To think the Physician Associate / Doctor row should focus on patient protection/ care transparency as opposed to a toxic work environment

[Ra1nRa1n]

https://www.bbc.co.uk/news/articles/c2dly5ldrxjo

Was becoming increasingly worried under the Tories how PA numbers were increasing whilst doctor numbers seem to be diminishing and how you often have no idea who you’re dealing with or indeed any choice.

Glad labour are looking at the issue but why is the focus more on a toxic environment as opposed to patient care and protection?

toxic environment can impacts on patients care.

I want them to be regulated like all health care professionals. I think it’s so important to do this and sets out clear guidelines on their role and position.

Yes toxicity can impact patient care but far lesser qualified staff treating patients with little transparency or choice is even more dangerous. I want to know how qualified people treating me are and to have a choice when needing treatment from a doctor.

There seems to be little focus or concern about this other than from doctors who can see the risks.

I think the issue is both.

The issue of regulation and governance is vital but the bullying that is rife on Twitter is unprofessional and in many cases smacks of elitism. If that level of behaviour and ostracism is going on in a healthcare setting that’s a huge risk. It’s well documented that communication is often cited as a contributing factor in SIs, this would just feed into that.

Any examples of elitism? Do you feel the same about the nurses on twitter complaining about and raising concerns about NAs?

Did you even read the article beyond the first paragraph? There is plenty of concern about patient safety voiced in it. In fact, the article (aside from the first paragraph) is really mostly about that.

Well elitism is more than justified! They’re not doctors and their training is nowhere near on a par to that which a doctor has .

How about we discuss the decline in doctor numbers, how med students struggle to get jobs and how patients often have little knowledge or choice re PAs.

The bulk of this article isn't about a toxic environment, the bulk of it is about safety concerns. I'm not surprised the environment is toxic, this should never have been allowed to get to this point. Lesser qualified staff, on higher pay and favourable T's and C's placed in roles that are beyond their skillset, whilst not actually having a defined scope of practice actually creating more work for staff picking up the lack of competency problems all whilst posing a danger to the very people who need treatment. That wasnt what anyone involved on any side should have signed up for, and it's insane it was allowed to go so far.

I think uniforms should be regulated, including the private sector/care homes/community etc so that you know who you are dealing with without having to ask.

It’s totally mad that now my lovley GP husband can’t find a job in practice in a country with huge GP shortages due to the huge push in the NHS to fill gaps with PAs who have a third of the training (at best!). Dangerous for patients!

Most certainly did but care transparency to patients and patient choice/ voice does not seem to be much of a focus in the upcoming discussion.

Exactly this .Read the threads with parents of med grads unable to get jobs or training posts. It’s nuts and has been done so stealthily. Patient choice and knowledge re qualifications in care are being eroded .

There is another thread on this and I am afraid it's the patients who are now concerned with PAs. PAs being ambiguous about their role with practice has not helped and only results in lack of patient trust. We all pay for the NH S and deserve the same access to qualified professionals. This could have been handled all so better.

We will soon have assertive patients refusing to engage with PAs and demanding to see doctors and I think they have a cause.

It's so wild that there are any doctors unable to find jobs, especially GPs, Labour should be sorting this as a priority but of course they won't. There are also newly qualified nurses and midwives struggling to find jobs due to budget cuts and overseas recruitment; yet we hear about the short staffing constantly. Awful.

Was it a stealthy Tory policy to get cheap “doctors” on the quiet?

GP online booking services are now forcing you to have non doctor appointments with little choice or knowledge re who you are seeing. I’m not talking about the normal nursing, pharmacy appointments but diagnosing new condition appointments! You get no say, choice or knowledge re who you are seeing at ours now.

They are not regulated but there is an informal custom and, when working in a hospital, you are issued with a standard uniform based on your role. There are also typically posters with uniform examples, there are in my hospital. OTs wear bottle green, PTs wear navy. That never stopped patients referring to OTs as "physio" or "occupational health". There will be different uniforms for nurses and HCAs too, but HCAs are often called "nurses". In fact, all AHPs are collectively called "nurses" even by the government. The whole nurses pay dispute was actually about nurses and AHPs but we didn't even get a mention.

Do they not tell you on your online app or when calling that you appointment is with Dr Tiller or Mrs Clarke? Mine does.

Agree with this. I will never willingly see a PA again. Luckily I didn’t trust diagnosis (nothing wrong) and moved to another GP practice where I saw brilliant GP who got things sorted for me.

But I live in a city where there is a good choice of GP practices. If you can, vote with your feet!

Use the online complaints at your HP practice to complain about them employing PAs they have to respond and maybe if enough people complain it will make a difference ?

Often staff are introduced by their first name so you don't know who you are talking to in hospitals. My DD insists she is referred to as Dr for the patient"s sake not because she thinks she above anyone!

I don’t have time or skills to root back through the last couple of years on Twitter for evidence, and I have literally never seen a nurse complaining about NAs on there, let alone naming people and sharing photos of them but if they did, I absolutely would have an issue with it.

Off the top of my head, the elitism presents itself in the witch hunts for named individuals, or when situations are described where someone has requested a test or asked a question and a pile on is encouraged about how ridiculous it is that someone might do this. There is an undercurrent of Doctors don’t make mistakes (which is obviously completely untrue), so let’s all laugh at this silly thing that this non doctor did.

I completely share some of the concerns, around governance but the toxicity is also an issue and just because someone is a medic, that doesn’t excuse it.

(I am not aligned with either side of this argument to be clear)

Because they’re not doctors so they don’t need that training 🤦🏼‍♀️

They’re different jobs and as long as practices and practitioners are transparent about that, it’s OK. They’re trained for the job they do. Doesn’t make doctors better than them, it makes them different.

But patients shouldn’t be treated by a non doctor in a doctor situation. Doctors will make less mistakes because they have double the training. We want more doctors not PAs. More mistakes have a knock on with more to sort out and risk surely. Patients should be told every time they are being treated by a PA and given the option to be treated by a doctor if preferred- which makes the PA position seem like a white elephant. They are not doctors and they’re not nurses.

I've only ever seen people share names or posts about stuff already posted on social media- surely everyone is by now aware that once you post something it's 'out there'? Also never seen anyone say doctors never make mistakes, but highlight the logic that if highly qualified and experienced professionals like doctors sadly make mistakes sometimes, there is no metric of logic that suggests someone lesser qualified is going to make less mistakes. The main discussions have been around lapses in care of basic fundamentals- is that not okay to point out? Saying stuff is elitist is often a way to shut conversation down or to dilute the actual content of the posts; surely you wouldn't be doing that though would you?

Hospitals and practices aren’t transparent and you are not given a choice in hospital or at the GP. This does not seem to be of any concern just hurt feelings in the workplace. Why are money and roles being wasted on them?Med student grads and experienced doctors can’t get jobs and they impact training opportunities .Patients want access to doctors not PAs.