Are physician associates safe to see instead of GP?

[ourchildrenareourfuture]

The news articles are really scary seeing people getting misdiagnosed or being given prescriptions they shouldn't have been prescribed, and being made to think they're seeing a doctor when they're not.

Has anyone else had any issues with physician associates, or PAs, when they've wanted to see a doctor? Have you had a delay in getting a diagnosis for something, or misdiagnosed?

@Bathtimebarbara sadly, I know from my work in the Coroner's world that the disasters have already happened and from what I've seen I can only anticipate there will be many more

I'm not sure. My surgery are really pushing them.

I went to my local surgery last week... was the only person In Waiting room. We have a real issue with lack of drs and the ones we do have are all part time.

The physician associate I saw was male and wearing bright nail polish. It put my right off and made me think he was unprofessional from the start.

My experience of a PA was that she was very young and just a bit useless - not dangerous but the appointment was pointless and I am no further forward.

I've had great experiences with nurse practitioners who seem to have the experience as well as the training, so it's not like I am insistent on seeing a doctor every time.

Have you complained to the practice manager about him?

My son was very ill last year, we saw a PA who said he could see nothing go away for two weeks, it'll get better, come back if it doesn't.

We saw the GP two weeks later and she called the hospital within the hour. 9am the next morning son was in hospital and by the end of the day had had a scan, with abiopsy the following day, and then was referred up to the teenage cancer unit at UCH.

We are still offered this person when we book appointments and always decline and request an actual GP.

@CormorantStrikesBack Yes. Made no difference.

I saw one with crippling stomach pain. She referred me for an urgent scan and told me to present myself via A&E who, she said, would send me to the ward to have a scan done on the ward, as the radiology/x-ray dept had no available appointments. She assured me that A&E knew I was on my way and knew what to do. I got there, A&E hadn't had any communication and so I had to explain it all to them. They phoned the GP surgery and about 3 hours later, I was pointed towards the woman's unit. When I got there, they started the admissions process, even though I protested I was only there for a scan. But I had to go to my allocated bed, etc. Finally, several hours later, the registrar arrived and went through a lengthy questionnaire, and finally said he wanted to examine me - I pointed out where the pain was, i.e. my stomach, and he immediately told me I was in the wrong place as it was clearly an abdominal problem, but the PA had referred me for a gynae pain. So basically, discharged and told to go back to the GP to get a proper referral to the right dept. When a PA doesn't know the difference between where the stomach is as opposed to "gynae", you know they've not got a clue!!

This is farcical and shocking. You or your mum need to put a written complaint in to the practice manager and partners, explaining exactly what is happening and making it clear that your mum does not consent to having her medication reviewed by a PA as it's been prescribed by a consultant cardiologist. Copy the cardiologist in and make it clear that you have done so. Make it clear that you/your mother will hold the practice responsible for any harm she suffers as a result of this farce 😡

I believe that a great deal of what makes a doctor is training in diagnostics and cold hard experience. Someone with a science based degree and a couple of years further tuition cannot possibly have done the hard yards that even the worst doctor has to do to properly qualify.

@Cattymonster we've done all of that! The cardiologist also made a formal complaint. And the pharmacist who was sick of the prescriptions getting changed 3 times in one week. The surgery doesn't care.

I'm a GP.

I think there may be a limited role for PAs in hospital medicine, where it is possible to become knowledgeable enough in one very specific area to be of some assistance to the clinical team.

I think there is absolutely no role for PAs in general practice, where presentations are completely unfiltered and a huge breadth of knowledge is required, as well as instincts that can only be honed over time. The most critical job in GP is differentiating the small percentage of patients who are seriously ill, or potentially seriously ill, from the majority who have self-limiting illness or more chronic complaints that will never be life-threatening. I don't believe that PAs can have the knowledge or experience to do this. GPs get it wrong frequently - because it's hard! - and replacing them with people with significantly less training seems astonishingly dangerous.

Well that's just mind-boggling 😳 Can your mum move practices?

@Cattymonster No. Or she would have.

We have one in our surgery. In a recent medication review he asked why I needed to be on pain relief for stage 4 endometriosis that has needed surgery since 2019.
He actually uttered the words “I didn’t realise endo was painful”

To be fair many doctors might not either. Hopefully he listened and learned.

@CormorantStrikesBack Yes, that's true. Went in with a persistent cough (Dr a week before had dismissed it) Long story short: now an owner of a lung tumour, looking likely to be benign (Fingers crossed)

He just seemed far more keen to put me through tests than wait and see, if that makes sense? Perhaps I got a good one!

No one is infallible, including gps. A family member of mine was misdiagnosed by one. Having said that, if I had quite complex symptoms I would want to be seen by a gp. My quite obvious
UTI ( as an example) I don’t care who I see.

Well that’s terrifying. Is this not being flagged formally? Why are they still pushing forward with the PA expansion if there is clear evidence of harm? ‘Isolated incidents’??

Gosh some of these are scary. The ones I’ve worked with are within a speciality and done extra training for that. They still work with a doctor and run things by them.
I’ve been treated by one myself and my experience was good but it seems the general consensus is they aren’t very good.

i agree, I don’t think they should be within general practise though, GPs work hard to get to that position, I take my hat off to them.

I think my daughter was seen by a PA when she amazingly for a same day appointment at my stretched local GP practice for a stomach complaint. It would be good if someone here could help with determining whether this was a PA (?) as they had to send a prescription for a GP to sign presumably as they weren't entitled to do this themselves. They were also introduced by their full name by the receptionists not as 'Dr. X'.

If this was a PA I do feel let down as at no point did the practice make it known my daughter wasn't being seen by a fully fledged GP. For diagnosis I would really prefer my family to be seen by clinician with the training and experience to detect a diverse range of conditions accurately. If it was a straight forward BP check fine but this was an examination of a severe abdominal pain which could be caused by a number of reasons.

PAs have so little training that it terrifies me. It isn't the fault of the individuals, but of the system.

I met a PA (sister of a work colleague of DH). She was a science graduate with no real life experience of note in healthcare. She seemed nice, but very timid and anxious (only met socially) and I found it hard to believe that I could be referred to hospital and be seen by her. She freely admitted that there were huge gaps in her knowledge and experience and that she worried a lot. She found she was left or expected to do much more than she had originally expected. I can't imagine she stayed the course tbh.

I find itmiind blowing that we are degrading our professions like this. For what?! I was told about Nurse Associates the other day too, but can't quite work out what they're for either.

I feel strongly about this. It's just about money.

It's similar to an ACP in a hospital. Not a Dr, not medical school, practically an unregulated system. Frightening.

In that case I would want to be seen by a Nurse Practitioner - a professional with full training and much experience. Not a science grad with 2 years of 'medical' training.

Our GP has a list of staff on their website with their roles, maybe yours has the same? Or you can look up any doctor on the medical register.