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Occasionally, surveys are also used to assess the geographical distribution of physicians [ 13 ]. In Canada, the Canadian Institute for Health Information (CIHI) aggregates physician benefits information from provincial government into a comprehensive database called the National Physician Database. This database offers a wealth of information on physicians geocoded to postcode of main activity. The information can also be used to calculate FTEs. CIHI also maintains the Scotts Medical Database which can be used to obtain physician headcounts. As in the United States, these datasets have been used to study relationships with various outcomes [ 14 , 15 ], and the geographical distribution of physicians [ 16 , 17 ]. Note that while the US-AMA Masterfile and Scotts Medical Database are privately sourcedd, the US-Medicare data and National Physician Database are organized by public bodies. Given, the diversity of datasets, and the possibility of overlapping uses of these datasets, it is important that the degree of agreement or disagreement between them be understood. However, there has been limited effort in this direction either in the United States or Canada. High quality data on GP locations are available in the United Kingdom which have been used in a number of analyses [ 18 , 19 ]. GP address data are available from different sources in Ireland [ 7 ] and have been used to study issues of geographic access. Geographic GP and physician datasets in Australia in the context of Australias healthcare system Similar to Canada and the United States, multiple sources of physician and GP data sources exist in Australia. However, unlike their North American counterparts data custodians in Australia operate a relatively restrictive data access regime and some data custodians do not release data at small geographies either to researchers or the public (see discussion). Also, unlike the CIHI in Canada, no Australian body functions as a centralized aggregator of physician data. These complications result in a greater multiplicity of datasets in the context of Australias health system.
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18 edition of the Medical Journal of Australia , Melbourne’s Age reports (Nader, Age, 9/18). The use of mifepristone, which when taken with misoprostol can cause a medical abortion, was prohibited in the country until the Federal Parliament in February voted to pass legislation that removed Health Minister Tony Abbott’s authority to veto the importation of it. The Australian Therapeutic Goods Administration in April announced that it had authorized two Queensland physicians to import and prescribe the drug ( Kaiser Daily Women’s Health Policy Report, 6/15). Mifepristone and misoprostol in combination is considered the best method for a medical abortion, the Age reports. However, Marie Stopes , an abortion provider, is testing methotrexate’s use in medical abortions because of the delays in approval of mifepristone, according to the Age. “There do seem to be more people out there using methotrexate and misoprostol than we were aware of,” Christine Tippet, president-elect of the Royal Australian and New Zealand College of Obstetrics and Gynecologists , said, adding that the application process to supply mifepristone is complex. According to de Costa, “several hundred [physicians] annually” in the country are administering the methotrexate-misoprostol combination or just misoprostol alone “under the radar.” Both drugs are licensed in the country, and physicians are permitted to use the drugs for purposes for which they are not licensed as long as they are effective and safe, the Age reports (Age, 9/18). According to de Costa, physicians are using the drugs to abort fetuses up to 13 weeks’ gestation in cases when severe fetal abnormalities are detected (de Costa, Medical Journal of Australia, 9/18). This article is republished with kind permission from our friends at the The Kaiser Family Foundation . You can view the entire Kaiser Daily Health Policy Report , search the archives , or sign up for email delivery of in-depth coverage of health policy developments, debates and discussions. The Kaiser Daily Health Policy Report is published for Kaisernetwork.org , a free service of The Henry J. Kaiser Family Foundation .
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Why the nurses are so actively against it is interesting but one would have to ask all opposing groups are they interested in opposing for oppositions sake, are they interested in providing health services to patients who currently find it difficult to access them because the workforce is not there, or are they interested in preserving the status quo with siloed health professional practice? The health service and its constituent parts is a very complex organism but every part of it should work together to improve patient care and not work only in the interests of the health professional or have I got that wrong ? The health and social welfare workforce is currently the largest in Australia 1.4 million and like the rest of the population, it is ageing. We will need to recruit about half a million new workers at least to this sector over the next decade a significant challenge that policy makers and politicians do not seem to be fully accepting at present. Where are these new workers to come from? Current recruitment will not achieve these targets so perhaps some innovation is required. Trials of new models of care have been carried out by Queensland Health and the South Australian Health Commission in respect to PAs. These trials, albeit small, did suggest that these new health professionals would be useful across a variety of health care situations. They actually assisted doctors in care delivery, worked together with Nurse Practitioners as part of the care team, and value added to teaching of students rather than impairing it. So why the opposition? Sad to say but may I suggest pure self interest as always wrapped up in cries that the introduction will impact negatively on patient safety and quality, reduce learning opportunities for medical and nursing students and generally speed the dumbing down of health care delivery none of which can be supported by the many trials of PAs in Australia and overseas . Now I have to declare my bias, having introduced the PA program at the University of Queensland in 2009. One of the reasons was that of recruitment, the fact that in the US those joining PA programs do not want to be doctors or nurses. So it adds to the health workforce, and that is what we have to do. There is going to be so much work out there in health care, we need all the person power we can get.