Surgeons add their voice to concerns about the introduction of physician associates

Te Whare Piki Ora o Māhutonga - Royal Australasian College of Surgeons (RACS) yesterday wrote to the Minister of Health calling for a pause on plans to use physician associates to plug workforce gaps in Aotearoa New Zealand.

This follows a joint letter written by the Association of Salaried Medical Specialists (ASMS), the Resident Doctors Association and APEX, along with the Royal New Zealand College of General Practitioners, the College of Nurses Aotearoa (NZ) and the General Practice Owners Association, asking Dr Shane Reti to rethink plans to introduce the new category of healthcare worker.

Physician associates, also known as physician assistants or PAs, must be supervised by a doctor, but the supervision can be done at arm’s length and the supervising clinician does not have to be in the same room or even the same town.

RACS says that raises questions about the quality of supervision and may compromise patient safety. The College also queries the value of physician associates to an already stretched workforce, where doctors would be required to spend time providing training and oversight.

Dr Ros Pochin, a Nelson-based general surgeon and Chair of the RACS Aotearoa New Zealand National Committee, urges the Minister to carefully consider the role physician associates can play within the Aotearoa New Zealand healthcare system.

"There is a real need for regulatory clarity. It is crucial that we fully understand the implications of introducing new roles like physician associates before pushing ahead."

The College points out there is growing disquiet overseas regarding the physician associate role, with several UK medical organisations raising concerns about patient safety, workforce shortages, and the lack of capacity for physician supervision and training.

It also points to support roles that are already regulated within the Aotearoa New Zealand healthcare system, including Mātanga tapuhi nurse practitioners who can work autonomously and have clinical education and training.

They have a well-defined scope of practice and are regulated by Te Kaunihera Tapuhi o Aotearoa - Nursing Council of New Zealand.

Dr Pochin says: “We would like the government to explore the option of expanding the use of such practitioners—with appropriate regulation—¬before introducing a whole new category of healthcare worker to our medical workforce.”