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?

My GP practice must be reading this thread as it has finally acknowledged you will be seeing a PA. However I wonder if you do turn up at a GP surgery and are seen by a PA can you request instead you should be seen by a GP (even though you would have to wait)?

I feel I pay enough in taxation to see a fully qualified medical professional and PA introduction to GP practice is concerning route of introducing sub standard consultation on the cheap. It's not the PAs per se but the system.

Will Labour be changing this

I think think Labour won't change this. Its too hard to turn around . Sliding in PA is so embedded in the long term plan to out sorting heath provision.
Thete is so much money to be made out of the NHS and social/ home nursing eg the Hospital at Home , Hospice at Home , remote monitoring companies , locum / temp agencies paying GPs to employ PAs! So many multi nationals touting for contracts from a beleaguered NHS.

@yaki i saw one yesterday who tried to say my strep throat was acid reflux. And it was an emergency appointment. Ive been in a lot of pain and if i had objected i likely would have had to rebook. So cant even see a GP in an emergency now. I used Pharmacy First last week Posted this on another thread

went to the pharmacy last week because a sore throat is listed as something they treat (not because i was told to by GP but because its drummed into us to go there first,) Difflam Spray and Chloralieve lozenges were recomended. It didnt touch the sides Neither did copious amounts of Lemsip Pain is even worse today and i cant swallow without pain even when drinking water. I have a GP appointment at 5pm but had to physically go in to book it as there were already thirty ppl in front of me when i rang at 8am. If i had gone to the GP first i would have saved myself at least an extra five days of pain, particularly todays excrutiating pain and trouble swallowing. GP first all the way from now on. Throat looks red and inflamed at the back. It started as part of a bad cold ten days ago and got worse

The PA ummed and ahhed and said my throat did look a bit inflamed but did go and get a GP (she referred to them as a senior GP) to sign off some antibiotics. I know she was a Physician Associate because a badge round her neck said so. I did feel it was misleading to say senior GP Why not just say GP Its like she was inferring she was a GP by refferring to them as a senior GP. It made me remember this thread which is where i first heard about PAs

My appointment was in our new NHS hub

DM is 88 deaf and English isnt her first language If she sees one she wiil never understand they are not a GP

Yes it is oh so sneaky - saying
g ' I'm one of the team' or ' lll get senior GP. '

Why the deception if there's nothing to hide?. But of course there's plenty to hide.
Like new PAs are paid loads more than a junior doctor .

Without sounding like a conspiracy person, why pay over the odds if not to swell the number of PAs in tbe system.

I know Qualified GPS are losing their jobs and can't find a new one easily. Ridiculous

No wonder ppl are going to A&E Its the only way to see an actual doctor

https://www.dailymail.co.uk/health/article-13679799/amp/Newborn-left-disabled-signs-illness-missed-physician-associate.html

Found a Twitter account called Askforadoctor

Just found out the British Medical Association , doctors union is taking the General Medical Council to court over Physician Associates .

www.bma.org.uk/bma-media-centre/bma-launches-legal-action-against-gmc-over-dangerous-blurring-of-lines-between-doctors-and-physician-associates

The BMA say ,rightly, PA are not the same as doctors so can't be regulated the same way as doctors. The also say blurring the doctors job with that Physian Associates is purposely misleading rhe public. The GMC won't even go to mediation to find a compromise.
The BMA is asking for donations to fund the case.

To add insult to injury a PA newly qualified is paid loads more than a new doctor.
Who in government thought making Physician Associates was a great idea . I can't see anyone putting their hands up.

there should be a mandatory requirement for PAs to state their role and to offer patients the right to see a GP of requested even if there is a wait. The conference that a PA is a fully qualified medic by obfuscating their role is devotion in my opinion and many patients in distress will not see this and quite rightly put their trust in the NHS to deliver the best possible care.

It's a difficult stance to take on this thread because it is hard to criticise someone's ability in a job especially when they have trained for it and enter patient care for altruistic reasons yet it has to be done.

I think part of the challenge is that GPs look like the 'bad guys' trying to prevent modernisation and wishing their profession to be a closed shop (and protecting salary). This is simply not the case so we need robust argument from the medical profession to reverse this trend or we will see more misdiagnosis.

Part of the problem is that a GP surgery sees a lot of trial inform patients often elderly and they simply do not have the courage to demand to see a GP. It takes a lot of assertion to ask a receptionist to downside you see a GP and you will probably be seen as a difficult patient. It's hard.

Younger possibly more aware patients may look carefully at staff roles but in a busy department running at pace this to has its challenges.

I wonder if inclusivity has a part to play in this with governments showing you don't have to have a raft of A stars to become a medic and therefore have more working class staff in the profession??

I work with a Pa on a ward, tbh she's not confident, lacks knowledge and a bit useless. I wouldn't want her making decisions on my family members.

But the government has pushed for the a nd funded them on two year courses even if they don't have any previous medical knowledge. Id not want to see one myself.

No

Just seen this thread. DD is an advanced practitioner in a city hospital and goes on about them all the time. She has nurse and doctor friends and it's a hot topic.

That said, I saw one last Saturday who was on the ward with my DB who was in hospital for pneumonia. He was a nice nice young man, great bedside manner and explained about the medication DB was on and why, was very patient, called the consultant to ask advice on something he couldn't answer and completed the discharge papers.

He didn't say he was a doctor, but he didn't say he wasn't either, I knew what he was by the black scrubs and the name badge. My elderly mum kept calling him Dr though and he didn't correct her.

I do think the introduction should be "Hello Mr Brown, I'm John Doe the Physicians Associate, which means I'm here to support the Consultant" or similar.

I think it's unforgivable and I would love to pick back through the civil service papers to see when it really began. We've had so many health secretaries and it will have begun a long time ago, possibly a New Labour thing as too many ideas were greeted with 'they do it in Anwrica it must be good' back then. But I have my eye on Steve Barclay who certainly oversaw at least one major expansion in numbers for this scheme but passed the hot potato so quickly that he got out with reputation intact.

https://www.bbc.co.uk/news/articles/czxvww97pleo

too many ideas were greeted with 'they do it in Anwrica it must be good' back then.

They do it differently in America. As often happens, much of the nuance was lost in transit over the Atlantic. The huge difference that makes all the difference in American healthcare is the threat of being sued and the enormous awards that the courts can order for malpractice. Hospitals and medical practices are careful about supervision and can and do fire PAs.

Even still, there are parts of the US where doctors are thin on the ground and primary healthcare is often handled by PAs who have basically graduated high school and got a diploma from a community college or some online institution, with results that are woeful, including addiction to painkillers because PAs have prescription privileges and not enough education to understand pharmacology. They are shielded from criticism by the extremely powerful nursing unions and lobby.

I have read a few books recently written by Americans set in the modern day in poor areas of the Southern States. They were nit about health but they gave a clear picture of health care services in those huge areas eg healtcare deserts .
Thee latest Bernie Saunders book is political look at the US ' broken ' health care system. Its not like in the movies!

Here is some hard data on PA in London.

https://keepournhspublic.com/the-not-a-doctor-will-see-you-now-is-there-a-non-doctor-problem-in-ne-london/

It's one thing to have PA on a ward with other properly qualified / experienced staff around - but not in A&E and with a bleep. Imagine a nurse with years of experience calling for emergency help and a PA turns up.

In an emergency situation the crash team would be called which is an entire team including senior doctors

re bleeping - they are all individual numbers so know who I would be contacting