One day before Peter Capaldi made his debut on the small screen as the new Doctor Who, the BBC reported that the Department of Health is planning to rapidly expand the number of people in “doctor’s assistant” roles.
The Patient Association has raised concern that hospitals will become more reliant on physician associates because they are paid less. Regardless of how competent Clara Oswald is in the TV series, is it any surprise that in real life patients’ automatically reaction is that they want to deal directly with the Doctor? There will definitely be a requirement for careful communication regarding this role and in time, with real experience, there should be acceptance.
But how do doctors themselves feel about the prospect of delegating a proportion of work to these new assistants?
Delegating new tasks to new people will come more naturally to some than to others and the pros, cons, barriers, do’s, don’ts are regularly discussed on our medical leadership and management courses. Though everyone wants help and support, some will inevitable feel precious to some extent or lack belief that this is the right move. Unlike Doctor Who, however, there is no suggestion that anyone should happen to end up with an assistant who has arrived there by chance and with no training for the unknown events about to unfold.
Effective delegation is quite different from abdication. Genuine delegation implies that tasks are clearly allocated and outlined either to a competent person or to another as part of their ongoing development. What is both in scope and out of scope must be explicit and understood, plus there has to be real supervision at all times. Trust is essential.
The Department of Health’s intention is that these physician associates will be “supporting busy doctors to spend more time with patients, not replace them.” The success of the initiative will in the large part be dependent upon doctors’ willingness and ability to delegate – a skill which has to be learned and practised.
