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?

You must complain. This is cost cutting exercises and desperate measures to try to plug the enormous gaps in NHS. Unfortunately it’s these experiences that shows corner cutting isn’t productive. And could lead to very poor outcomes. Someone else might think, well the dr is concerned so I’ll just struggle on. Things won’t change if we don’t complain.
But most importantly I wish you well on your treatment and hope you get a lot of support and make a full recovery.

Nope, one the PAs in our surgery is Dr His Name but he isn't a medical doctor. Some of them are very good but some are way out of their depth. It horrifies me that they don't have a regulatory body.

There have been very similar cases reported in the press recently leading to diagnoses being delayed. The PA concerned in at least one case was removed from duties.
it’s hard to complain, but you will be helping others if you have the patience to do it.

I question the use of the non-medical version of Dr in a medical setting. The title in this situation clearly implies the professional as a medical degree. This also goes for dentists who practice in hospital, using the title doctor, ANPs with PhDs etc.
Being in hospital as a patient or relative is so stressful and second guessing who is treating you is not what a patient or relative needs not may the have the capacity, mental strength to question.

I’m so sorry to hear about your diagnosis, OP.

Your story made me so angry on two levels. First, you should have been assessed by a GP, and not a medic.

Secondly, I’m also so flipping tired with the medical profession treating back ache as a musculoskeletal problem without ruling out other conditions. My mum had a terrible back ache at Christmas, went to the GP twice in the space of two weeks, before dying at home in atrocious pain. It’s a doctor on Mumsnet who indicated to me it could have been caused by an aortic dissection. While there hasn’t been an autopsy (France being France 🙄), I now believe this is what happened to her.

💐 I hope you’re getting all the care you need now. 💐

OP, first of all, I’m glad you’ve now been diagnosed, though sorry — obviously — that it’s cancer, but I hope you can be treated and will be okay. Please do report this person — can you imagine if it had Ben someone else who’d accepted it at face value and not asked for a second opinion?
I hope you’re doing okay… x

So sorry to hear about your diagnosis.

The most important thing right now is your health. However I would write to the practice manager and explain what happened. And say that the reasons you are writing is to highlight this so that this medic gets the appropriate training and that this doesn’t happen to anyone else.

I’m so sorry about your diagnosis. I think you should make a formal complaint although I understand atm you probably least feel like doing so with everything that’s going on.

I experienced similar with my partner although that was an actual GP who dismissed with antibiotics when a simple blood test would have clearly indicated cancer. Instead my Partner struggled on and put off going back to GP for 6 months!

In this time things progressed. I didn’t complain as I just didn’t have the energy at the time. Our surgery knew though, I made sure that the senior GP’s were aware. We are always dealt with swiftly now!

Take care and all the best with your treatment x

I have a good friend who works in nuclear medicine, not as a Dr. He has a nuclear physics PhD and refuses to use his Dr title for work (e.g. on his badge, letters, email signature) to avoid confusion. He jokingly says it's so he doesn't get roped into any resus situations but really it's so as not to confuse patients or other staff as to his role and knowledge.

Yes, he worked bloody hard for that PhD and earnt it fair and square but I can't help but agree with him here

It is very unsafe and misrepresentation to make patient think they are a doctor while their not. It is sadly a recurrent problem. Absolutely complain.

Elsie256 I am so sorry to hear of your diagnosis. I hope you have good treatment from now on. and that all goes smoothly, as it should. What a good thing you have so much common sense!

I'd say you most certainly must complain. The Practice I use had a notice saying they had a complaints procedure and we could ask for a form from the desk. I think it can be done online too.

It is not only you who needs to have your faith restored in this GP Practice, you must protect the health of other Patients.

If somebody else has this happen and does not have your courage to ask for another appointment, or simply thinks she has seen a Doctor and that she is fine, she could go on suffering and her condition could be left too late for a good outcome.

It is shocking that "I'm one of the medics" can be said like that and you are not told exactly the status of this person seeing you at the Surgery. "One of the medics" would mean a Doctor to me if I were expecting to see a GP.

