Physician associate… should I report? Yes or no?

[Elsie256]

phoned my GP to book an appointment, was told by reception I’d be seen by the emergency doctor covering.

i’ve really been struggling with really back pain and weight loss and was so grateful to have gotten an appointment. Arrived at the surgery and was called into the room and the guy introduces himself as ‘one of the medics’ , I go onto tell him my symptoms and he was very dismissive, told me I was probably overreacting and that I need not worry.

I felt something wasn’t right in how dismissive they were so I asked if I could see someone else at reception before I left the surgery.

the receptionist said ‘well if you’re still worried I can book you in with a doctor in a few days’. Turns out I’d seen a physician associate but they’d just introduced themselves as ‘one of the medics’ so I thought that meant doctor

finally got to see a doctor a few days later who looked very worried and referred me onwards straight away and very sadly been diagnosed with kidney cancer

I’m really upset about this initial visit to the GP and felt I was really misled especially as they didn’t properly introduce themselves and clearly didn’t have the appropriate clinical experience to recognise my symptoms were something more serious. should I be complaining?

I genuinely don't know what PAs can do that other registered people can't.

Please enlighten me!

https://www.fparcp.co.uk/

here you go. Info is in here.

What is unique about the role?

You cannot say one thing that PAs can do that another registered, regulated profession, that your daughter could have applied to, can do.

Good grief. I hope I never have the misfortune of being looked after by @Strawfairytart, whatever healthcare role it is she allegedly does.

*can't do.

There is nothing unique that PAs bring to the table. Other than speed of training. They are quick to train. They take no responsibility, because they can't. And then they claim to be "one of the medics". The government wants cheap doctor/ANP/ENP etc replacements. And they think patients will accept it.

Soon, this will be the NHS - staffed by those with little training, and little insight into what they don't know. If people want doctors, they will have to go private.

Meanwhile, doctors leave to go where their training is respected, and they don't have to risk their own registration signing off other people's decisions.

If people want to be doctors, there is medical school. Nurses, nursing school. Any of the many other competent, registered health care professionals - their training and registration.

No one can tell me what PAs offer uniquely. Because they don't.

So there are benefits to the PA role.
They offer stability. PAs tend to secure a post and stay there for quite some time. This reduces transition periods with regards to staffing. A stable workforce is also beneficial for patient care and PAs are part of that stability. They are very familiar with the policies, procedures and protocols of the area they work because they stay there.
Collaboration is of course essential to team working and PA s are able to develop good working relationships within the MDT due to the familiarity that they bring. They are able to hone their leadership skills, supporting staff who are new to the clinical area.
In an ideal world, the government would double or triple the number of medical school places and training positions. However, I believe that it was the BMA who rejected increasing medical training in the first place- citing devaluing the profession. Sometimes you reap what you sow unfortunately.

Resorting to a personal attack, because you can't argue on the topic, and answer my question?

ANPs etc and trust/staff grades offer stability.

It's not unique. Try again.

Which is why regulation is so important.

GPs are expected to see patients about various issues, whether it be a minor ailment such as a cough, or to see a patient with a chronic disease for a long-term condition review. Contacts like these take GPs away from the more serious and specialised areas they can help patients with, be it identifying moles on the skin, or assessing lumps and bumps. PAs can take this workload away from GPs. They can focus on both of these areas, sometimes spending morning sessions running a minor illness clinic and spending the afternoon seeing long-term condition reviews.

Having a clinician who can see a combination of these areas not only helps the GPs at a practice, but also Practice Nurses, who would then not be required to see quite as many long-term condition reviews and instead could focus more on baby immunisations, sexual health, smears and so on.

Nurse Practitioners are also helped as the sometimes-endless duty lists that they deal with can be seen to by PAs as well, be it by the telephone or seeing a patient face-to-face. Overall, most clinical members of staff within a GP practice are aided by and benefit from having a Physician Associate on the team.

I know they do which is why I said PA s are a ‘part’ of that stability, not the only aspect.

Nurse practitioners (who are registered, and can prescribe) have been fulfilling that role.

PAs offer nothing new, and offer less.

No, just idly observing you demand a poster explain her daughter’s choice of career and reflecting on what sort of healthcare role that sort of person would have.

They offer nothing unique other than speed of training. And the government hopes patients won't notice.

The speed of training isn’t unique though. You can do 2 year PG courses in radiography, physiotherapy, OT… you can do the STP and be a clinical scientist in 3 years.

I'm curious as to why anyone would choose this role, outside the obvious -it's quick, and paid better sooner. There must be more to it I'm missing. Enlighten me.

I strongly disagree. All my medical doctor friends refer to themselves as “medics”.

