Why Doctors HATE Physician Associates..?

Timestamps:
00:00 Intro
01:47 What is a PA?
03:13 What are the benefits of working with PAs?
04:40 Reduced funding for Dodctors
07:55 Unclear guidance on working capacity
12:00 Patient safety
13:50 Low pay of doctors in comparison
16:05 What should doctors do about it?

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What's up guys! My name is Kenji and I am a doctor working in London. In this video, I talk you through the recent controversy between doctors and physician associates.

If you enjoyed the video, please give it a like and a comment so I know to make some more! Also please show support by sharing it with a friend who's also interested in Medicine :)

Thank you so much!

Sub count:

[alasryh]

I’m a PA-C (in the US) and have lots of thoughts on this.
1) The way we are trained is to eval/diagnose/treat the 80% bread and butter cases. That’s where PAs excel and the nice thing about that is it takes the load off the physicians (who nobody should ever argue against the fact are more highly trained, educated and have more practice) to take on more complicated cases. Of course there are PAs in the US who after many years of practice are able to expand their case load, but it comes with time, study and education. I always was grateful for my collab and supervising physicians who I could shoot my dx and plan to and were always available in the case of complicated patient cases. And when in doubt, we referred out to ensure the best care.
2) There’s always a lot of hate on the pay PAs get. We get paid a full salary right out of school. In my opinion, it’s ridiculous that residents don’t get paid as much or more for the work they do especially with the crazy hours they work. That’s an issue with the system, direct your hate and anger there, not at PAs. Part of the reason of the pay difference (learned this from a PhD in economics who did his specialization in health Econ) is that 1) there is a need to limit the number of physicians in the pool to hyperinflate the pay attending physicians get. Two, because PAs are able to be put to work without the residency aspect, we make the clinics and hospitals more money more quickly and the pay we get is less than hiring a physician so they save more in the long term. It’s all about the money at the end of it, as always. Hiring 2 physicians and 5 PAs to see the same number of patients versus hiring 7 physicians. It makes a huge financial difference, and since we’re typically doing those bread and butter cases in whatever the specialty is, physicians can take on the more pressing responsibilities that are not in our scope of practice.
3) The PA profession is wayyyy too new in the UK for it to be moving to less supervision so quickly. That’s alarming.
4) If you’re in medicine, you know that malpractice cases including physicians are far and wide and 98% of them never make the light of day because they’re handled by lawyers in dark rooms with big payouts and licenses are maintained. The number of cases I’ve come across with sheer malpractice and irresponsibility on the part of physicians is wild and I know physicians with similar stories. Just because a single case come to light ( I don’t know the specifics) in the midst of heat and controversy, it needs to be evaluated with more nuance and more questions should be asked regarding the actual case and what went down and was the issue truly the PA was acting outside the scope of their practice or were there other factors being overlooked due to media sensationalism.
Maybe I’m a little passionate about this because I as a PA have caught the mistakes of physicians I’ve worked with more than a few times and thankfully corrected and informed the provider before anything could’ve happened but in the world of medicine where patients are pumped through the door like cattle, providers are overworked, burnt out and drowning in documentation, there’s a huge revamp that needs to happen in both systems in the US and UK. Otherwise, the shortage just gets worse, patients get less care and it sucks for everyone.
Also in the US, it’s a little different, we are able to order diagnostic labs and imaging and prescribe medications. So we’re way more liable for our patients. I definitely empathize with you on the fear of now taking liability for patient who wasn’t yours because you have to order tests on behalf of someone else.
Hope that helps!

[Dragon-uprb]

6 years in medical school, IELTS, Plab 1 and 2, F1 and F2, first 3 years in specialty training, more responsibility and on call but still earn less than PA 😂

[jisoohusband]

I don't get it why physician associate are getting paid more than doctor? If so, joining med school is nonsense.

[StudentDoctorAntonioPatterson]

If you want to be a doctor and do what a doctor does, go to medical school!

[jackofalltrades.]

People who are thinking about DOING PLAB and going to UK, this vedio is for you.

No one should go to UK this pathway.

The amount of payment and this new issue will really mess you up if you are middle class aisan like BANGLADESH OR INDIA and come to UK.

