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 Nurse practitioners won't solve our GP shortage 

Nurse practitioners won't solve our GP shortage

02 Oct, 2009 05:00 AM
AN attempt by the Federal Government to deal with the shortage of doctors may backfire, according to a local general practitioner.

The Senate is currently looking at legislation which would give nurse practitioners prescribing, pathology and referral rights almost equivalent to that of a GP.

Tuesday's Gippsland Times reported that a chronic doctor shortage continued to plague Wellington Shire, with people unable to see a doctor for urgent medical treatment.

Family First Senator Steve Fielding said it would make more sense to spend the $59 million it would take to implement the proposal on boosting the number of GPs rather than on nurse practitioners.

"This plan will disadvantage towns like Sale where there is already a GP shortage because families will be forced to see a nurse instead of their family doctor, while their city counterparts can still get in to their GP,'' he said.

"This is going to create a huge disparity in the standard of health care between the country and city.

"Country people still deserve access to a doctor.''

Senator Fielding said he held grave fears that the flawed reform would compromise patient safety and fragment the primary health system further, particularly in regional areas.

"Nurses should have more rights so they are able to lessen the workload of GPs by assisting with routine tasks but this should only be done under the supervision of a GP within a doctors' clinic,'' he said.

"This legislation is going to give nurse practitioners rights almost equivalent to a doctor and allow them to work completely independently, without supervision from a GP.

"The government is virtually replacing GPs with nurses, particularly in towns where there is a GP shortage.

"Nurse practitioners are highly skilled health professionals who are certainly capable of doing more in the primary health team, but no one can replace your family GP who knows your history and your health issues,'' Senator Fielding said.

"This flawed health reform is only going to fragment health services further, make the GP shortage worse and end up costing the health system more because it will lead to multiple consultations and claims.

"The GP should remain the cornerstone of the primary health team and the first port of call for patients.''

East Gippsland Division of General Practice chairman Dr David Monash said the changes were not a good response to the doctor shortage.

"It will make our work rate harder; it's not going to take work off us,'' he said.

"It'll fragment the care of patients.

"If a nurse has pathology rights ... if they can't treat it, they'll refer it to a GP, and they may need to do another pathology test.''

Dr Monash agreed with Senator Fielding that nurses should only be given pathology and prescription rights if they worked in a medical clinic.

He had concerns that expanding the role of nurses would overwhelm specialists with referrals which may be unnecessary.

"It'll increase waiting times at specialists,'' he said.

Dr Monash said there were many jobs nurses weren't allowed to do, such as signing medical certificates, which could take a load off GPs.

"It'll free me up to do the work I'm trained for,'' he said.

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I completely disagree with this article. The US very successfully uses nurse practitioners in many clinical settings where they work "together" with doctors rather than "underneath" them. Doctors should not feel threatened by nurse practitioners, they should welcome the extra set of eyes on their patients. Patients, in turn, will be more satisfied with their medical care if they're able to see someone about their symptoms faster than usual. Personally, I feel that the nurse practitioners give better attention and time to their patients because they aren't as stressed or short on time as doctors. The accuracy of their diagnosis therefore is possibly better than what Dr Monash gives them credit for.
Posted by Anna, 2/10/2009 12:20:14 PM

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