Hope Alexander MPH

Posts Tagged ‘doctor’

The below article is a guest column written by Hope, that was published in the “Medical Forum WA”  magazine, Western Australia’s Independent Monthly for Health Professionals July, 2009 edition. Her article is on Page 10 and the orginal article can be accessed at http://www.medicalhub.com.au/component/option,com_docman/task,doc_download/gid,130/Itemid,228/

With the ageing population, what can the Australian health consumer expect in the way of primary health care, and by whom will it be delivered? One strategy to overcome the shortage of trained health professionals is to utilise the skills and strengths of nurse practitioners.

The article “On solutions to the shortage of doctors in Australia” states that:

• WHO estimates a current global shortage of 4.3 million health workers;

• Australia … compares unfavourably with other OECD countries in respect to doctor numbers;

• The overall shortage of doctors in Australia … is exaggerated by the disciplinary, cultural, and demographic misdistribution of the doctors relative to need and utility;

• Australia … is one of the most reliant of the OECD countries on foreign doctors; and

• An increase in spending on health promotion and disease prevention is essential.

“The majority of health professionals recognise that there is a gap in health service delivery in this country, and that nurse practitioners can contribute to filling that gap” (Cerasa, 2009).

Anecdotal evidence from patient X has a woman attending a GP surgery to have weekly dressings on her leg after day surgery. But can either of the two practice nurses reassure the patient that her wound is healing? No. Can the GP who sees the wound on an irregular basis? No, “It is OK.” What does that mean? So the patient returns to the surgeon to get a definite opinion. “Yes, the leg is healing, everything is proceeding as normal.”

If a consumer consulted a nurse practitioner specifically trained in wound care, the outcome would be much different. The skill and knowledge base would be there. Information would be given to the patient to best manage her condition: how often would dressings need to be done, for how long, and what the patient could do to resume her normal lifestyle. As a consumer, I have faith in the education and training of nurse practitioners. Many consumers have been let down by GPs who do not communicate, who do not share information and/or evidence, and who “do not want to treat old people” or “people with no money”.

As an older consumer with a chronic condition brought about by medical treatment for another condition, I would say “Yes, I am willing to consult a nurse practitioner” for routine checks and most ailments. Part of the nurse practitioner training is to differentiate between serious and minor complaints. I see their role as being similar to triage. Instead of referring a patient to a GP, it may be a referral to an exercise physiologist, a dietician, or a massage therapist.

GPs are trained in the medical model, but many consumers, particularly those with chronic conditions, and older ones, would prefer a non-drug treatment, along the lines of the New Zealand “Green prescription”. In addition, consumers find it difficult to access a GP who is willing to write an Enhanced Care Plan. Excuses given are “it takes too much time” and “we don’t get paid enough”. Consumers may well ask “But what about us?”

Hope Alexander

July 2009

© Copyright Hope Alexander

Date: Wednesday 27th May 2009

Time: 9:15 am – 12:45 pm

Place: Boulevard Centre, 99 The Boulevard, Floreat Park, Perth, Western Australia.

• 9.20 am
  Tim Benson
  Welcome and Opening Remarks

• 9.30 am
  Bronwyn Nicholson
  Emergency Department Joondalup Hospital “On my role, what does the future look like”

• 9.55 am
  Questions

• 10.05 am
  Hope Alexander
  Nurse Practitioners in the Future: A consumer perspective

• 10.30 am
  Questions

• 10.40 am
  Morning tea

• 11.00 am
  Dr Scott Blackwell
  General Practice and Nurse Practitioners: The Way Forward

• 11.25 am
  Questions

• 11.35 am
  Professor Phil Della

• 12.00 pm
  Questions and Discussion

• 12.25 pm
  Action for Health Consumers’ Council

• 12.40 pm
  Tim Benson
  Closing remarks and thanks

Nurse Practitioners in the Future: A consumer perspective – Hope’s PowerPoint presentation can be viewed here

Hope has been invited to be a guest columnist for “Medical Forum WA” magazine, commenting on current issues from a consumer perspective …  because of her passion for best practice in health. Hope sits on several national working parties and committees which include doctors and medical researchers and therefore is able to provide to professionals the grass roots understanding of what is “done to and done for” the consumer.

Hope attended the Wanneroo GP Super Clinics “Better Health Care for Australians” as a delegate. This seminar was sponsored by the Department of Health and Ageing.