Are Australians willing to be treated by a Physician Assistant?

BackgroundPhysician assistants (PAs) are deployed to extend the role of the general practitioner and other doctors in Canada, England, Scotland, The Netherlands, the United States and elsewhere.  Because Australians have little experience with this type of provider, we undertook a study to test the willingness of patients to be treated by a PA. Method  A time trade-off preference survey was administered to women naïve about PAs in Northern Queensland in 2009.  Each survey described one of three scenarios of injury and asked the patient to make a decision between waiting four hours for a doctor or one hour for a PA.  ResultsA total of 229 candidate patients unconditionally participated (225 met criteria).  Two-thirds were between the ages of 20 & 35 years.  All but two of the participants (99%) selected to be treated by the PA regardless of the scenario.  When choices of time differences between a doctor and a PA were reduced to 2 hours and 1 hour, respectively, the preferential choice of seeing the PA persisted.  ConclusionAustralian women in Northern Queensland were willing to be treated by a PA as a theoretical construct and without actual experience or knowledge of PAs.  The familiar doctor care was traded for that of a PA when access to care was more available.  Developing PAs in Australian society may be practical and patient attitudes more accepting, than realized.  The concept of willingness to be treated has utility in socioeconomic research

The Economic, Medical & Social Costs of Road Traffic Crashes in Rural North Queensland: A 5-Year Multi-Phase Study

In Queensland in the year 2000, for example, the risk of dying (per capita) in a rural versus urban crash was 4.2 times higher, with resulting costs 2-3 times higher in rural areas compared to urban areas. In response, the Centre for Accident Research and Road Safety – Queensland (CARRS-Q) at Queensland University of Technology and James Cook University have designed a program of research to reduce the incidence and economic, medical and social costs of road crashes in Northern Queensland through the development and implementation of tailored road safety interventions

Shared antenatal care for Indigenous patients in a rural and remote community

BACKGROUND: An increase in perinatal mortality prompted a review of services to pregnant women in remote northern and western Queensland, Australia. In order to address the needs of the Indigenous population in particular, a range of service changes was implemented to improve outcomes.\ud \ud OBJECTIVE: This article aims to highlight the changes made in the delivery of local and regional antenatal services.\ud \ud DISCUSSION: Mt Isa Hospital is the supplier of obstetric services for the north and west of Queensland. Poor antenatal access rates and other service issues for Indigenous patients were identified as contributing to these poor outcomes. Consultation with Indigenous patients and health service providers prompted changes in modes of delivery of services that in the short term seem to have improved results. The models for delivery of services include primary health care clinics in remote communities, Aboriginal community controlled health services, and flying obstetrician clinics

The Expanding Role of Generalists in Rural & Remote Health: A Systematic Review

APHCRI Conversations was a regular program of presentations held at the Department of Health to facilitate exchange between APHCRI Network researchers and Department policymakers. Topics are developed jointly with the Department of Health and involve a range of speakers from APHCRI, including CRE invited experts, CRE Chief Investigators and stream project Chief Investigator

Are Australians willing to be treated by a physician assistant?

Background: Physician assistants (PAs) are deployed to extend the role of the general practitioner and other doctors in Canada, England, Scotland, The Netherlands, the United States and elsewhere. Because Australians have little experience with this type of provider, we undertook a study to test the willingness of patients to be treated by a PA. \ud \ud Method: A time trade-off preference survey was administered to women naïve about PAs in Northern Queensland in 2009. Each survey described one of three scenarios of injury and asked the patient to make a decision between waiting four hours for a doctor or one hour for a PA. \ud \ud Results: A total of 229 candidate patients unconditionally participated (225 met criteria). Two-thirds were between the ages of 20 & 35 years. All but two of the participants (99%) selected to be treated by the PA regardless of the scenario. When choices of time differences between a doctor and a PA were reduced to 2 hours and 1 hour, respectively, the preferential choice of seeing the PA persisted. \ud \ud Conclusion: Australian women in Northern Queensland were willing to be treated by a PA as a theoretical construct and without actual experience or knowledge of PAs. The familiar doctor care was traded for that of a PA when access to care was more available. Developing PAs in Australian society may be practical and patient attitudes more accepting, than realized. The concept of willingness to be treated has utility in socioeconomic research

The ARTS of risk management in rural and remote medicine.

This paper describes an action research process (in which the researchers are active participants throughout the process of development, testing and refinement) to develop a framework for clinical risk assessment and management in the context of rural and remote medicine. The framework is needed to support educational, medicolegal and quality improvement processes in rural and remote medical practice. The research process included identifying a problem and gradually developing a research question, developing a potential model for application in a specific context, refining the tool and piloting the tool in a limited context. The research question and framework were developed during a series of teleconferences under the aegis of the Censorial Panel of the Australian College of Rural and Remote Medicine (ACRRM). After the framework was developed and refined, it was tested at a workshop in conjunction with the ACRRM Scientific Forum in Alice Springs, Australia, in July 2004. Workshop participants were principally but not exclusively rural medical practitioners from across Australia. The main outcome measure was a working framework for risk management broadly applicable in rural and remote medicine. The process clarified differences between safety and quality approaches in metropolitan and rural and remote medical practice, culminating in an appropriate clinical risk management framework. The action research as undertaken resulted in a workable risk management framework that is worthy of further development and that may be a valuable educational tool, both for existing practitioners and for future rural doctors. Further, it has potential as a means of providing legal protection to rural practitioners when actual rural practice is at odds with "best practice" as defined by a metropolitan group of experts