Physician's Assistants

[MissMarplesNiece]

How would you feel as a parent if you knew your seriously ill child's treatment was being managed by a Physicians Assistant who had just two years training, only 3 weeks of which had been spent in paediatrics?

This isn't the first advert I've seen recruiting PAs into paediatric departments. This is a post at Registrar level so why isn't a qualified medical doctor being recruited for the post?

Why are NHS Trusts playing fast and loose with children's health?

@Pippa246 - I trained in the 1980’s. When I qualified I worked on a surgical ward. There were 5 qualified on the ward for days in total. Three RGN’s (I was one), and 2 EN’s. The EN’s were totally left in charge on shifts. And they did medicines without doing an extra course,

Ÿes but experienced GP,s know when a patient needs to be referred to a specialist.

I also trained in the 1980s - in Scotland, they did not administer medicines.

@Pippa246 - I’m intrigued now. Did you always have a RGN on shift? Even on nights? Our nights only ever had a SEN on if we were lucky or a third year student.

@x2boys

"

I can understand your concerns but if you had a seriously ill child I don't think their care would be solely managed Aby a physcians assistant "

In reality it may well be. PAs in hospitals remove jobs from doctors. Doctors also have to sign off the PA's prescriptions, whilst managing their own excessive case load.

It is probably already happening that PAs are calling for help and there is no available doctor to offer it, because the only one available is already doing the job of two people and dealing with a much sicker patient group.

Patients like this poor woman have already died because PAs who haven't the first clue what they were doing misdiagnosed conditions that a qualified doctor would immediately recognise: https://www.bbc.co.uk/news/uk-england-manchester-66168798

The fact that some people seem to think AI can replace doctors genuinely scares me. I hope the people saying that on this thread are just full of shit and don't actually believe it, or if they believe it they have no power to do anything about it. It's a seriously dangerous and majorly stupid belief. AI cannot in any way replace doctors and believing they can shows immense ignorance of what doctors actually do.

Actually its not, my contract as with many others allows 1 PA for admin thats 4 hours a week. The rest of non clinical contact or SPA is my time for professional development and technically should be used for only that which is 2 PAs. Imagine 4 hiurs a week to review all 60+ patients from my clinics! Not to mention pre-surgical review Basically only urgent flagged up requests are seen to anything anyone else requests is ultimately their responsibility to review.

Always an RGN. Senior students could “take charge” on their management module but there was always RGN on shift on both days and nights. This was a big acute trust though - a university teaching hospital with a lot of specialties so maybe better staff than smaller district general hospitals and the like.

I'd never heard of physician's assistants until I went to the surgery last year when I thought I would be seeing a doctor. She told me she was a physician assistant and that she "could do everything a doctor could". Those were her exact words. I wondered why therefore she wasn't actually called a doctor.

And this is why they should be heavily restricted. Their misplaced confidence is pretty scary.

Physicians assistants have a place and are valuable members of the multidisciplinary team where their skills and knowledge are understood and utiised.
Lot of ill informed comments by people who should know better.

When doctors are losing training opportunities and are unemployed because PAs are on their rotas and taking their jobs, I don't find anything misplaced. Want to play doctor ? Go to medical school.

PAs that work as assistants are great. Ones on the Reg rota are not.

PAs are now complaining they are being properly supervised in GP. Whereas before they were just left to do their own thing & GP would just sign it off (yes weren't supposed to but what's the point of a PA if all their decisions have to be checked - might as well have a real GP). So so dangerous and costly to the NHS.

The arrogance
Arrogance with knowledge and experience is one thing, not great of course and does lead to mistakes
However, arrogance with minimal “experience” is just another level

What's the point of medical school ? 5/6 years + 2 doing 40-70 hour weeks, shifts, nights, more exams.
Or 18 month basic science plus 3 years doing 9-5.
Applying for the same job. Pay cut for the PA though.
PA legally has to be supervised and can't prescribe.

Not replacing doctors my arse.

Oh wait. The PA version of this job will earn more than the doctor version. And you wonder why doctors are angry.

I work with both doctors and PAs. PAs being primarily ward based and doing jobs such as taking bloods, starting paperwork, chasing test results, updating relatives etc I have no problem with. It’s a great idea.

PAs believing themselves to be ‘able to do everything a doctor can do’ is dangerous, misplaced and sadly not an uncommon view. There is nothing ill informed about being extremely worried about this trend of PAs being used inappropriately and without clear role definition and scope.

No one actually thinks that except PAs . Barely trained in anything, bullying junior doctors .

PAs are paid more than doctors - with a fraction of the training.

No wonder doctors are leaving the NHS (in droves) for jobs abroad or in the corporate world when they are treated so abysmally.

Lot of ill informed comments by people who should know better

Who? The patients who have been treated by PAs who have either wilfully misrepresented themselves as doctors (completely and irrefutably unethical) or have claimed they can do everything a doctor can do (totally incorrect, misinforming the patient & dangerously arrogant)?

What place?

What are their unique and special skills that other members of the mdt can't provide?

I know what a physiotherapist brings, an OT, a cancer nurse specialist, a surgeon, a podiatrist.

PAs bring nothing new.

They have no skills that don't exist already among other HCPs who are paid less.

It's a desperate shame that all the money poured into PAs isn't being used better elsewhere. More nurses, more doctors for a start.
A proper doctor's assistant could be useful. Paid at band 4, a general gofer with some basic skills like cannulation.

Somebody who would actually help would be a scribe, a chaser of results, a form filler and someone to chase stuff up on the phone.

This sort of person would be really helpful, release loads of medical time and prob a Band 4 so loads cheaper.

I don't need someone to do the doctoring, that's the enjoyable bit!

A human roll programme the computer, train the AI. Nothing is infallible.

No of course not. But machine learning is comming on leaps and bounds and should help a lot.