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Time to consider doctor assistants

I would like to make a suggestion regarding Eilish O'Regan's article on the shortfall of 165 junior doctors to fill healthcare positions (Irish Independent, January 5). When former US President Lyndon Johnson signed Medicare into law in 1965, suddenly American physicians were inundated with patients seeking medical care.

At Duke University, Dr Eugene Stead knew there was a growing pool of young men who had been trained as medics by the navy and army and had intense medical experiences while serving in Vietnam. He developed the first Physician Assistant (PA) programme to tap their experience and bring them into the provider ranks. I have been a practising PA for 30 years.

All PAs are licensed to a supervising physician. We do not practise medicine as indep-endent providers. We can perform about 85pc of the duties of the average physician.

Our duties are defined by who we work with. For instance, if I am working with a neurosurgeon, I might be doing lumbar punctures, back injections, and admitting patients to the hospital, doing ward rounds, discharging patients and dictating discharge summaries.

In a family practice clinic, PAs usually see their own patients and may not need to confer with their supervisors unless they were having questions about some issues of care.

Overall, a PA's duties are very similar to junior doctors'.

When I first started many years ago, some patients were resistant to being treated by a PA, but nowadays acceptance is very good.

PAs can be on the job after 24 months of training; they are paid about one-third of what it costs to hire a physician.

Today, the Netherlands has two PA programmes. The UK's NHS had a pilot programme to bring PAs into its system. Is it time for Ireland to consider incorporating PAs into the national healthcare structure?

Terry Clark MPAS
Iowa, USA

Irish Independent