Financial Crisis may hasten move to Shift Responsibilities away from Doctors, warns outgoing WMA President

A warning that the global economic crisis could lead to health authorities saving costs by shifting tasks away from doctors to other health professionals is to be delivered by the outgoing President of the World Medical Association.

Dr. Jon Snaedal, in his valedictory address tomorrow (Friday) to the WMA's annual General Assembly in Seoul, South Korea, is to say that doctors must expect changes in the way they work, but he predicts that the current economic turmoil will accelerate the move towards shifting doctors' responsibilities to other health professionals.

'Many of the other health professionals are willing to take over tasks that we have traditionally provided. These tasks include, for example, prescribing of drugs, diagnostic work and even treatment and follow up of patients.'

Dr. Snaedal, a geriatrician from Reykjavik in Iceland, says this is happening throughout Europe, in the US and across Asia and Latin America. Yet reports on the issue had highlighted a lack of good evidence to underpin the change. There was a lack of regulation, lack of proper education and training and also cultural objections to the development, by doctors as well as patients.

Dr. Snaedal says the driving forces behind the change are that other health professionals are cheaper than doctors and the fact that other health workers wished to expand their role. However doctors had to recognise that they themselves had often failed to respond to patients' needs, particularly where patients had chronic conditions and were in need of continuous and easy access to medical services and medical help. Where this occurred, pressure arose from others such as nurses and pharmacists to step in.

Doctors should respond to this by organising their services better and by leading the move to work in teams of health professionals.

Dr. Snaedal says that where ill guided authorities attempted to bring in changes without consultation and regulation, doctors should seek to defend their traditional roles. But sometimes, task shifting is appropriate and doctors have to accept that their role would change.

He says that the WMA is now discussing this whole issue with the World Health Organisation and with the other health professions. Unity among the health professions would result in more effective changes. The WMA would be organising a meeting in Iceland next March, to look in further detail at human resources for health, task shifting and interprofessional relations.