You can write to the Practice Manager and point out that you were misled into thinking you were seeing a Doctor and that the person was a Doctor because he said "I'm one of the Medics." Do make the point that had you not decided to ask to see another Doctor, you would not have known he was not qualified as a Doctor and your cancer would not have been diagnosed promptly and could have spread. Point out that asking to see another Doctor takes courage as you don't want the Receptionists to think you are fussing.

The Practice must:

1. Ask if a person would be happy to see an Associate and explain what that is.
2. Never send anyone to an Associate who introduces themself as "One of the Medics". The Associate must say, "I am not a Doctor".

Well done for getting the proper Doctor to see you. Good luck with everything. I hope you make a good and quick recovery. Sending lots of love. 💐

Coffeewinecake.
Regarding PhD and Medical Degree, I absolutely agree. I am the former and worked in a Psychiatry Dept. but always told Patients or their Parents/Carers I was a Psychologist not a medical Doctor.

I do think that any healthcare professional should introduce themselves and their job title " hello, my name is ... and I am a physician's associate, my role is ..."
My father believed he had seen a doctor when he had actually been seen by a paramedic in the ED whose role was advanced care practitioner, not the same qualification at all. He had a stethoscope around his neck and wore scrubs. My dad is elderly and didn't ask who he was, just assumed.
It's courteous and avoids confusion.

Completely disagree the only professionals who have studied Medicine and practice Medicine are doctors. I would never call anyone other than a doctor a Medic. No one working in the profession in hospitals would call anyone other than a doctor a medic including nurses paramedics and nurse pracs.

You should always complain when you’re mid-diagnosed. At the very least it allows clinicians to understand mistakes they’ve made and learn from them.
Even single Hcp has mis-diagnosed someone at some stage. (I remember mine)

I’m so sorry to hear of your diagnosis and thanking heavens that your gut didn’t let you just walk out the door. In answer to your question YES YES AND YES

This is simply not true.

@Elsie256
Im sorry to hear about your diagnosis and wish you a speedy recovery.

I think you should report to the practice manager - I suspect they would’ve discussed it internally as the GP picked it up but it’s worth flagging it up so it can definitely be discussed on how to avoid in the future.

Regarding the PA situation - yes they should be completely transparent about who they are when introducing themselves.

In my experience, I know n=1 so it’s only my experience of them, my practice employs a couple of them. My mother was diagnosed with pancreatic cancer recently and this was on the back of multiple visits to the practice with weight loss over the year and then explosive diarrhoea and she saw 4 different GPs who did some tests and gave some medication to stop the diarrhoea.

It wasn’t till our 5th visit when we saw the PA who was visibly concerned who mentioned the pancreas and referred her to the hospital for an urgent scan because of her weight loss and diarrhoea. The scan confirmed she has pancreatic cancer and we are under the care of the hospital now.

I think like GPs or nurses you will have some good ones and some not so good ones I guess and it’s a lottery as to who you will get.

The practice needs to hear your voice though so things like this can be prevented going forward.

Incorrect. The BMA has no control at all over med school places...and indeed they are being doubled. PAs are a dangerous disaster experiment

Yes I would complain. You are right to think medic means doctor, they should’ve introduced themselves as physician associate as is their title. I’ve come across a lot who overstep the mark and it’s not helpful for anyone. Sorry you are going through this and I hope it’s all treatable

Spot on ....criminal matter to pretend to be a registered medical practitioner...

The patient was misled....the inference not corrected was that the patient was seeing a doctor. Why not say I am a nurse/ pharmacist/ physican assistant/ bottle washer etc etc

YANBU
I am so sorry you are having to deal with this on top of your diagnosis.

The PA was being deliberately misleading - they are a PA and therefore should introduce themselves as such. They are not doctors. In the same way that a doctor should introduce themselves as ‘a doctor’ and a nurse ‘a nurse’.

Please make a complaint about this.
This is wrong and they need to be held accountable for their actions

1. in being deliberately misleading, and
2. for being dismissive of your concerns.

I wish you the best with your treatment.

All consultations whether at the GP or hospital should start with a name and position Eg GP, nurse, medical rank. I am a retired Consultant and was shocked to find that my unsatisfactory consultation which was supposingly by a specialist nurse was actually with a nursing assistant - not even a qualified nurse!