Physicians Associates

[DevilsKitchen]

I’ve just been prescribed something by a PA that is not recommended in pregnancy due to the risk of deafness and cleft palate.

I am only by virtue of being an inherently distrusting person that I am not now taking this. I mentioned I was pregnant and the PA said “oh yeah I’m pretty sure it’s fine” which to me is not good enough so I checked with the pharmacist who told me categorically no and go and ask for something else.

My colleague also had a bad experience with a PA when her daughter was prescribed something inappropriate for her specific condition.

And it’s no wonder is it? It’s two years training at masters level which is obviously nowhere near enough. It was a nice idea to try and reduce the waiting list and I don’t even think it’s their fault because they are doing their best but AIBU to say it’s time this experiment was ended?

I would like to say my surgery has dealt with it really well and I am now booked in to see an actual GP.

A physicians associate can't prescribe medicine. It has to be signed off by a GP. So the responsibility is actually the GPs who has authorised it

Surely they should do a computer check on drugs, it would have been flagged up immediately. My GP always checks everything on the computer and he's a GP. Was it just over confidence? Very bad though.

That’s unforgivable really. They have the information at their fingertips so it would only take them a minute or two to work out that some medications shouldn’t be given to pregnant women.

I’m not a huge complainer, but I’d actually make a complaint about this. The consequences could have been catastrophic, and the next pregnant woman he comes into contact with might not question it.

Wow, that's a huge concern! Mis-prescribing a drug and saying 'it should be fine' rather than a simple check of the online BNF, is terrible! I hope the GP looks after you properly and it's good that the surgery is taking action, but, what if you hadn't been so suspicious? Many people trust that the person prescribing knows what they are doing!

Yep. They’re not actual doctors. there’s no comparison as regards training or knowledge.

My DP had a terrible experience with a PA (who introduced herself as "a medic" and did not correct him when he repeatedly addressed her as "doctor").

It is only because I am a HCP and pushy that I asked for a second opinion and he saw the Consultant who arranged for the surgery he needed. They should be banned IMO.

It didn't happen! physician associates aren't allowed to prescribe ! They can send a recommendation to the doctor and then the fully qualified doctor prescribes.

As others have said, how did this happen when they aren't allowed to prescribe anything? They can only make suggestions which a GP then has to approve and prescribe or decline it

I didn’t know they couldn’t prescribe. It’s seems you are a little muddled up, OP.

As other people have already said, PAs can’t prescribe so you have a GP issue here. As you seem to be adamant that this mistake means that the PA role doesn’t work and should go, does that mean that a mistake like this means that GP roles don’t work and should go?

A single clinical error does not mean a whole profession doesn’t work. That’s even if there was an error here. We do sometimes prescribe medications that aren’t routinely used in pregnancy but we may do so on a risk benefit basis in partnership with the person.

Echoing that they can’t prescribe so it’s not a them problem, it lies with the DR above them.

Agreed the only time I saw a PA they didn't disclose that and only introduced themselves as "part of consultant X's clinical team" and they were in scrubs so I assumed they were a registrar until I got my clinical letter after and was really shocked but it made sense why they couldn't answer any of my questions about my MRI result. It seems to be a common thing that they're not being honest about their position so I agree they should be banned.

Is it on your notes that you're pregnant?

I was prescribed antibiotics for tonsillitis by a paramedic who was working a bank shift at our GP surgery.
The receptionists will be prescribing soon.

The issue being they are NOT a profession.
They are not regulated like GP's or nurses.
They do not have a governing body- they cannot be struck off.
2 years training- that's it. Its not adequate- they are dangerous.

She told him she was pregnant

That would be an ACP- who has done masters level training in addition to his paramedic role- and also a prescribing qualification.
He was acting as an independent, autonomous practitioner.
There is a whole world of difference.

I thought there was now a move away from that role.

Not true, they are now regulated by the General Medical Council. You know the organisation that was founded so the public could have confidence in identifying an appropriately qualified doctor rather than a “quack” How times change!

What they said.

GP =5/6 year medical degree, 2 year FY training, 3 year specialty training

PA = 2 years

This is why I always ask someone's role in a clinic/hospital and refuse to be seen by a PA.

The fact physician assistants unilaterally decided to change their name to physician associates shows their arrogance and lack of concern for patients/wish to mislead patients,

I do think that in their original role of “physicians assistant” truly assisting with admin and documentation there could be a role. But the mission creep into assessing undifferentiated patients is very dangerous. Sadly the role seems to attract, at least in part, people with an overinflated view of their knowledge and skills. And in effect up until now never actually held accountable for their decisions.

There have been a good number of deaths caused by PAs. In addition there have been lots of FY1 medics put in the invidious position of being expected to sign off prescriptions for PAs.