To put that I don’t want to be treated by PAs in my ELCS birth plan?

That is scandalous.

PS PAs are more expensive than doctors

@Calamitousness but F1/2 face unemployment because of PAs. Are losing training opportunities yet have to sign their prescriptions for them. Can you not see why they might be a bit angry at the situation,

What does a PA do that a doctor can't ? Because we have enough doctors, we don't have enough jobs for them.

Med Twitter is toxic right now. It’s all I use Twitter for, it used to be a good professional forum but right now there is one FY doctor who is absolutely unprofessional and ruining all sharing and learning opportunities. I’m not the biggest PA fan but at the end of the day neither would I refuse care in a public system where there may be no other option. And I do think that doctors don’t need to do everything. There is a role for PA’s in healthcare.

Quite frankly, given the headlines about maternity care in the UK this week, the thing that is making me the least angry is PAs.

https://www.bbc.co.uk/news/articles/c4n1jv7xxpwo

@onlyyarrknhe and if that was what they were doing it would be fantastic. But instead they are often pretending to be doctors, taking their training time and needing the doctors to prescribe for them.

The original job scope makes sense if it was supposed to be 'progression' for other HCP. These days however those paths themselves have so many advanced routes, PA is irrelevant.

It makes sense for PA's to do the admin and provide more patient face time in place of a GP or other HCP. Routine things like taking blood etc fair enough.

Not replace doctors. If anything, I'd rather be seen by a nurse not a PA.

@Pinkfluffypencilcase v few ex nurses or other healthcare staff choose it now. And the ones that do comment on the lack of decent training. It's a plan that seems to have gone v v wrong. Really feel for those PAs who don't want to play doctor and really do want to assist them instead. They do exist but are over shadowed by the ones who replace doctors in clinics, surgeries and GPs.

www.mirror.co.uk/news/uk-news/nhs-plans-physicians-associates-8-32492871

www.telegraph.co.uk/news/2024/03/30/physicians-associates-qualify-courses-degrees/

Many F2 doctors have no jobs from August. Many incoming new doctors don't know where they are going in July. But hey, PAs can rock up, work 9-5 (don't do nights) and earn 30% more than a doctor. After 18 months 'training'.

But, they can't move abroad as no one recognises their qualification.🤔

Agree with this. There’s a gap and the govt are pushing a short sighted solution.

I think PAs originally would have a narrow field of expertise. And the original PAs were former nurses.

What I disagree with is the unregulated nature of their role. And that their conditions and pay are better.

A lot of the PA defenders on this thread don't realise that there are other HCP who have far more training and qualifications than PA's .
An advanced nurse practitioner as you stated is one, paramedic prescribers,speclist nurses, advanced clinical practitioners, etc.

The main problem with PA's is, apart from the lack of training etc is the push to employ them over GP's. Practice funds are being squeezed and there's ring fenced funding to employ them the former.

www.dailymail.co.uk/health/article-12630607/amp/NHS-blunders-prompt-call-stop-physician-associate-recruitment.html

And there are NO GP shortages. There are unemployed GPs because the government prefers to fund PAs. We could have thousands of extra GPs tomorrow.

www.bma.org.uk/bma-media-centre/bma-calls-for-independent-investigation-into-hospital-trusts-replacing-doctors-with-physician-associates-on-medical-rotas

@wednesdayaffairnc they are in some hospitals. Torbay being one.

@Neverpostagain yes they do, some have even killed people. And the doctors were blamed for not supervising (Google it). BMA now issued guidance so doctors can say no to prescribing for patients they have never met.

They DO work unsupervised in some hospitals (Cornwall, Birmingham are 2). There's one doing unsupervised endoscopies in Cornwall - he even has a van to go mobile. On his own.
Just because 'you've not come across them' does not mean they don't exist.

And they do not need a degree in science. So could do 3 years English and then 18 months PA and off you go. I'll find some evidence when get a minute. It's all frankly terrifying

Seriously physician's associates do not act as anaesthetists or surgeons. They just don't. These stories are pure scaremongering.

@OneFlakyReader Even healthcare experience isn't necessarily going to be a nurse or paramedic though I can see both of those would be good foundations. It could be a few weeks as a HCA as to a homeopathy degree....
Personally I am very happy to see an advanced nurse practioner as they are highly skilled and experienced. I'm afraid I would not trust a PA other than to complete paperwork or take bloods.

We don't have PA's in maternity at my unit. It's kind of an accepted thing that there isn't really a role for them in obstetrics.

I read that article and it says accepted with healthcare experience. So they’re not without a skill set.

You can get onto a nursing degree from any level 3 course.
So it’s not a big surprise that experience is accepted.

Hey,

for those saying PAs must have a life science or science degree

https://www.telegraph.co.uk/news/2024/03/30/physicians-associates-qualify-courses-degrees/

having a science degree in itself does not count as training towards human anatomy physiology, pathology and pharmacology that makes up the science of medicine.

An intelligent person with a pHD in fungal mechanics and propagation (for example) will be no further forward in their understanding of medicine.

PAs learn ‘medicine’ at a superficial level with multiple choice exams that have a 100% pass rate nationally, and much less stringent entry criteria (all medical students must achieve top marks at school to have a chance to get in to medical school).

there is already a fast track medicine route known as graduate entry medicine where the medical curriculum is condensed into 4 years. 2 years is simply not enough to have a reasonable grasp of the complexities of the human body. It does not help that PAs are consistently told they are studying medicine. The degrees are not comparable as attested by the few PAs who completed their degree and went on to study medicine.

there are tensions as PAs with far less training and skill are being used to replace doctors, getting preferential treatment, and getting paid £11k more at starting salary. Indeed it takes junior doctor up to 7-10 years to out earn PAs, presuming a PA doesn’t move up the pay scale.

if junior doctors are losing training and career opportunities, this eventually means fewer, and less well trained consultants in the future.

i have been following med twitter, and appreciate their frustrations

Can you give a link to what you are reading?

This is what I was thinking. I wouldn’t go with such rigid plans, I think birth plans are pointless anyway I’m not doing one.
PAs have specific tasks they’re trained to do. The issue is they’re expected to cover tasks that should be done by doctors.

Great, another PA bashing thread. Just what’s needed.

YANBU to make whatever birth plans you feel you need to, but you can’t denigrate an entire profession - most PA’s are extremely thorough and dedicate themselves to their work and their patients. I’ve seen some REALLY shit doctors. Dangerously shit. I’ve seen some amazing PA’s, and some not so great. It’s impossible to make blanket statements and generalise.

PA’s have their place in the NHS. What’s vital is that patients understand who is treating them (onus is on the individual PA to be clear and honest) and that without exception, they must work within their defined scope of practice.

It depends what the PA is meant to be doing surely?
We don’t currently have PAs where I work but every now and then we have a woman turn up who will want a consultant doing everything for her and doesn’t “consent”
to any care from junior docs, midwives, HCAs etc.
Obviously we aren’t able to facilitate/indulge that so the women are informed they won’t get care.
I imagine if they have a PA doing a regular, routine task, like doing everyone’s bloods, then you will get a similar answer.
Or women saying they’ll only accept a consultant doing their ELCS, or even only accepting a consultant with x years experience? Obviously they’ll be told that can’t be facilitated if a a SpR is doing the list that day. The hospital decides who can do which tasks and that’s who’s on to do if. You can’t demand they don’t do it any more than you can demand the head of Medicine come down and do your BP?
You can decline care from anyone of course but that will often mean you don’t get the care rather than you get someone else.