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Are others concerned about the roles of Physician Associates in hospitals and GP surgeries?

I

ianf0ster

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Many whistleblowers about them making mistakes and doing things they are supposedly not allowed to. such as writing prescriptions.
It's scary that in some GP surgeries and NHS hospital trusts there seems to be a budget for PAs rather than junior doctors - who have over twice the training and yet are paid less than a PA.
For anything non-trivial I would insist on seeing a qualified doctor.

Here is a link to a tweet about safety:
https://twitter.com/x/status/1765337055427485945
 
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I've only had one encounter with a PA and sadly it was not good and another doctor had to sort it out. There will be many things they can do though
 
How are Physician Associates different to the Nurse Practioners?
The latter seem to have been at our surgery for several years now
 
The idea is supposedly to treat simple cases, but they are being used to diagnose undifferentiated patients without having a full medical degree and extra years of experience that a GP would have. Also to substitute on shifts for 'Junior Doctors' - which contrary to what minister says are fully qualified doctors who have not yet become GPs or consultants i.e. in their late 20's and 30's.

Perhaps a bit conspiracy theorist, but some see it as a part of UK governments destruction of NHS and in particular it's fight with the Junior Doctors (though they are fighting nurses, midwives, GPs and Consultants as well).

I think the qualification levels for both Nurse Practitioners and PAs are similar in that they need a masters degree.
The difference is that a Nurse Practitioner actually needs 2yrs clinical experience where A PA needs no clinical experience (or very little whilst doing the 2yr postgraduate diploma or masters qualification recognised by the Faculty of Physician Associates.

From Google:


Are physician associates qualified doctors?


PAs are not medical doctors and are trained to provide care as a PA, with supervision from a senior doctor (GMC-registered consultant or GP).

Physician Associates - St George's University Hospitals NHS ...​


stgeorges.nhs.uk
https://www.stgeorges.nhs.uk › education › physician-ass...



Search for: Are physician associates qualified doctors?

Why become a physician associate instead of a doctor?


Why be a Physician Associate instead of a Doctor? There are several reasons people choose to become a PA instead of a doctor. Typically, it is a fantastic option for those people who are passionate about clinical medicine but prioritise a good work-life balance and are okay with fewer career progression opportunities.

What is the Difference between a Physician Associate and a Doctor?​


medmentor.co.uk
https://medmentor.co.uk › blog › what-is-the-difference-...



Search for: Why become a physician associate instead of a doctor?

Do physician associates earn more than doctors?


(2,3) This means that a newly qualified doctor earns around 34% less than a newly qualified physician associate, despite working more hours. With respect to training and knowledge, a medical student undergoes several thousand more hours of clinically relevant training than a PA over a 5-year study period.4 Sept 2023
 
Personally, I have had to deal with so many harmful decisions made by fully qualified medics that I don't see a lot of difference. I take nothing on trust and do as much personal research as I possibly can. And I always read the leaflets that come with medication. I'm been prescribed some totally unsuitable drugs a number of times.

This is NOT to denigrate the medics that have been excellent and thorough. It seems to be very individual, and I suspect interest, intelligence and logic can prove to be better than any amount of qualifications.
 
The thing about PAs is that they are supposed to be working under the `supervision` of a Registered Medical Practitioner, as are ANPs etc. and are also supposed to be working within their competencies - which means that their `supervisor` should be checking what they do anyway and if the PA is taught to properly document their work then `supervision` should fairly straightforward. As a former Practice Manager and Specialist Advisor at the Care Quality Commission I would have doubts that the supervision is either effectively or consistently carried out by Doctors if the reported horror stories are true. The suspicion must be that Doctors are just letting the PAs "get on with it" and one day when there is a significant error made by an unsupervised P.A. the Doctors will seek to find a scapegoat - or shoot the messenger! We seem to be happy with Advanced Nurse Practitioners taking on more of the doctor roles and being properly supervised so why not PAs??
 
When the idea of Physician Assistants was first floated in the UK (they've been around in the US for years, but the two systems aren't comparable) all these issues were raised. At the time I was responsible for policy on GP training and there was a lot of disquiet in the profession and elsewhere. The contrast with nurse practitioners was drawn - NPs were an expansion of an existing role, giving limited ability to prescribe (etc) in carefully defined circumstances. Practically the NP change worked well - eg a diabetic nurse no longer had to go to the GP to vary a metformin prescription - the NP could take that decision.

However we had never had Physician Assistants in the UK and the role was new and undefined. Some of the stories I've heard are concerning - PAs pretending to be doctors, allowing patients to assume that they are etc. and acting outside the remit of the job. These issues weren't unforeseen, but (if I remember correctly) about 20 years ago the decision was taken to set up training courses and create the role. The decision (in my opinion) was driven mainly because PAs are cheaper than training and paying either a doctor or a nurse.

In principle I don't think there's a lot wrong with the concept, as long as the individual is adequately trained and competent to do the job, isn't given work and responsibility outside the scope of the role, accepts the limitations of the role, knows when to refer to a doctor or nurse, is adequately supervised etc. It seems that this minimum often can't be guaranteed these days.
 
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