Several questions remained unanswered in the ambitious, politically motivated study reported by Jedro et al (1). They did not discuss what a medical lay person even knows about the job and medical qualification of allied health professionals. A considerable number of patients assume, for example, that the entire staff in a pharmacy consist of qualified pharmacists (results of our own sample-based patient survey, data not published to date). Many are not aware of the difference between pharmacists and pharmaceutical-technical assistants, or they are indifferent to who provides them with even medical advice in the pharmacy.
This undoubtedly questionable trend in analogy almost casually explains the increasing readiness of patients to be treated by allied medical professionals for certain “minor illnesses” (although I am not sure what that actually means) completely, without any accompanying contact with a doctor. This supposed alternative should be discussed critically and should be thought through in great detail.
In Germany, the legal profession is comparable to the medical profession, but similar models of delegating legal tasks to paralegals have—quite rightly—not been discussed even though the work volume is probably similar. If a delegation model is adopted at all, this should apply only in well argued exceptions and within closely defined limits, provided the allied health professional is subject to strict quality assurance and technical supervision (2). But even so, many essential questions—relevant not only in the health insurance setting and the legal framework of billing—remain unanswered. Furthermore, rather than delegating medical tasks to allied health professionals, a far more professional solution, especially with the focus on patients, would be to relieve doctors again from the obviously politically favored, permanently increasing documentation and administration tasks and let them return to meeting their genuine medical responsibilities.
Prof. Dr. med. Dr. rer. nat. Michael G. Haufs
Facharztpraxis für Dermatologie, Arbeitsmedizin, Allergologie und
Conflict of interest statement
The author declares that no conflict of interest exists.
The authors of the article have declined the opportunity to respond.
|1.||Jedro C, Holmberg C, Tille F, et al.: The acceptability of task-shifting from doctors to allied health professionals—results from a representative telephone survey of members of the National Association of Statutory Health Insurance Physicians. Dtsch Arztebl Int 2020; 117: 583–90 VOLLTEXT|
|2.||Mergenthal K, Leifermann M, Beyer M, et al.: Delegation of GP work to qualified medical staff in Germany—an overview. Gesundheitswesen 2016; 78: e62–e8 CrossRef MEDLINE|