pract 2017; 67(664): e785-e791.
| Crossref | Google Scholar | PubMed |
18 Wilsher SH, Gibbs A, Reed J, et al. Patient care, integration and collaboration of physician associates in multiprofessional teams: a mixed methods study. Nurs Open 2023; 10(6): 3962-3972.
| Crossref | Google Scholar | PubMed |
19 Royal Australian College of General Practitioners. Physician assistants in general practice Position Statement – February 2018. Available at https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Physician-Assistants-in-General-Practice.PDF [accessed 25 November 2023].
20 British Medical Association. BMA position statement on physician associates and anaesthesia associates. 2023. Available at https://www.bma.org.uk/news-and-opinion/bma-position-statement-on-physician-associates-and-anaesthesia-associates [accessed 25 November 2023].
21 Royal College of Physicians. Physician associates – background to the profession. 2023. Available at https://www.rcplondon.ac.uk/news/physician-associates-background-profession [accessed 25 November 2023].
22 Agarwal R, Hoskin J. Clinical supervision of physician associates (PAs) in primary care: who, what and how is it done? Future Healthc J 2021; 8(1): 57-61.
| Crossref | Google Scholar | PubMed |
23 American Medical Association. Physician assistant scope of practice. 2018. Available at https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/arc-public/state-law-physician-assistant-scope-practice.pdf [accessed 25 November 2023].
24 Abey-Nesbit R, Jamieson HA, Bergler HU, et al. Chronic health conditions and mortality among older adults with complex care needs in Aotearoa New Zealand. BMC Geriatr 2023; 23(1): 318.
| Crossref | Google Scholar | PubMed |
25 Royal College of General Practitioners. Physician Associates – October 2017. Available at https://www.rcgp.org.uk/representing-you/policy-areas/physician-associates [accessed 25 November 2023].
