January 19, 2006

Australia is considering having nurses perform some physician duties. The Australian Medical Association reacts:

AMA national vice-president Choong-Siew Yong said proposals to replace doctors with “lesser-trained and lower-skilled” health workers was unacceptable.

“A doctor is a doctor is a doctor,” Dr Yong said.

“Australians in the city and in the country in all states and territories want quick and affordable access to a doctor – not a doctor substitute.

“Voters will not accept a lower-quality health system.” Dr Yong said the report ignored the real solution to doctor shortages – training more doctors and providing incentives to doctors to stay in the system or attract others back to the workforce.



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{ 14 comments }

1 Anonymous January 19, 2006 at 2:02 pm

Ah yes–the dirty, medical monopolists screeching to keep their profits!!!

In countless areas–nurse practitions, optometrists, nurse anesthesiologists, ending credentializing means more and cheaper and better health care.

Abolish all credential requirements!!!
let the market sort things out–it’s certainly not perfect but MUCH MORE RELIABLE than doctors’ vain, self-serving and FALSE SENSE OF PROFESSIONALISM.

2 Anonymous January 19, 2006 at 6:51 pm

Nurses have been performing Drs duties for many years and in many cases just as well if not better. We need to work as a team, it is not about taking roles away from Drs but helping patients.Stop being so egocentric and let us all get on with our jobs. I am completing my Masters to be a NP not a Doctor in Australia in Critical Care, I have yet to meet a Doctor who percieves me as a threat, I am part of a team that can ease their busy work load.

3 Anonymous January 19, 2006 at 8:27 pm

Anon:

The blog screaming only evokes an unpleasant picture of the sort of thinking you seem to have and the way you behave, neither of which seems rational or civil. Was that on purpose?

You seem to need help of the kind you are not likely to find here.

4 Anonymous January 19, 2006 at 9:44 pm

Agreed. May I suggest a counsler

5 Anonymous January 19, 2006 at 10:27 pm

hey anon 9.44– before you tell me to get a psychiatrist, you should get an orthographist. you know I’m right, but rather than admit it you call me crazy. Hah! How typical!! Hey, were you one of the doctors who declared political dissidents insane in the old USSR, locking them up forever? Glad you find a new career.

6 Anonymous January 19, 2006 at 11:15 pm

The medical profession allows more turf encroachment by lesser trained people than any other profession.

Notice how CPAs and lawyers dont allow underlings to take over their tasks from them.

Of course, when you are dealing with healthcare, everybody considers it a “fundamental human right” so of course government responds to letting anybody practice medicine.

7 Dr Dork January 20, 2006 at 8:09 am

A lot of anonymous comments, I note.

Have the courage to stand by your convictions, people !

Yes, I am a doctor, so those of you in a “market” healthcare system like the US will perceive a conflict of interest.

I greatly respect nurses, and have no problems with them doing whatever they are qualified to do. But the government motivation is all about cost cutting, not optimising healthcare, which is the priority, to my mind. If a nurse wants all of the responsibility of a doctor, fine, go to medical school. Entry is entirely based on academic merit here. Cost is negligible, relative to the US.

It’s simply a lot cheaper to have someone less qualified…and my longterm solution is training more doctors ! Especially we should be recruiting talented people from associated healthcare fields…which rather deflates the “self-interest” argument, as I’m advocating more “competition”.

Sure, there a few bad docs. They tend to get struck off. But consider this – one must be highly intelligent to train in medicine..intelligent enough that we can have our pick of careers. If it was about the money, we would be lawyers, stockbrokers, not carers for the sick and the suffering.

8 Anonymous January 20, 2006 at 8:27 am

Dr. Dork, your sanctimony is endearing.

But you do make one point that needs to be addressed. You talk about how intelligent physicians must be, how there are a few bad ones. How is the public, at least in the US, able to sort out the good from the bad ones?

What standards can we look to in making a decision on which physician to use? Physicians are more protected by the way healthcare is funded than credentialing requirements. As it is now, people just go to whoever has the earliest available appointment and is in their plan.

CJD

9 Dr Dork January 20, 2006 at 10:05 am

Ha ha …”anonymous; CJD”

No sanctimony intended. Sorry if you interpreted my comments that way. Exactly how was I sanctimonious ? Is anyone who disagrees with you “holier than thou” ?

You’re not a “nurse practitioner” (sic), perchance ? I am open about my “bias”, what is yours ?

“Physicians are more protected by the way healthcare is funded than credentialing requirements. As it is now, people just go to whoever has the earliest available appointment and is in their plan.”

Makes no sense to me. Please explain. You are also making broad statements without evidence. Please justify.

In all honesty, I am interested in open debate on such issues. Please provide the evidence to support your population-based statements.

Cheers
Dr Dork

Sorry for the sententiousness ha ha

10 Anonymous January 20, 2006 at 8:54 pm

You know CJD your poor attempts at sarcasm are tiresome.

“How is the public, at least in the US, able to sort out the good from the bad ones”

Why not begin with the state board of medical examiners? It may not guarantee a “good” doc but there may be red flags. My own state medical board website (azmd.gov) clearly lists any discipline issue (including PDF’s from the board of the sanction and event), number of malpractice events, and board certification. Of note, my state bar website (arizona) does not list malpractice events or action taken by the bar against a given lawyer under that lawyers “bio”. Though if you dig around the site long enough you can find actions taken by the bar against lawyers by the year (no PDF’s or explanation however). Now CJD, you tell me which system is more open? You might want to look at your own house before throwing stones at others.

“Physicians are more protected by the way healthcare is funded than credentialing requirements”

Interseting, I can’t tell you how many time insurers have denied claims “after the fact”, that is after treatment has been given. Out of curiousity CJD, what do YOU do when a client refuses to pay his/her bill?

11 Anonymous January 20, 2006 at 8:56 pm

Anon 2:02/10:27:
May I suggest the next time you become ill, instead of going to a doctor, go to your local shaman, ND, or faith-healer instead.

12 Samson Isberg January 21, 2006 at 1:56 am

One can’t help feeling that the Aussies have gotten themselves into this mess…(Yes, I am a little sore here, but it feels good to express the soreness)…when I applied for a work permit in Ozland I was told they had “enough doctors, thank you,” and referred me to the Embassy of New Zealand (as if I would want to work in a place where the doctor is jailed when the patient dies). Some research made me understand that I could come to Australia, but that driving a cab in Hobart, Tasmania was the likely outcome while I took the entire med school over again (in Australian, I was led to believe, I didn’t know that Australian biology was so different from European, perhaps the humans are marsupials also, that’s why they don’t need an OB) if I wasn’t deported outright.
“For those who come across the sea, we’ve boundless plains to share”— but not a boundless supply of patients, apparently…

… that felt good, getting it off my chest

13 Anonymous January 21, 2006 at 6:16 pm

Anonymous 8:56: Having an MD is no guarantee of quality–and I’m sure if permitted a lot of PAs, RNs, ODs, midwives could do better jobs.

Require disclosure of performance metrics and let the market decide–not self-serving professionals.

14 Dr Dork January 22, 2006 at 9:36 am

Samson – I’m surprised that it was so difficult for you.

However our immigration department is notoriously restrictive for strange reasons…I’d suspect your prospects might be better now. We are facing a growing doctor shortage.

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