Magic remedy?
Professional decompartmentalization, or expanding professional practices (EPP), is what happens when acts carried out by specific job titles are transferred to, or shared with, other job titles. The concept is not a new one, nor is it new that it’s practiced in institutions.
What is new is the health and social service minister’s determination to make EPP one of the magic remedies that will solve the problem of insufficient staff, as part of his Plan santé (plan to reform the health care system). In fact, he wants to extend EPP to close to 20 professions.
While EPP does unquestionably have its good points (such as increasing professional autonomy, fostering interdisciplinarity within work teams and providing service users with better access to care), it can also have negative effects on workload.
It’s all about getting the dosage right
When tasks are shared between two job titles, that can sometimes reduce workload. Which is a good thing! But sometimes it has the opposite effect, and that’s why we need to pay attention. Three scenarios are common:
- Non-specialized tasks are added. For instance, a medical technologist is assigned mainly to planning digitizations or calling service users.
- Specialized tasks are added. For instance, professional or technical employees are asked to carry out specialized tasks without appropriate training, or, when they do have the necessary training, are required to restrict themselves exclusively to the most demanding tasks of their practice.
- Supervisory tasks are added. For instance, a qualified technologist is assigned supervision and training responsibilities for employees with job titles under expanded professional practice, who are acting as reinforcements.
When the solution becomes the problem
Our members don’t share the minister’s enthusiasm for the virtues of EPP. Many are already experiencing an increase or intensification of their workload because of EPP, according to an extensive survey carried out among 4,000 APTS members.
The same survey showed that a majority expects EPP to have a negative impact on workload, even if some benefits are acknowledged (particularly in terms of interdisciplinarity and access to care). And only 4 people in 10 think that EPP is needed to reduce workload.
In any case, EPP will certainly have consequences, both positive and negative – and if the minister gets his way, these consequences will be here to stay. We need to be vigilant, because the pressure on the ground to implement EPP will be significant.