The role of the ATSIHP

One of the things that I’ve noticed about working in the NT with the Aboriginal and Torres Strait Islander Health Practitioners here is they have a really different range of practice and range of skills to the people that I was used to working with when I was in Victoria. And I understand that’s both historical - that health workers especially in remote communities were expected to take on really quite significant clinical roles, even at times running clinics entirely independently – but also the training and competencies here and what they’re both allowed to do and expected to do is quite a bit of a bigger range to what I was used to.

I was talking to someone else who has also worked a fair bit in Aboriginal health about how, well, when we realised that the health workers could take blood for us we were very excited that someone else could take blood and I thought that was a great clinical skill. But actually they found that a bit irritating because they have lots more skills than that simple, very practical physical skill. And I have heard stories of people being involved in planning whole of community health programs for things like dealing with scabies, or nutrition, or getting, improving childhood vaccination rates. They actually do that as part of their basic training; it’s a core skill.

The role of the ATSIHP

To the best of my knowledge most Aboriginal health services, certainly in the Northern Territory, have what we describe as a Health Practitioner First Policy, that is, that when clients come through the door, the first people that they will see will be the health practitioner.

This is somebody who has professional skills, qualifications and training, and whilst they do some fairly standard and routine types of the health checks and assessments, it’s an opportunity for that person, particularly if it’s somebody that they know or doesn’t have good language skills or who may not be familiar with the health service or with the doctor. To be able to get a lot of that very personal and individual information if you like, so that those notes can be made in advance of that client seeing a regular GP or a Registrar.

So it’s a way of trying to provide a better level of better level of information to the GP, to the health professionals, so that the care that can be provided is actually appropriate and relevant, but it also is an opportunity for the GPs and Registrar to communicate back with the health practitioner about saying, look, it would be really helpful if you could explain to this client you now the medication that’s going to be prescribed, or the procedures or the tests that might need to be conducted and having that conversation with that particular client, so they are much better informed and so that people can make informed choices and decisions about their health care options.

The role of the ATSIHP

I think sometimes GP Registrars who haven’t worked in an Aboriginal health service or with Aboriginal Health Workers* don’t really understand their role very well. Quite often it’s misconstrued our role is misconstrued as being dare I say this but as the help in the place... and that can be really really offensive.

Not only because it doesn’t - not only is it disrespectful to our profession... from a historical perspective particularly when you go back to the protection days you know when the stolen generation... were removed and people were put in homes and... they were often then sent out as domestic servants and things like that so from a historical perspective we actually see that as really really offensive and yeah so...

If you don’t know anything about health workers – go and sit down with them and ask them... just be quite honest - look I haven't worked with health workers before I’m just interested to know what what is your role and what sort of things can you do?

* Note: You will often hear people use the term Aboriginal Health Worker (AHW) when refering to an Aboriginal and Torres Strait Islander Health Practitioner (ATSIHP). For more information see: Difference between ATSIHPs, AHPs, AHWs and ACWs.