PAs (Physician Associates) ?!

[fireflylara]

Just want to find out what people thought about this.

Recently went to catch up with a friend of mine who is a lawyer with the GMC (the organisation that inspects doctors) and she had some work colleagues round. They all were talking about physician associates ("PAs") and how they absolutely would not want to see one.

Turns out there's a big push with governments for NHS to use PAs and is funding them as a priority but they are vastly less skilled in terms of their depth and standards of education compared to a doctor as they do a what sounds like a crash course of medicine in 2 years but the courses have no quality accreditation like doctors' university courses do. They spoke about how the GMC is now also inspecting the PAs and will just automatically approve most PA training schemes even though the GMC are aware that quite a few of these have some issues.

I thought I hadn't really met any, but it turns out for some of me and my family's appointments at a GP we were seen by these PAs and we all thought they were doctors. Because I'd seen him before, I assumed I was seeing a doctor but just thought to ask and then he said he was actually a PA. He got very defensive and kept saying he is "medical" and has lots of training but I felt very uncomfortable about the whole thing. Especially as countless times we've said things like "thank you doctor" and it wasn't correct, which really misrepresents everything. I spoke to my friend again and she highlighted to try and request a doctor at the GP even though the surgery don't need to give us one. It worked for my husband when he went for a review of his problem the PA saw and he got a refferal to a specialist after the GP saw him. When I mentioned to my friend that he'll be seen with a rapid 2 week referral, she said that's because its to check for potential cancer. I looked this up and it's true. Very upset about the whole thing and trying to understand what on earth these PAs are doing in healthcare if they don't have the right training? If my husband had seen the GP 3 months ago, this could all have happened much sooner.

Has anybody else come across these PAs and what were they like? My main worry is that I am not especially qualified or educated in this and neither are my family (I work in sales, husband is in IT) and the only reason we got a heads up about this is because of my friend who clearly is very familiar on these matters even though she's not a doctor or nurse. I think she's already proven her point of saying she definitely doesn't want to be seen by one and it looks like all her colleagues were in agreement too - I just didn't register the gravity of it when I met them! Even considering moving GPs to a place where there are no PAs there to avoid seeing one by mistake which is a shame as the older GPs at the surgery are very good and nice and have helped my family a lot over the last 12 years we've been in this area.

There is obviously a plan to make the NHS similar to social housing and legal aid - just for the poor. Everyone else will soon get private medical via work or be self funding. A procedure rather than a holiday or a better car.

You will not be able to see a real doctor unless you pay privately. All the details are here The Roundhouse: an alternative model for primary care - PMC (nih.gov)

I was offered a place training to be a PA years and years ago and declined the place due to various concerns. Back then it was paid training, no uni fees….think the grant was 10k.

I’d been a midwife for many years when I applied and fancied a change. Other people being interviewed all seemed to be biochem graduates. So I’m sure very intelligent but no healthcaRe experience.

I was worried initially about the lack of jobs…..I still have never seen any locally either in the hospital or GP surgeries. But yes, also worried about the responsibility after two years training.

I don’t necessarily believe you have to be a doctor to be a good healthcare provider but I don’t think two years is enough for someone without a nursing background. I’ve certainly worked with some amazing ANPs who would be happy to be seen by, who have better knowledge and experience than SHOs. I’ve been seen by an ANP in a&e and was happy. Dd had her life saved by an ANP in a&e who suspected what was wrong two weeks after she had been told by a doctor it was anxiety (it wasn’t).

But i think there’s a massive difference between someone who has done a nursing degree, had years of experience and then extra training to become an ANP. And to be honest i don’t know why the NHS aren’t pushing this model more rather than the PA model. To be this would make more sense, they are registered, they can do a prescriber course and then prescribe so are more use, the training to be an ANP would be cheaper and shorter than a PA course. Though I suppose if PA courses now incur uni fees (I assume they do) maybe that’s not a consideration. And maybe with the nursing shortage they can’t lose nurses to it 🤷‍♀️. That they need the nurses to be “basic” nurses?

Anyway I would not see a PA in primary care, I wouldn’t want to see one in a&e. If one needed to Clerk me or take bloods, etc in hospital they could do that.

Absolutely @CormorantStrikesBack , ANPs have more rigorous training and specialise. A friend who was a Macmillan Nurse ran her own clinics and had a lot of specialised knowledge and experience. Some PAs previously qualified as nurses, but I agree that it is a pity that they did not see ANP as a good route for their careers. PAs are proud of being generalists who can flip between specialities, which is just bizarre.

I think it's money and time...the push with ring fenced money for more PAs , is because the DoH see them as a quick cheap solution to the workforce crisis.
ANPs...are going to be more expensive, take longer from the beginning to train, and are specialists...not what the government needs.

Absolutely.
Think ppl need to realise they have been recruited right across hospitals as well.
In peadiatrics, in A&E, in anesthesiology and down here in London in neurosurgery.
There's literally no role for them. Their 2 yr post grad degree is 8 yrs short of D training, 3 yrs short of senior nurse or paramedic training ( at least).
There is no way in a month of Sundays either I nor any of my family will consent to being treated by them. They're not even regulated and well documented preventable deaths have occured. The training is abysmal - one module on circulation teaches on a level of science GCSE. Because that first degree? It can be in anything. From media studies to geography to fine art. It does not even have to be a science.
But also very importantly unless you know you are or may be treated by an unregulated health care worker there is no consent obtained to treat you.
So it's not just at the GP to be aware

x.com/mmamas1973/status/1799865416405111099?s=46&t=3GTBkCDQwCMoT7yhcEaMPw Interesting

Indeed!