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.

In my experience they are being over used and expected to do too much. They make prescription decisions well above their pay grade.

If you can still make mistakes with 5 years medical school and 5-7 years postgrad training head training as a GP, how on earth are you arguing that a PA with a 2 year course isn’t going to make many, many more mistakes? Less training. Less exposure. Little basic medical science content in their course.

Thats a paramedic practitioner, they are very commonplace and can prescribe. The ones I've come across are quite good as they're usually more knowledgeable and 'nicer' than GP.

Trimethoprim I would imagine. Folate antagonist.

I am not arguing, I am simply saying mistakes are more likely to happen when anyone, working within the scope of their training, is under pressure or services are under resourced.

I’d want to know what the drug was. Many drugs have the odd pregnancy study that has thrown up a possible safety concern. That has to be balanced against all of the other data as well as the benefits to you and your baby of treating your condition. Your stage of pregnancy also needs to be taken into account. Pharmacists are often not the best people to assess this as they veer towards blanket avoidance

Just to add- this is my exact field and I can’t think of a single drug that has been convincingly linked to both clefting and deafness. Clefting would onlY be a concern with use in the first ~11 weeks and deafness would be later in pregnancy

I changed doctors because all I keep getting was Appointments with PA .. was no continuation of care was diabolical

Why do we have PAs when there aren't enough jobs for newly qualified doctors?

I'd guess because they're cheaper..

OP has not been back to answer the suspicious queries

They don't seem to be particularly cheaper, based on a quick Google, but obviously doctors do get more expensive.

This ain’t true. I was see by a PA and by the time I’d left the surgery my prescription was ready to pick up.

It is true. PAs cannot prescribe. Your prescription would have been completed by someone else.

In the two minutes between me leaving the room and getting to the door?

If a PA prescribed, it would be illegal. They are not qualified to prescribe.

I saw a PA at my surgery who put on my medical record that I have atrial fibrillation. I don't. I only found out because I did a drug study and the doctor there asked why I hadn't declared it. I complained and it was removed from my record, but no explanation was given.
Another one I saw for a UTI put my urine sample in a bottle meant for blood and it couldn't be tested.
I don't go to the doctor's often but I don't want to see a PA again.

Well they did, and they do.

Of course they can. Ironic….

Not at all. DD worked alongside PAs on a couple of wards when she was Foundation 2. Not only could they not prescribe but there were a range of other, important, procedures they were not allowed to undertake. Yet they were better paid, only worked set week day shifts, had a lot of paid training time (DD's Deanery used the old contract so most doctor training had to be in your own time) and had no staff responsibilities.

More importantly they had proper contracts, with pensions, sick pay etc.

50% of F2s who finished last August had no jobs to go to. A lot of the rest ended up on 12 month locum or clinical fellow contracts, with no guarantee that there would be anything after that. Agency locum work is zero hours and, because of the large number of unemployed doctors, can be exploitative. (DD was paid half the salary of the person she was covering for.)

Doctor jobs are open to worldwide competition and entry level vacancies regularly attract hungreds of applicants. It is difficult for those at the start of their careers to compete with more experienced candidates. Yet bizarrely, newly qualified doctors are not allowed to apply for PA positions, even though these jobs would allow them to continue to gain experience within a UK hospital setting.

The whole thing is daft. We don't need PAs when we have so many doctors looking for work.

Where as I'm the opposite and would definitely trust the pharmacists decision over the GP/ consultant. But that's because I've been saved from inappropriate drug interactions and doses by pharmacists and also been prescribed drugs by a GP that was an absolute no in pregnancy (known to cause heart defects, not simply untested in pregnancy).

And don't underestimate the inflammatory effect of underqualified new starting PAs being paid more than FY1s. I know a number of residents who say that was the last straw that made them vote for the most recent round of industrial action.

They're awful in my limited experience. Limited because i rang up and told the receptionist I didnt want to be contacted by them again. Its not their fault, no, but potentially dangerous

Quite possibly, it’s all electronic. The PA presses a button, it flashes up on the GPs screen, they have a cursory glance and OK it. Can be done in under a minute.

Same here. When I handed in aprescription for a vaginal infection to the chemist, he took one look at it and asked me to sit and wait while he phoned the surgery. Half an hour later he called me over to tell me to go back and pick up another prescription. Apparently the gp had issued a one off high strength antiobotic by accident to be taken 3 times a day for a week! So I’d have had 21 doses of a one dose drug.