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Could GPs Order Diagnostic Procedures Directly In New Zealand?

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According to New Zealand's health minister, Tony Rayall, The GPs in the country will be able to order MRI MRIscans for millions of their patients without having a need to go through a specialist first. Mr. Ryall told Radio New Zealand on Wednesday that the Government is discussing allowing GPs direct access to MRI scans.

Nine expressions of interest (EOIs) were designed to deliver "better, sooner, more convenient" primary healthcare have been shortlisted and waiting for Government approval and implementation. Among these EOIs are three proposes involving the use of MRI scans as part of a package of diagnostic procedures that GPs would be capable of ordering directly for their patients. The EOIs from the Greater Auckland Integrated Health Network (GAIHN), the Health+Alliance and the Wairarapa Community PHO are examples. According to the GAIHN project, GPs throughout greater Auckland are going to have the ability to directly order MRI, CT and ultrasound scans, in addition to traditional x-rays and other diagnostic procedures, without having a need for the current specialist review and authorization. The GAIHN network is covering 1.25 million in Auckland. GAIHN's business case reported that "This process will provide earlier diagnosis, faster access for patients and more appropriate use of specialist time," Adding "General practice will order diagnostic tests within a framework in which they are fully aware of the cost and of their responsibility to work within a constrained resource environment."

On the other hand, RNZCGP President, Harry Pert, is strongly supporting the new suggestions of allowing registered GPs freely access to diagnostic procedures, as he mentioned that such registered GPs are somewhat specialists themselves. Pert said "As more and more work is going to be delivered in the community by specialist generalists, we have to be able to have appropriate access to diagnostic tests so we can do our jobs effectively," However, the new Government's plans are not always supported by everyone. For example, Helen Moore, an Auckland radiologist, said that allowing GPs to order MRI scans directly is going, eventually, to increase the costs of the procedure in New Zealand. Dr. Moore added that while ordering more MRIs will save extra lives, for every life saved the country will find itself paying for many more scans that are requested with no clinical outcome and are considered improper. She commented about GPs "I'm sure many would do a fantastic job," she explained "But whether you have an outcome that's useful…is a completely different story."

Yet, Lannes Johnson, a Waitemata GP, thinks that allowing GPs to directly order MRI scans and other diagnostic procedure is a welcomed and positive change that was long requested. He said "We have been asking for this for years," he added "I'm all for it and I don't think there are any negative aspects to it at all."


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