AMA President Dr Danielle McMullen provides members with the latest from the national AMA.
Hello and happy Friday!
Scope of practice has been a hot topic again this week with the announcement of new standards from the Nursing and Midwifery Board of Australia (NMBA), which will allow some RNs in future to prescribe medications under a delegated framework. While the visibility of scope issues waxes and wanes in the media, it's always a top priority at the AMA.
Medical practitioners have the most comprehensive training in assessment, investigation, clinical reasoning, diagnosis and both the selection and monitoring of management. We know when to prescribe, and importantly, when not to prescribe. We are trained to continually test and retest our assumptions and differential diagnoses, and to keep our eyes out for zebras. Australians rightfully expect to see a doctor when they are sick. Task and role substitution without careful clinical governance and consultation is not OK.
Prescribing is one of our highest risk roles - medication misadventure is a common cause of iatrogenic harm, and potentially preventable hospital admissions. It's why we fought so hard to ensure that RN prescribing has safeguards in place. It's not perfect, but it's significantly better than the initial model we were consulted on more than two years ago.
We continue to engage with the NMBA, Ahpra and the Department of Health to work through our ongoing concerns and to make sure patient safety and quality care are front of mind.
You can read what else we've had to say on RN prescribing this week.
Importantly, as I told The Medical Republic this week , this model is fundamentally different from pharmacist prescribing models being rolled out in some jurisdictions, which allow independent prescribing without appropriate oversight - a model we strongly oppose.
Our healthcare system is facing immense pressure, and we need to continue to fight for appropriate funding, innovative models to provide high-quality care outside of hospitals, enough training positions to meet the needs of the future, and of course for patient safety above all else. Medically led, collaborative, team-based care is the blueprint to safe and effective patient care in a system facing increasing demand.
While we're on appropriate funding, this week we called for all levels of government to end the ongoing blame game over public hospital funding and prioritise the needs of patients, amid stalled negotiations over a new hospital funding arrangement. It has been nearly two years since governments agreed to a new funding model in principle in 2023, and yet we've seen little progress. For years, our Clear the Hospital Logjam campaign has highlighted the dire situation in our nation's public hospitals, with yearly report cards tracking the drastic decline of the public hospital system. Funding Australia's hospitals requires a partnership between federal, state and territory governments. Both sides must contribute their fair share of funding if hospitals are to improve - the Commonwealth previously promised a 45 per cent share and we think it's only fair they be held to that.
In other news, your AMA Council of Rural Doctors (CRD) had its final meeting of the year and celebrated the recent recognition of rural generalism as a specialty within general practice. This is a fantastic announcement, and much work is now being done to determine the finer details of what it means for training, accreditation, credentialling and MBS access. We were pleased to get an update from the Department of Health, Disability and Ageing on their early thinking about rural health funding. CRD used the meeting to plan ahead and identify services and regional training networks as ongoing priorities.
I also met with the RACGP this week - I catch up with their president Dr Michael Wright fairly often, but with so much happening in GP-land, it was great to have a more formal opportunity to discuss where our two organisations can work together to best support members. I was also really pleased to attend their Health of the Nation report launch, which showed the real need to modernise Medicare and restructure MBs items to make them fit for purpose.
Lastly, October is National Safe Work Month and we released a call for governments, hospitals, training bodies, and healthcare administrators to lead change to ensure the safety of healthcare workers, both in terms of physical and psychosocial safety. Doctors and other healthcare workers deserve to be safe at work too.
