Update on the regulatory framework | Regulating physician associates
Responsibility for providing a professional title for PAs sits with the Minister of Health. The Minister has confirmed the title as physician associate(s). In response, the Chair of the AoNZ National Committee wrote to the Minister saying we consider this title creates a risk to patients who may wrongly understand and trust they are being treated by a doctor. We suggested the title Clinical Assistant would avoid confusion for patients and make it as clear as possible these practitioners are not physicians, nurses or doctors. At a minimum the title should include Assistant, not Associate. This would prioritise patient safety and understanding over the preferences of the small current Physician Associate workforce. We recommended the Minister reverse the decision and adopt the title Clinical Assistant before MCNZ begins registration of this healthcare profession in October 2026.
MCNZ is now consulting on the draft Professional standards for PAs. These propose the principles and values of good PA practice and the professional standards expected of PAs working in Aotearoa New Zealand. Our RACS submission said we are pleased to see the emphasis on supervision in the PA scopes of practice. These state a PA may only work under the “employer-approved supervision of a doctor registered in a vocational scope of practice that is relevant to the practice setting and the [PA’s] role” with requirements regarding credentialling. We would like to see these more explicitly and robustly reflected in the Professional standards. We know PAs are currently working in Aotearoa New Zealand without onsite supervision, so the requirement for onsite supervision will be a significant change for those PAs and their current supervisors. We noted situations will arise where there is a risk to patient safety either because a supervising doctor does not meet their responsibilities, or where a PA acts outside of supervision requirements. The standards need to be clear where accountabilities lie in these situations, also what a PA must do when the relationship between the supervisor and the PA breaks down, or where the PA feels unsafe with the supervision being provided. Because the PA profession is relatively new to Aotearoa New Zealand, we believe strong emphasis needs to be put onto communication with colleagues and safe handover and transfer of patient care. The strong guidance on these in Good Medical Practice should be duplicated in the standards for PAs. At least initially, all PAs working in Aotearoa New Zealand will be overseas-trained, which requires a high degree of emphasis on ensuring they can establish relationships of trust with Aotearoa New Zealand patients. This includes being aware of cultural diversity and safety, and an expectation they function effectively and respectfully when working with and treating people of different cultural backgrounds. Again, Good Medical Practice contains some excellent guidance for doctors and should be mirrored in the standards for PAs.