Breast doctors losing turf war, says pioneer

Pioneer breast physician Jackie Blue says the Medical Council will destroy her profession if it removes recognition of breast medicine as a specialty in New Zealand.

Dr Blue, who became the nation's first breast physician over a decade ago before she became a National Party MP, said she was "incredibly saddened by the territorial turf protection by some - not all - radiologists".

The breast radiology section of the Royal Australia New Zealand College of Radiologists (RANZCR) had recorded in its minutes that it basically wanted to close down the breast physicians group, Dr Blue said.

Some radiologists who worked with breast physicians in multi-disciplinary teams understood the benefits, but those who hadn't worked with breast physicians were "very negative".

"We haven't been able to get into hospital breast clinics: they've blocked it. Or, if we have, we just been doing tokenist work - we've not been able to use ultrasound [on patients]."

The Medical Council divides doctors into three broad areas of practice - general, vocational and special purpose - and recognises breast medicine as one of 33 vocational scopes of practice. But now it wants to revoke that status as a separate area of medical specialisation.

In a consultation paper mailed to doctors on Friday, the council said that the Australasian Society of Breast Physicians (ASBP) representing the NZ specialists did not provide robust evidence of improved patient outcomes when a breast physician was involved, and there were deficiencies in its training programme.

"The council is proposing to revoke the vocational scope of breast medicine."

A re-accreditation review panel - comprising a radiologist, a general practitioner, and a lay member - has said the specialty's "defined body of knowledge" overlaps with other specialties, including radiology, gynaecology, and surgery.

The nation's breast physicians will no longer be recognised as specialists and will have to revert to registering in a "general scope of practice" if the existing recognition is withdrawn.

Breast physicians worked in multi-disciplinary teams in Auckland. "In the rest of New Zealand, patients are managed within similar multi-disciplinary teams, but without a breast physician," the council said.

Revoking their status might limit breast physicians to diagnostic and interventional radiology, or obstetrics and gynaecology or general surgery.

Dr Blue campaigned for five years for the Medical Council to officially recognise the special nature of her profession in 1999.

"My work as a breast physician was new and threatened traditional medical models," she told Parliament in her maiden speech as an MP.

- NZPA