To expect to be examined and diagnosed by an actual nurse or doctor?

[Cravela]

Stomach pain came on suddenly and worsened over 24 hrs. Telephone appt with GP who advised hospital and sent me to the surgical assessment unit. So far so good

Staff member arrives in scrubs and takes all my details and then starts examining me. Tells me the plan (CT scan) and that she will give pain killers in the meantime.

Noticed she wasn’t wearing a lanyard/badge so I asked her her name Dr?. She says oh I’m not a doctor, ok so you’re a nurse? (No issues with that always choose to see an advance nurse practitioner when I go to the GP and I have a friend who is a consultant nurse). No she says she’s not a nurse. I was getting quite frustrated at this point because she was clearly avoiding just telling me her job role. So I straight out said can you tell me your job role please. She said she was a “physicians associate”.

I’ve never heard of one before so I googled after she left and literally anyone can be one after a 2 year course. They don’t come under the GMC or the nurses governing body and aren’t able to prescribe medicine or diagnose people??

I asked the nurse in charge if I could see a doctor or a surgical nurse and they came 10 mins later. Doctor was quite apologetic and re-examined me.

AIBU to think if you aren’t a doctor or a nurse you should tell people that before you put your hands on them??

Well yes, I assume what happened is that she was assigned to you but the doctor.
She examined you to make sure that you weren't urgent then she explained the plan for you. CT and pain relief. She was acting as part of the team to ensure that you didn't get left on your own for hours without knowing what was going on.
Her only real mistake was that she didn't have id or explain who she was properly to you and was evasive when you asked.

According to NHS careers PAs have to have a Bioscience degree, then a further two years postgrad training, or a four year integrated masters. That sounds pretty rigorous to me! Certainly I'd say equivalent to nursing degrees.

If you're not bright enough and dedicated enough for med school, you have no business assessing and diagnosing patients. It's unsafe. Medical school is hard - that's the point.

Cheap "noctors" benefit the government and endanger patients.

That's nasty. Presumably you also look down on nurses who weren't bright enough for med school as well? How do you feel about PAs who were bright enough for med but chose something else?

Nurses are far cheaper than PAs btw.

@Theheartandtheshape did a PA piss on your chips or something

Not sure why the GP didn't see and examine you, they may struggle to make an appropriate referral otherwise?!

A PA (physician associate) are sore point. They train for 1 year at uni after doing a science based degree then claim to be as experienced as us. They only work 9-5 and get paid more than us too! Welcome to the NhS.

Not enough doctors. So they make up a role to plug the gap.

The government refuses to fund medical school places

And while I agree with this to an extent, the NHS also needs to make more F1 vacancies - most years there are newly qualified medics with no job. No point the Gov funding another 1000 med school places if that leads in five years time to 1000 unemployed medicine grads.

Tell me about it 🙄

In our trust they tried to improve relations by getting the PAs to present their job role to the doctors. Claimed they can manage all sorts of conditions including neurological emergencies 😂

I think the talk just made things worse. Try giving us fair pay for our skills rather than adding under skilled workers in the mix and paying them more than us!

They are basically triage as they can't prescribe and cant order radiation imaging 😂 as experienced as FY2 they claim- i think not!

They are highly trained and the course is extensive. I was a PA in another country and the entry requirements (after completing a 4 year bachelors degree) are extremely high. The just ‘2 years’ masters degree (U.S.) included the same classroom hours as a 4 year medical degree at that time and there was almost no time off. They are often used in roles at the same level as an ANP or nurse practitioner, the difference being the model of which they are trained.

They aren’t commonly used in the UK as the push back from doctors has been huge as they are viewed as failed doctors/job stealers but this isn’t true at all and one of the reasons I don’t work as one here. I think they would help with the significant pressures on NHS if utilised. But I do see where the confusion would be in terms of role.

@Theheartandtheshape like ANPs, they can follow a strict protocol or guideline, but they don't have the intelligence and broad based medical education to think laterally

This is really rude and untrue. I can't speak for PAs as I have no experience of them (outside watching ER), but I've worked with some fabulous ANPs who outclassed a lot of the junior doctors within their own specialty. They're independent prescribers so of course they're intelligent and have gone through quite intense post-grad training.

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Some really horrible posts on here
I’m a Sonographer and I make diagnoses but I’m not a dr. Do I have no business being near patients? I’ve done years of post graduate training courses / university courses to get to my skill level. I’ve never met a PA but given the shortage or drs they can only be a good thing as a support service

A Physician's Assistant is a seriously qualified role. It's between nurse and doctor. Very common in America but just coming into being here. YA deeply U.

Wow @Theheartandtheshape you sound seriously insecure about your role (assuming you are a doctor? If not you have no place making such sweeping statements!). And very offensive to other professionals too. Poor multidisciplinary communication, as often happens when doctors have their heads shoved up their own arse, is also a massive patient safety risk. As I’m sure you must know given your superior intelligence…

I've been seen by one. It seems to me to be a totally pointless role. They can do less than a nurse would do!

they don't have the intelligence and broad based medical education to think laterally

Most obnoxious post of the day award.

This

Physician associates are trained (with a background in health care) and are eminently capable of doing the basic assessments to provide your doctor/hopsital consultant with readings, data to monitor and triage your your condition. As are paramedics etc

I've heard of physician associates and even the students I teach have heard of it and some are considering it as a career in the future. YABU. There are so many allied health professions in a hospital that do an important job - not just doctors.

I think this reply shows a lack of understanding of ANPS and nurse consultants. Usually ANPS and nurse consultants have decades of hands on clinical experience within their scope of practice . ANPS are intensively trained to MSc level and nurse consultants have a PhD! It’s not about nurses trying to ‘play doctor’ it’s about highly experienced and trained individuals developing and extending their scope of practice to fit the need of that area.

Like it or not, clinical roles will develop and change over time- PAs worry me though as they are normally young science graduates with little hands on clinical experience.

@Theheartandtheshape Do you need some salt and vinegar to go with that massive chip on your shoulder?

It's cheeky. Sounds more like a glorified clerk. Stomach pain can be extremely serious.

YABU they’re doing a job they’re qualified for, why is that a problem?

they should’ve had a name badge and introduced themselves though

Your wrong about physicians associates. My niece is one and spent 5 years at university. To qualify as a doctor she needs a further 2 years at uni.
So get your facts right before you assume that these people have no qualifications

This. And they will be regulated by the GMC they are just setting out parameters at the minute.

This is one of the most ill-informed posts I've read in a while.

I don't know much about PA training. But I know plenty about ANPs and to be an ANP you are educated to a higher level (normally MSc) and trained and assessed to diagnose and prescribe. Scope of practice will vary for ANPs in clinical areas, but they are not failed doctors or pretending to be one.

I can diagnose and prescribe, but my scope of practice is older adults (so I would not be competent to diagnose I and prescribe for a child), but there are plenty of ANPs who work in GP surgeries and minor injuries units who are skilled and competent in diagnosis and registered prescribers for all ages. And have to evidence that competence on a regular basis.

For OP - that PA should have introduced herself, so YANBU from that point of view, and it would have also given you the option to ask about her role and whether she would be outlining a treatment plan or not.