Medical Observer - Nurses to grab half of minor cases 4.09.2009

Nurses to grab half of minor cases: expert - News - Medical Observer

Nurses to grab half of minor cases: expert

Page 1 of 1

Andrew Bracey - Friday, 4 September 2009

GPs can expect to lose up to half their patients with minor ailments to new nurse practitioner clinics, a leading practice consultant has warned, and must consider new business models to combat the threat as a matter of priority. The warning from practice management consultant David Dahm follows last month’s announcement from nurse practitioner clinic operator Revive that it plans to franchise its model through up to 150 pharmacies by 2012. Quantifying the potential financial impact of the new model, Mr Dahm said that in areas where a Revive Clinic or similar operator opened, general practices could expect to lose between 30% and 50% of patients with minor ailments such as coughs and colds. “[Patients] will try the pharmacist and the nurse first, then they will go to the GP,” he said. “This is war that has been declared between GPs and allied health workers. This is the new environment, and it is up to [GPs] to take charge, not hand it over without complaining.” Even supporters of nurse practitioners have their doubts about the new model. Bundaberg GP Dr Patrick Byrnes (pictured) – whose practice was the first in Australia to employ a nurse practitioner – said these professionals had a definite role, but only in an integrated and collaborative model. He urged legislators to prevent a competitive system. “The Revive Clinics are aiming at a very specific acute market, in a competitive model to general practice,” he said. “The Government needs to decide whether it wants this type of fragmentation.” The Revive Clinic model will take full advantage of controversial midwives and nurse practitioners legislation, currently before Parliament, that will open up access to the MBS and PBS. Doctors’ groups have vocally opposed the legislation, saying without a clear collaborative framework involving GPs, the new laws would fragment care (MO , 28 August). Mr Dahm made the radical suggestion that practices consider co-location with those pharmacies with a Revive which would ensure the nurse practitioner service would be collaborative, and benefit both their patients and Professor Mark Harris, professor of general practice at the University of NSW, was supportive of stronger partnerships between GPs and pharmacists. “We ought to be creating teamwork, not competition.” Revive director Louise Stewart rejected the notion it was introducing a competitive model, saying the clinics aimed to work collaboratively with local practices and would mainly see patients who would not have otherwise consulted a Doctors were welcome to establish Revive Clinics within their practices, she said. As MO went to press, the advisory group that will inform the Government on the collaborative framework under which nurse practitioners will be required to operate was due to have its first meeting.