Nurses and other health professionals in Australia might be allowed to discharge services rendered by general practitioners. That seems to be the federal government's way of fighting the acute shortage of doctors plaguing the country.
Health Minister Nicola Roxon announced Wednesday that the government would be setting up a panel to review the country's primary healthcare scene. She was speaking at the Australian General Practice Network (AGPN) conference in Sydney.
Following her speech, she told journalists she expected the review would upset some doctors and medical organisations.
"Change is always difficult," Ms Roxon said.
"I'm sure that there will be robust debate about it, but we think we have to address this issue."
When asked if nurses, physiotherapists and other health professionals would be given limited prescription rights, she said changes that put the patient first would be paramount.
"We're not going to rule things in or out," Ms Roxon said.
"I think if we look at it from the patients' perspective some of the answers to these questions will become much more obvious."
But the health minister warned that whatever the outcome of the review, GP's should expect changes to the way they deliver patient services.
"It is going to be complex," she said.
"It is going to require change on behalf of a number of health professionals and their representative bodies."
AGPN chair Tony Hobbs will lead the independent reference group, which will deliver its initial report mid next year.
But doctors are not amused. Patients' lives will be at risk if the federal government encourages them to bypass GPs in favour of nurses and allied health workers, they warn.
Australian Medical Association (AMA) president Rosanna Capolingua said the underlying agenda behind the government's move was to push people out of doctors' surgeries and into walk-in nurses' clinics.
Dr Capolingua said the AMA did not support giving patients access to Medicare-subsidised treatment from nurses and allied health professionals without a referral from a GP.
"The minister, I am wondering, is sending a message out to Australians that you don't need a doctor to actually make that assessment but you can go directly to the allied provider and get your Medicare rebate," she said.
Dr Capolingua said nurses worked well under medical supervision but did not have the training to be able to independently assess and diagnose patients.
"Things will be either missed, as in not detected, or there will be a misdiagnosis, as in something in error," Dr Capolingua said.
"What we are doing here is throwing in a solution to accessibility which actually compromises patient care and clinical care standards.
"Let me tell you that when something goes wrong, in the worst-case scenario I think the buck should stop with the health minister for wanting to implement this."
But nurses argue they are perfectly capable of independently treating patients who, in many cases, have to travel hours to see their closest GP.
Australian Nursing Federation federal secretary Ged Kearney said a range of highly qualified health professionals could form part of the solution to the problem of increasingly difficult access to GPs, Melissa Jenkins reports in Australian newspaper.
"At the moment the real gatekeepers of the primary healthcare dollar are GPs and as we know the number of GPs is decreasing - it is very, very difficult to get in to see your doctor now," she said.
"It makes absolute sense to look beyond that square and start thinking, well, how can we improve people's access through people other than doctors."
Nurse practitioners have five years of study under their belts, including specialities such as rural health and diabetes, plus years of practical experience, Ms Kearney said.
"Nurses are health professionals. They work within a legal and ethical framework," Ms Kearney said.
"A nurse practitioner would know when a patient was beyond their scope and know when to refer a patient on to a GP, just the same as a GP knows to refer a patient on to a specialist."