Nurse with Doctor's Rights? Reform Raises Concerns Among Physician Assistants

In search of a solution to improve the healthcare situation, the Ministry of Health is considering, among other things, the possibility of expanding the professional duties of nurses, writes Diena.

Industry representatives fear that this may mean the abandonment of the physician assistant profession and their replacement with retrained nurses. However, the Ministry of Health emphasizes that both specialties will be preserved.

The draft amendments to the professional standard, which grants nurses competencies similar to those of doctors, has also raised objections—here, the Ministry of Health is criticized for not conducting discussions with stakeholders.

According to statistics, there are 121 medical workers per 10,000 residents in the EU, while in Latvia, there are 73; the number of practicing doctors in OECD countries and Latvia is comparable (3.7 and 3.4), but there are half as many nurses (9.2 and 4.2). The number of hospital medical staff per 1,000 residents is also lower (14.8 and 11.45).

Until 1993, Latvia trained paramedics, but the profession was eliminated in hopes of attracting nurses to ambulance teams, which was not realized. In 2004, a new specialty—physician assistant—was created to ensure the operation of emergency services, said Sandra Akmane, deputy head of the professional society of physician assistants of the Latvian Ambulance Service, at a meeting of the Saeima subcommittee on public health. According to her, the competencies of physician assistants include diagnosing and treating the most common diseases, prescribing medications, conducting preventive measures in conjunction with doctors, including cancer screening and patient education, as well as certifying death. They are required to participate in the aftermath of emergencies and in medical support for military operations.

Currently, there are 4,366 registered physician assistants in Latvia, of which 2,660 are practicing; in areas where access to a family doctor is difficult, these specialists provide assistance to the population (125 practices: in Latgale - 50, in Kurzeme - 25, in Vidzeme - 44, in Zemgale - 6). Akmane emphasized that in the current geopolitical situation, it is important to strengthen this profession and prevent its reduction. However, Sven Henkuzens, Deputy Secretary of State at the Ministry of Health for health policy, noted that the Ministry's strategy places greater emphasis on the development of the nursing profession.