This is to differentiate themselves from the other friends with doctorates in philosophy or such non-medical studies.

Someone, in any context, but especially in the context of a doctor’s surgery having requested an appointment with a doctor, who goes on to introduce themselves as “one of the medics”, would have had me assuming they were a medical doctor.

As was their intention. Otherwise they would have introduced themselves as a “Physician’s Assistant”.

OP please complain. This is so scary. You are in an unfortunate position to evidence, so clearly, why this is a dangerous practice.

I made an appointment at my GP surgery because l'd found a hard lump that l was concerned about. Face to face appointment, so l believed when l booked it.
I was just about to leave the house to go to the surgery when my phone rang.
It was a doctor (an actual doctor) who said "You have an appointment about a lump you've found?"
And actually wanted to carry out a telephone appointment. For a lump.
I said "I have a face to face appointment at half past three. I'll see you then, l need to have this looked at."
And went to the surgery.
When l actually got in to see her, she was fresh out of medical school. Fair enough, we all have to learn and gain experience. But to actually ring a patient who has a lump they're concerned about, and think it was appropriate to carry out a telephone consultation?!
While l was in the surgery with her, she hummed and hawed, then went off and brought in one of the practice doctors, who took one look at it and said straight away that it was an epidermoid cyst. But because of where it was (on my temple, just behind my hairline), she said "We'd usually just remove something like this here, but because of where it is, we can't do that. l'll have to refer you to plastic surgery to have it removed."
Fine. So l left that with them to arrange, and went home. Back in the house ten minutes, 'new' doctor calls me. "Can you take a photograph of it?"
Well, no, l can't. Because of where it is, l can't see what l'm doing. Apparently the practice doctor had told her to take a photograph of it, but she hadn't.
I ended up having to go back, so she could photograph it.
I still can't believe that she thought, (after how many years is it they're at medical school?) that a telephone consult would be appropriate for a lump.

YANBU and you must complain, formally.
In my work I regularly need to speak to the duty Doctor at different surgeries and locally there are some very well-known PAs, ANPs or other AHPs acting as duty-doc. All well and good as long as it is managed within an appropriate governance framework but getting these individuals to tell you they are not a doctor is like pulling teeth.
Me: Are you the duty doctor; Them: yes, I'm the on-call today.
Me: So you are a doctor; Them: I'm the one on duty today.
Me: So you are a qualified doctor, what is your name and GMC registration number for my records please; Them: I don't need to give you that.
I've nothing against AHPs acting in all of these different roles (which the vast majority are very good at) however misleading people is not only immoral but also a criminal offence under section 49(1) of The Medical Act 1983.

Apologies to BrutusWood - fired without checking my arcs.

I keep hearing more and more stories about this type of scenario. Very unsettling.

Hope you are OK op.

Nurses and other AHP don't go straight from completing their nurse training to doing an advanced practitioner pathway.

They consolidate their training, choose their specialty and build up considerable knowledge and skills - in clinical practice - before studying to become advanced practitioners. This is usually over many , many years.

The PA pathway takes 2 years to turn people with science degrees into clinical assistants. It's a rapid pathway because the government thought PA were a cheap solution to the workforce crisis. They are not. They are well paid compared with other non-medical professionals, because the government realised they needed to pay a salary that would attract scientists. But any HCP will tell you that you don't learn your job at Uni. You learn from the patients you care for and from the team around you.

I have considerable sympathy for PA's who have no doubt gone into the role with the best of intentions. But they have been missold. You just don't acquire the skills, knowledge and experience the job requires in two years.

Once registration comes in, I predict a longer training and/or at least a year's supervised practice before qualifying won't be far behind.

That is terrible Op.

The receptionist told you that you would see a Dr!

I think the key thing is unexplained weight loss should always be investigated.

Indeed- I have no medical training at all & knew this!

So sorry to hear your diagnosis.

@katseyes7 you were probably being triaged. Many surgeries triage all patients and then book face to face for those who need it. This is not abnormal.

If the doctor you saw was fresh out of medical school, she was probably an F2 (likely the same person you would see if you presented to A&E with a problem, as many A&E doctors are at this level). This F2, like all F2's on their GP rotation, had a supervising GP.

It sounds like when the F2 was unsure of what to do, she went to get her supervisor, which is correct. This is a young doctor acting within her competence and seeking help when needed. I can see nothing wrong in the story you have told, just a misunderstanding of how the system works.

It doesn’t…technically PAs, nurses, paramedics- all medically trained, and therefore medics as a technicality! But I do think it’s naughty and misleading. I work in an advanced practice nursing role and I would always introduce as a nurse.

They didn’t lie, but it was poor practice and obviously in missing symptom red flags totally sub par!

…all the best, I hope you feel well soon OP!