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Non-medical prescribers threaten quality patient care

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What is happening to our health care system?

In the pursuit of perceived cost savings, successive governments have and are increasingly threatening the quality of treatment by encouraging and facilitating the fragmentation of patient care.

Heavy GPs workloads, the difficulty some patients have getting to see their family doctor, and developments overseas are often used as reasons for expanding the scope of non-medical health professionals.

These arguments are often given greater credence than they deserve because of promised efficiencies and savings to the health system. The Menzies-Nous Australian Health Survey 2012, for example, found that the majority of Australians were able to get an appointment with their GP on the same day or following day.

Most of the overseas health systems we compare ourselves with spend more per on health per capita and more of their GDP on health than us, yet we have one of the best performing health systems in the world.

Who would have thought that seeing a qualified medical practitioner could be labelled as an inefficiency in the health system?

The Australian health system is predicated on the fact that GPs, the only medical professionals trained to care for the whole person, help ensure the efficient use of scarce resources, as they are leaders in preventive health care, early diagnosis and treatment, coordinated care and chronic disease management.

The GP is the medical practitioner trained to take a comprehensive history, examine the whole person when making a diagnosis, and initiate investigation, management and treatment.

Yet the Abbott Government, despite its talk of supporting and strengthening general practice, seems hell bent on replacing the holistic approach of GPs with fragmented care provided by non-medical health professionals. In this respect it is not much different from its predecessors.

Last November, the nation’s Health Ministers sanctioned the development of a nationally consistent pathway for non-medical prescribing.

The Australian Physiotherapy Association applauded the decision, claiming a non-medical health prescribing framework would allow patients to receive improved care from physiotherapists, reduce the burden on doctors and decrease existing efficiencies in the health system.

But we know it won’t. In fact, it is more likely to increase the costs to the health system. The possibility for adverse drug events will be higher, resulting in avoidable hospitalisations. Then there is the greater likelihood of missed or delayed diagnosis because of the single-system focus of many non-medical practitioners, which could have a significant impact on the course of a patient’s treatment and health outcomes.

The AMA supports prescribing by non-medical professionals, but only when carried out within strict collaborative care arrangements in partnership with doctors. Most prescribing by non-medical health practitioners currently occurs in public hospitals under strict protocols. That’s to ensure prescribing is appropriate, and patient safety is protected.

The AMA maintains that only medical practitioners should have independent prescribing rights, and will continue to vigorously oppose any move away from this.