Health Professionals

New legislation in Ontario is set to be introduced soon, allowing health professionals to have a wider scope of practice. Some of the proposed changes include the following:

• NPs prescribing ultrasounds, set casts, and prescribe certain drugs
• PTs ordering X-rays
• Midwives taking blood samples
• Pharmacists renewing prescriptions

I suppose these changes are a good thing. They may help to offload the burden of work from doctors who will then be able to spend more time on complicated tasks. Having physicians perform routine services like immunization and check-ups that other health professionals can do with the same level of quality is an inefficient use of resources if doctors get paid more for doing that service. The same can be said for ordering diagnostic tests, prescribing certain drugs, and renewing prescriptions.

However, given the wide scope of a doctor's responsibilities, do we risk making the physician's role more specialized, rendering the role of the General Practitioner obsolete? Can we trust that physician's financial incentives are aligned with treating complicated cases?

As soon as we grant more autonomy to other health-care professionals, we have to be aware of competing interests for performing overlapping services, which may deter rather than foster cooperative interdisciplinary team-building. The difference in roles needs to be clearly delineated by regulatory bodies so that there are guidelines that balance efficiency goals of the system and hierarchical structures between professions. Also, the public needs to be aware of these changing powers by generating discussion from the ground up.

Given the state of today's health care system, government action of this sort is needed. There are more pressing concerns than the rivalry it might create among different health-care professionals who are all fighting for their piece of the cake. Currently, we see evidence of this between RNs and PAs. As a health professional, it is important to remember that your foremost duty and service is to the public even if it means making concessions to your colleagues. Perspective, something that healthcare professionals understand well about their patients, gets lost in settings where professional interests clash.

WC