To think Physician Associates are (mostly) a false economy?

I would always ask if unsure whether the medic I was seeing was a doctor or a PA.
This is really concerning.Why is the NHS hiring fake doctors.

Yes, complain to the practice manager. PAs are unregulated, there’s no one else to complain to.

It would help if we complain to practice manager every time something like this happens so they have evidence

I had a similar experience. After finally getting past the PA the GP referred my child urgently to paediatrics and we were seen that week. The PA caused this to be delayed by 6 weeks by just hearing the words "diarrhoea" and thinking acutely. If only we were given a GP appointment in the first place. I'm not sure how to even avoid such situations. I was very clear when I made the appointment my child needed a GP appointment, but we turned up and it wasn't.

@Amermaidandaman I agree with you. The point I was making is that a 30 minute PA time (plus the signing off from her supervising GP) costs much more than 10 minutes GP time. Sadly, this Tory government is short sighted and pushing for expediency. PS glad you’re better.

My main symptoms were dizziness and tiredness - plus a heap of work related stress that was causing me to feel depressed. She picked up on an ear infection even though the ear pain wasn’t that noticeable, treating that resolved the dizziness and lifted some of the doom I was feeling. I actually returned to work before my fit note ended.
The blood tests revealed iron and folate anaemia which I’m being treated for and my thyroid test indicated secondary hyperthyroidism which requires investigation from an endo.

A rushed, overworked and dismissive GP didn’t have the time to listen he just heard work stress and tried to fob me off. The PA did, and I’m already feeling better and hoping a few more weeks of tablets will help. I don’t think less qualified medical staff is the answer, but I think relieving some of the pressure on GPs has got to help, since they are already dangerously under resourced.

We do have PAs in Scotland. I had one taking blood for blood cultures when I was recently an inpatient. She already had a degree in Biomedical Science and admitted becoming PA as a next best thing to studying Medicine. She didn't attach the dressing properly and left blood gushing from my arm. Wasn't impressed.

@Amermaidandaman it would be interesting to know what the outcome of the 30 minutes with the PA, loads of blood tests, telephone call for follow up and Endo app is vs the previous quick appt with the GP and his advice for fresh air. The result may well be the same after you’ve seen the specialist. Also, imagine if the GP did have 30 minutes with each patient. Also, how is a 30 minute PA time less than a GP’s 10 minutes? It isn’t. PA salary 60K pa vs GP 80K full-time, or thereabouts.

My gp surgery seems to have a good system.
There is a GP in one office and 2/3 PAs in consulting rooms. The PAs take the appointment and then pop into the GPs office and run through/get prescriptions signed.

Ive had scenarios where it’s all gone as the PA said, times when the GP has popped in to check something herself or when the plan has changed after they have spoken.

I recently had a 30 min face to face appointment with the PA, went through piles of stuff with her and came out with a fit note a prescription and an appointment for a load of bloods. She diarised calling me back when the results would be in which she then followed through with and I now also have a referral to endocrinology.

I saw a GP a week before for virtually the same reasons and was offered antidepressants and told to get out in fresh air a bit more. I was so rushed that I didn’t mention the ear pain (that needed antibiotics) and he completely dismissed my concerns about my thyroid based on 6 month old blood tests, which the new ones have now flagged as out of range.

@Flossflower but the PA didn't prescribe you the antibiotics......because they can't legally prescribe anything! So same argument the gp had to be involved anyway

Yes, in general, it is a false economy. They don’t have the training, experience and authority to make decisions in the majority of cases. OP Your case illustrated the uncertainty, duplication of effort and waste of money. Regardless, end result will be a referral to the breast clinic…now or in a month. Might as well just self refer in the first place and miss the primary care step.

A physician associate missing breast cancer in a patient will potentially cost the NHS a lot more than the £36 you say is the cost of a gp appointment. Delays in referrals cost money but also a poorer outcome for the patient, though hopefully not in your case OP. It’s not as if we have great outcomes in this country to start off with.

I’d want to be either examined by a GP or a specially trained nurse, not someone who has had a mere two years training and not very much experience.

Yes US give better imaging in younger women than mammograms. Also certain types of lumps like cysts will be well imaged on US.

I took a referral from a PA today . They had not asked vital questions that a doctor would have known to ask.

Incompetent reviews are a waste of time. 10 years ago , we would have demanded that a competent person see the patient before they waste time and resources travelling to hospital . Now you just accept whatever care was provided. It’s rubbish . PA s need to be assistants not substitutes.

Ah ok, yes I’ve heard some women ( often also younger eg under 45) don’t suit mammograms well because they have denser breast tissue

I’m wondering why you don’t need a mammogram, rather than an ultrasound?
also, sometimes nobody can feel the lump for early breast cancer.
But also, most breast cancers do not present with pain.

@LuluBlakey1 that’s horrendous. Your poor aunt.

OP I don’t think you’ll get a referral for a US for a breast lump. You might get referred to the breast clinic, and that’s where they might do the scan. AFAIK referrals for breast US tend to be rejected otherwise.

I have two DNs in medical school atm. I love them to bits and they’re super clever girls, but nowhere near being able to diagnose etc after 2 years. And yes, I know PAs do 2 years after a first degree, but that’s not a medical degree and it’s not enough.

GP surgeries employ them because they are funded differently and not paid by the GP surgeries. £ free work and some will be ok or very good.

I am really shocked- both by what you say and by my ignorance of this. Is this a Tory thing or was it an issue pre-2010?

Yes, that’s exactly what is happening.
these are not ‘student doctors’ though, which sounds like they are still in university studying medicine. These are fully qualified doctors who have their MB BS degree and have completed 2 foundation years minimally. And yes, thousands have been turned away from GP and hospital specialty training. Because the government chooses not to fund them.

PAs are a complete waste of time and are being used as a temporary fix by the tories to massage the GP appointment crisis . Meanwhile actual doctors can't get GP training posts .

It’s likely the PA debriefed with the supervising GP and said they couldn’t feel a lump. The GP, being fully responsible for the PAs actions, decided they needed to check themselves as they didn’t fancy a law suit.
One of the problems with PAs is that they aren’t regulated, unlike all other associated care professionals.

Whenever I read or hear about other surgeries I just can’t believe how lucky we are with ours. Always seen a GP same day for urgent and within the week for non urgent. Granted we don’t use it loads.

I’ve never heard of them or encountered one. What’s the idea behind it?