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Why James Cook University is starting a Physician Assistant program

This is the third article in a Croakey series examining the potential of physician assistants to help improve access to health care, particularly in rural, remote and other under-served areas.

Allan Forde and Sharon Barnwell write:

This American term – PAs – has been whispered more around health circles in Australia over the last few years. You may have met one in South Australia or Queensland, states that have taken the plunge in the PA experiment.

Soon you’ll be hearing about them a whole lot more – home-grown PAs trained in Australian courses will appear in the very near future.

But first you may be wondering, what exactly is a Physician Assistant, and why should I care? Don’t we have nurses and allied health professionals already?

Well, yes, but Physician Assistants are able to do things that some of these professionals are not. A unique characteristic of PAs is that they work as extenders of doctor’s services. As part of this team relationship, medical and surgical privileges are delegated by supervising doctors to physician assistants.

PAs work for doctors to provide medical and surgical procedures, prescribe medicines, advise tactics for preventative healthcare and diagnose and treat illnesses. They are usually ‘back-up’ to a doctor in rural areas, providing the doctor with a trusty offsider and the community with a second senior person to be available after hours.

In Australia this is particularly important. There are huge distances between health facilities in rural and remote areas and a shortage of doctors willing to work, often as the only doctor, in these areas. Physician Assistants are a new and exciting option for health services to consider.

A small scale but successful example of the Physician Assistant model working in Australia is when two US PAs were employed by the Cooktown Multi-Purpose Centre last year as part of a Queensland Health pilot project. The pilot finished in June 2010 and so missed are the PAs by the doctors, nurses and community that Medical Supervisor Dr Tash Coventry said she would like to have two PAs on her staff permanently.

James Cook University in northern Queensland is beginning a new course for PAs in February next year. Professor Richard Murray, Dean of the School of Medicine and Dentistry, says the values of JCU’s medical program lend themselves to the establishment of the Physician Assistant program.

“We produce skilled, work-ready graduates with a strong foundation of scientific and medical knowledge. Our graduates value social justice, innovation and excellence, which are all part of the university’s mission as well as our own,” Professor Murray said.

“The School is a leader in our focus areas of rural and remote health, tropical medicine and the health of Indigenous Australians, and is particularly suited to people with an interest in health care for underserved populations,” he said.

Not surprisingly, because of its great flexibility, the PA model is popping up all over the world. Most countries are training or piloting PAs with a particular focus on filling specific areas of need within their medical workforce. The majority of these nations are members of the Organisation of Economic Development (OECD) and the Commonwealth of Nations.

Ireland and New Zealand are particularly interested in using PAs in surgical services. The UK has found PAs to be of great help in public hospitals and Scotland is starting a program focusing on underserved public health and primary care. Canada has been training PAs for use in the military since 1984, and now has civilian programs centred on providing PAs to emergency care and family medicine. South Africa is training Clinical Associates, modelled on PAs, to work in district hospitals. Saudi Arabia now has a military PA program and The Netherlands has benefitted from PAs for a decade.

So it’s clear that Physician Assistants are not a new idea for JCU, or Australia for that matter.

Professor Ian Wronski, Pro Vice Chancellor of the Faculty of Medicine, Health and Molecular Sciences at JCU, is credited with first investigating the US PA model. His specific area of interest was augmenting Indigenous health care in Western Australia and he believed PAs could be part of the solution. He debated the merits of the PA model with other academics, healthcare leaders and doctors as far back as the late 1980s.

These ideas were picked up by Professor Murray and adjunct Professor Dennis Pashen, former Director of the Mt Isa Centre for Rural and Remote Health (MICRRH) and former President of The Australian College of Rural and Remote Medicine (ACRRM). They are now two of the most ardent proponents of developing a PA-modelled healthcare practitioner for Australia.

Professors Wronski, Murray and Pashen realised PAs would be an ideal complement for Australian rural doctors, rather than a threat to clinical training opportunities or other healthcare professions. For those of you who might know Dennis, rest assured he has been particularly vocal and challenging to naysayers and opponents. We’re glad he’s on our side!

JCU is not just intent on supplying highly trained PAs to underserved areas and populations, but to take advantage of a ready and willing pool of experienced healthcare workers looking for a new challenge. Professionals such as paramedics, military medics, Aboriginal Health Workers and various allied health personnel looking for ways to extend their contribution in the clinical arena are eager to step up to this challenge.

The University of Queensland PA Program has included students as diverse as physiotherapists, pharmacists, nurses, an optometrist and a podiatrist in the last two years. Many of these workers would otherwise be lost to the system, disillusioned with the lack of opportunities to diversify their practices or advance their careers.

JCU’s PA program will emphasise recruitment of applicants from rural, remote, Indigenous and tropical communities just as the medical school does. We think selecting candidates from cohorts of mature non-medical health professionals who are already well established in rural or remote communities is a good strategy to increase the health workforce in underserved areas.

Finally, JCU has supported the PA movement in a unique way by employing three PAs direct from the US as academic staff in the School of Medicine and Dentistry. In addition to developing the curriculum, we all carry teaching duties in the MBBS course, especially in clinical skills.

I (Allan Forde) look forward to being a part of this exciting transition phase for PAs in Australia, from novel idea to reality, knowing that not only will professional colleagues benefit from the course but that the people in underserved populations will receive quality healthcare long after the program’s establishment.

For more detail on the subject of utilising PAs in rural healthcare have a look at a paper that was done for the National Rural Health Conference in 2009: Augmenting the rural health workforce with Physician Assistants.

• Allan Forde is a PA and Senior Lecturer in the JCU School of Medicine & Dentistry, and Sharon Barnwell is a communications officer and journalism student at JCU

***

Previous posts in this series:

We’re about to get our first crop of PAs

The evidence shows that PAs could help improve access

Comments 3

  1. Physician Assistant 1 says:

    It is good to see continued support for Physician Assistants from JCU. It is certainly great to see they have opened the offering for this year as it was sad to see no offerings in 2013. There are now several Australian Trained Physician Assistants working in Australia albeit they were trained at Masters level by University of Queensland in which the course was sadly closed in 2011. One PA in particular working in the Pilbara area with indigenous health. Several have private company jobs in off shore areas. Another has been working in a GP practice in rural Queensland for over 18mths. In addition to this one working with a specialist in Urology for over 12mths. Queensland Health now has the governance policy document as well as all the underpinning for recruitment. The Australian PAs employed as PAs are the Australian pioneers and the first in their field in Australia regardless of which education institution they are trained at. It would be great to recognise our pioneering Australians Dorothea Skelly, Jason Brown, Paul Roberts and Sharon Ashman, Deb Okrane and many more post students paving the way!!

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alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17