An associate doctor is a licensed health care professional. He is permitted to practice medicine under the supervision of a licensed physician. He is responsible for patient education and enhancing care of patients1. He is trained to perform a wide range of medical services in every medical and surgical field2.

The history goes back to 1960s when there was a need for more medical workers in the US. Recently other countries like Canada, Netherlands, UK, Australia etc. have also included the scope for an associate doctor3. New Zealand is also accepting the role of an associate doctor due to lack of doctors and staff in the rural and semi-rural regions and this has yielded positive results4.

An associate doctor must go through a special medical training, the duration of which varies in each country. They are defined as the middle ranking or the new class of medicos by Jeremy Hunt4, the health secretary of NHS (US); they are placed between a physician/doctor and a nurse/ward boy.

It is necessary to manage associate doctors in order to get the best results :

Medical Training

Associate doctors are trained as per the physician they work with and the duties they are expected to fulfil. Their major roles include history taking, basic physical examinations, laboratory tests, X-rays, diagnosing the problem, assisting in surgeries, home-care facilities etc. They are also expected to counsel patients, educate them and work towards preventive healthcare services. In absence of a physician, they should be trained to deal with emergency situations. Most countries are yet debating whether to allow associates to prescribe drugs or not.

Insurance

In most countries, the associate doctors are covered under the insurance policy of the supervising physician or health care centre. They may also be allowed to get their own malpractice insurance cover1.  Most insurance policies for patients cover the services provided by an associate doctor. Some insurance policy companies, bill for the associate directly, while other bill through the physician or healthcare centre that has employed the associate1.

Informing the staff and patients

Educate your staff that the associate doctor is an extension of you. The staff tends to influence the patients. Hence, it is important that they learn to respect and value his services. This will help the patients respect the associate doctor. Ask your staff to explain the patient the advantages of seeing the associate in cases when the consultant is not available or busy with an emergency. Introduce the associate personally to all patients as this will help develop faith in him. Inform the patients how the consultant and the associate will work hand in hand to provide best healthcare to them.

Respect and freedom

The relationship of a consultant and associate doctor is based on mutual trust and confidence. This association can be beneficial if it is based on autonomy. The consultant is confident that the associate will take the best decision in his absence and seek advice from him whenever necessary. Also, the associate is sure that the consultant will teach and guide him in cases beyond his expertise. The associate must realise that he must perform his duties well so that the consultant can be available to handle other complicated cases.

Trials have shown that associates are skilfull and can provide high-grade services to patients. Various researches have shown that hiring an associate can enhance the healthcare results and help in expansion of the setup. Since the associates work under the supervision of the consultant, patients are equally contented with the combined outcome5. One must be aware and alert that the associates do not take the liberty to practice as the consultant doctors, risking the lives of the patients.

Contributed by Dr. Rachita Narsaria, MD

References:

  1. http://www.pac.ca.gov/forms_pubs/what_is.shtml
  2. http://medicine.yale.edu/pa/profession/index.aspx
  3. http://www.health.govt.nz/our-work/health-workforce/new-roles-and-initiatives/current-projects/physician-associate-physician-assistant
  4. http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-patients-to-be-seen-by-doctors-on-the-cheap-9684751.html
  5. http://www.aapa.org/twocolumnmain.aspx?id=289#sthash.BT3aJUsO.dpuf