How physician associates are strengthening general practice in Te Awamutu

General practice in Aotearoa New Zealand is under sustained pressure, particularly in growing and rural communities. Workforce shortages, rising demand, and an ageing clinical workforce mean many practices are having to rethink how care is delivered.

One response has been the gradual introduction of physician associates into multidisciplinary primary care teams.

At Te Awamutu Medical Centre, five physician associates (Pas) now work alongside GPs and nurses as part of a deliberately broadened clinical model. Specialist GP Dr Alison Glover says the shift reflects a wider reality across primary care.

“We now have PAs, nurse practitioners, GP registrars, clinical pharmacists, specialist practice nurses, nurse prescribers, health care assistants and NZREX doctors. This is a huge team of clinical resource,” she says.

Despite their growing contribution, PAs remain relatively uncommon in New Zealand.

“There are only about 50 PAs in New Zealand. Mostly this is because of over a decade of attempting to become a regulated workforce here,” Dr Glover says.

Within practices that do employ them, PAs work as broad generalists, assessing patients and supporting diagnosis and management within clearly defined scopes under doctor supervision.

Jenna Oppliger, a PA originally from Washington State, says collaboration is fundamental to the role.

“PAs are highly trained to evaluate and treat within their scope, but always in collaboration with a doctor,” she says. “We work as part of the team to ensure safe and effective decisions are made for the benefit of the patient.”

For Tricia Stuart, who trained in Denver, Colorado, working in New Zealand has highlighted the value of a more accessible health system.

“In the United States, there’s a large subset of the population that does not have adequate access to health care and medication, which results in higher disease burden,” she says. “I enjoy providing health care in a more equitable system that tries to take care of as many people as possible.”

In Te Awamutu, the expanded workforce model has become an important part of maintaining access.

“We are in the primary care business to serve our patient population,” Dr Glover says. “Without this additional clinical resource, we would be like so many others and have to reduce our list size and close our books.”

She also points to the longer-term workforce risk facing general practice.

“If we don't support our existing doctors better, they will burn out long before a sensible retirement age, at which stage the training senior capacity will be decimated, like in the UK currently. Let us not follow them.”

Manuel Pompa, a PA from Arizona, says the need for primary care support in smaller communities was one of the factors that drew him to New Zealand.

“When reading and learning more about New Zealand prior to arriving here, I kept hearing of the increase in need for primary care in smaller or more rural communities,” he says. “Coming from a larger metropolitan area, it was easy to feel lost and crowded, whereas practising and living in a smaller setting allows you to be a part of the same community you are treating.”

He also values the balance the move has enabled.

“As an avid photographer and a hobby cyclist, it felt like the perfect place where I could achieve greater work-life balance and have fulfilment in as well as outside of work,” Manuel says.

Nationally, consultation has recently closed on establishing a formal regulatory framework for physician associates in Aotearoa New Zealand. Decisions are expected following consideration of submissions.

For practices already using the model, the focus remains practical, ensuring communities can continue to access timely primary care as workforce pressures grow.