NZRDA Warns Clinical Assistant (Physician Assistant) Regulation Must Not Lower The Bar For Patient Safety

The New Zealand Resident Doctors’ Association – representing over 3,000 resident doctors across all specialties in Aotearoa New Zealand – is sounding a clear alarm over the proposed regulation of ‘physician assistants’. The recent consultation proposal does not restrict this group from seeing patients with new or undiagnosed symptoms, posing a catastrophic risk to patient safety.

When a patient presents at a clinic with a vague symptom such as chest pain or a headache, identifying whether this is a minor issue or a life-threatening emergency requires a complex medical process called differential diagnosis. This high-stakes skillset is honed through decades’-long, rigorous medical training that all doctors undertake. It cannot be replicated by a two-year postgraduate degree.

“Clinical assistants lack the breadth and depth of training to safely navigate clinical uncertainties. If they miss a ‘red flag’ symptom, the patient is put at significant risk before the doctor even enters the room,” said Dr Deborah Powell, National Secretary of the NZRDA. “This is exactly what we’ve seen happen in the UK, where loose regulatory controls and public confusion over these roles have tragically led to at least six patient deaths in recent years.”

The NZRDA submission firmly opposes this assistant workforce seeing undifferentiated patients and calls on the Medical Council (the regulator) to restrict their scope of practice to post-diagnosis care only, under direct instruction from a supervising doctor. It also calls for clarity in their title to avoid confusion with doctors; another feature that has been implicated in Coroner reports of preventable patient deaths overseas.

“The use of ‘physician’ in their title has misled many patients into believing they were seeing a doctor,” said Dr Powell. This was a key finding of the UK’s independent review into the physician associate role, with grieving families noting they would have sought further help had they known a doctor was not involved in their relative's care.

“New Zealand maintains a stellar patient safety record – much better than the countries currently using this model,” said Dr Powell. “The fact is this workforce fills no unique skills gaps that cannot already be filled by our own locally trained and regulated practitioners. If their regulation is to proceed, we must ensure there are clear guardrails to uphold patient safety above all else.”

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