WMA leader’s warning over substituting physicians

Governments and international organisations that promote the training of nurses and community health workers rather than fully trained physicians are effectively denying patients’ access to quality health care, the Chair of the World Medical Association, said today.

Dr. Frank Ulrich Montgomery, speaking at a WMA/Israel Medical Association conference in Tel Aviv entitled ‘Physician 2030’ on the future of the physician, said: ‘We must be clear and firm that under a concept of Universal Health Coverage, health care must involve physician-led teamwork and this must be thoroughly financed. And let’s be very clear: a patient-physician relationship demands a physician – not a substitute or surrogate’.

Dr. Montgomery criticised governments for their hesitancy in reacting sensibly to the global shortage of physicians.

‘Instead of increasing the number of students in universities and the number of training posts for specialization, they opt for cheaper alternatives instead’.

Yet it was a fallacy for organisations such as the World Health Organisation to argue that moving tasks away from physicians to less specialized health workers could make more efficient use of available human resources.

Dr. Montgomery said patients deserved physicians. Quality of medical care and the right of access to a fully trained doctor were basic human rights. However, he added that in cases where there is no physician it will be helpful to have nurses filling the gap as well as possible, and where there is no nurse this will have to be done by community health workers.

He said the number of physicians was growing too slowly to compensate for the challenges that lay ahead for the healthcare system and he warned: ‘I firmly believe that if we do not actively address physician shortages now, the situation for patients will deteriorate in the years ahead’.

Referring to the emergence of new technology in the field of health care, he said that these were only tools in the patient-physician relationship, they could not be substitutes.

‘Patients will always need physicians to be a source of professional expertise and empathy – perhaps even more so as sources of dubious online health content are called into question.

‘We have to maintain and fight for our position as serious information brokers to our patients’.