A few years ago, a private cardiology clinic approached me with a request to train one of their medical receptionists to become their new pacemaker “technician”. While I appreciated their recognition of the need for specialised training, this request felt akin to asking a high school graduate to train and practice in a specialised field of law, ignoring the pool of law graduates eager for the role. Recent events have made me reflect once again on that experience. Here are some of my Autumn Quarter thoughts:
Addressing Government Responses
The government aims to reduce reliance on industry for workforce labour, ensuring compliance with the established international standard of care in both public and private sectors. The practical implementation of this goal is a pressing concern, because the loss of one workforce opens up real vulnerabilities. Cardiologists will need to consider employing and compensating their own staff appropriately. The notion that a receptionist or “one of our nurses” can do that (despite a shortage of nurses) should not be the only perceived solutions. We have immediate concerns about patient safety, as there is nothing preventing a cardiologist from using an unqualified individual to fill in for the (possibly highly qualified) company representative who can no longer attend, paying them cheaply instead of ensuring proper compensation for skilled professionals. There is a better solution, but it involves a collective commitment to quality care.
Regulation and Progression of Cardiac Physiology
Alarmingly, among the five Cardiac Physiology modalities, only Echocardiography has safeguards in place to prevent unqualified, unregistered, and potentially incompetent staff from practicing (albeit far inferior to AHPRA’s safeguards). Although a “supervising” cardiologist is legally responsible for procedures performed by Cardiac Physiologists, this oversight alone is insufficient to ensure patient safety.
As technology becomes increasingly complex, it is imperative to advance and regulate the Cardiac Physiology workforce. The technical expertise required in certain focused areas of cardiology now often surpasses the knowledge base of many cardiologists. Therefore, it is crucial to adopt a multidisciplinary approach, empowering Cardiac Physiologists to advance their practice and more comprehensively support their teams. There is huge potential for progression of all five cardiac physiology modalities.
We must do more than just hope for a better future
It is imperative that the voice of Cardiac Physiologists is included in workforce planning at a government level and that we lead conversations about competency, scope of practice, and regulation. As the private sector moves away from reliance on industry and towards a more appropriate labour model, we especially need to fully engage in supporting the existing and future cardiac device workforce, including industry-employed Cardiac Physiologists who will continue to play an essential internationally accepted role.
Advocacy and Actions Over the Autumn Quarter
Advocacy and Leadership
Over the autumn quarter, PiCSA has been actively advocating for the profession and providing strategic leadership to advance our field. We have shared our Entry and Career Pathway document extensively as a practical guide for employers and workers regarding training, remuneration, and regulation. This document serves as a resource to guide appropriate employment decisions, such as hiring science graduates rather than receptionists for cardiac physiology roles. We have also proactively supported current research efforts that will directly impact protocols and service funding. Collaboration with our sister professional associations in respiratory, neuro, and sleep physiology has been a focus, fostering shared interests, values, and goals, and promoting our shared registry of accreditation, the ACCP (the ACCP fills the gap for Cardiac Physiologists not covered by ASAR).
Engagement and Visibility
We continue to maintain visibility with multiple organisations, including ASA, ASAR, CSANZ, MTAA, Hearts 4 Heart, our New Zealand counterparts, and unions, regularly inviting feedback and collaboration. Educational content has been a priority, with webinars and newsletter articles, including a fantastic social event for Australia’s National Cardiac Physiologists Day (May 21st), celebrating our profession and building a sense of professional identity and community.
Strategic Development
Our strategic plan and constitution are being redrafted, and we are supporting a new educational pathway for Cardiac Device Physiologists (details yet to be announced). We have initiated work on scope of practice and competency assessment documents and continue to flag current challenges such as disparities in pay, variation in scope of practice, difficulty accessing education or competency assessment tools, and lack of employer support for paid continuing professional development. Through these efforts, PiCSA remains dedicated to promoting the highest standards of practice in Cardiac Physiology, advocating for the profession, and ensuring patient safety in an evolving healthcare landscape.
To our PiCSA members, thank you for your membership. As a volunteer organisation, we rely on our membership numbers to validate our authority as the voice of the profession, and to fund our activities. Your input as a voting member is crucial in guiding and directing our activities. If you are an Australian Cardiac Physiologist who isn’t yet a PiCSA member, please consider joining us by signing up at https://picsa.org.au/join Employers can also contact PiCSA to negotiate a discounted membership rate (group discount) for eligible staff working in ECG (non-invasive), Cath Lab, Echo, Cardiac Devices, and Electrophysiology.
To our other readers, thank you for engaging with this “From the Chair” newsletter extract. PiCSA’s mission is to promote a commitment to excellence in standards of clinical best practice, provide resources for ongoing continuing education of our members, and raise the profile of cardiac sciences both within and outside the profession. We hope you will continue to follow our journey and engage with us in supporting cardiac care throughout Australia.
Warm Regards,
Miriam