[jfoiju]

1) Why the name change from assistant --> associate in the first place ? Only acts to artificially inflate trust in the role by blurring lines, an associate physician is a highly experienced DOCTOR

2) If you put multiple barriers in front of incredibly hard working and academic individuals who care about what they do, but don't put these barriers in front of less qualified people, what do you expect?

[esvedra]

Doctors need to learn to be better leaders, practice teamwork skills, and most importantly, agree to supervise PAs. Doctors that refuse to cooperate with PAs are the problem. It's not like PAs need any of this extra drama.

[naimac]

If the intention was to make the service more efficient then I'm sure no one would argue with that. But if the intention is to cut funding then that's a different thing all together. 'Sacrifices' will always be made. In this case, it is your health. Efficiency is the government's euphemism for cutting funding.

[I.identify.as.a]

If a doctor hates a PA… there is something wrong with the doctor. The person doing the hate is always in the wrong. Its a healthcare team now not a dr only team. Doctors that have this thinking are horrible to work with or upset they did a bunch of schooling and people are not kissing their feet like the old days. There is a reason a Pa education is popular and why the 2024 match had a bunch of open spots left lol.

[MR-dhxo]

It is harder for you to get onto a training post because of the overseas trained doctors who are being brought to the UK

[comedystuff]

With all respect but please look into the requirements for applying for physician associate studies, there is no medical school in the country which will accept a student with a history degree no way I challenge you on this in the nicest possible way

[brucenome]

In undergrad, in the United States, you have to take science core classes for the PA program. Chemistry biology anatomy statistics and some higher science course's like biochemistry upper level

[ashs]

Most PA courses require a science degree, you can get on without a science degree but you usually have to have significant healthcare experience and the course is so intense that without that I would imagine a student without that background would not do well.

Yes there should be more training places for doctors and they should be paid more, but maybe that should be separate to the discussion of the PA role. PAs have been practicing in the NHS for 20 years and maybe if more had been done to regulate them earlier and define their role this wouldn't be an issue.

I think there should also be a caveat that the role of a PA in a GP surgery vs a hospital in terms of working independently is different. And there is also a difference between a newly qualified PA and one who has been working for 5-10 years.

The solution to what you're expressing doesn't seem an easy one but the hate towards PAs is intense and like you say they are also trying to do their best for patients and also have specific training but it seems like they are being targeted as the focus of hate regarding issues facing Dr's that should be resolved on a higher level.

[NN-kofu]

I see many other videos like this and even though author says, im not biased, some statements blur the line as such..

Here in the US..

Both PAs (physician assistant/associate student) and Medical students have the same prerequisites to entire their program. Both can have a art degree or a science degree as long as they meet science prerequisites. Both are very competitive to get into.. (PA schools require prior health care experience, Medical schools may require research or community service etc.)

Medical school is 3 to 4 yrs (3 yrs for accelerated tracts in GP/IM, OBGYN, Pediatrics and psychiatry which are growing in numbers)..
PA schools take approx 2 to 3yrs the work force as a general practioner with the ability to specialize in any area..

Notably: PA schools are accelerated with only 1-2 wks break in between semesters.. thats what makes it 2 to 3yrs long..
The same for 3yr accelerated Medical school programs vs the traditional 4yr medical school programs which have considerable more breaks especially in the 4th year which can be used for research or subinternships and interviews for residences

At the end of both programs, both PAs and medical students are GPs.. YOUR TRAINING DOESN'T BEGIN UNTIL RESIDENCY..
Residency training ranging from 3yrs for Family medicine or IM or EM to 8yrs for Neurosurgery..

PAs don't have residences and entire the workforce with limted knowledge with the expectation to grow that clinical knowledge and expertise overtime within their specialities..

Both newly minted PA snd residents are and should be supervised. As both gain more clinical knowledge, the more autonomy is given..

I don't believe a PA thats has been working the same specialty for the past 5 to 10yrs (except for the surgical specialities) should be supervised or micromanaged just as much as a resident who trains for 3 yrs is no longer managed after their 3yrs..

[Mimi]

What's wrong with doctors? Even in USA doctors I hear they do not like the Doctorate Nursing Practice DNP. They forget that A mathematicians or psychologists they can be called doctors if the individual achieved a doctorate degree.

[AtifKhan-iroe]

Physicians advocating for a halt in Physician Associate recruitment, rather than advancing structured definitions and levels for PAs, seem to align with outdated, elitist Conservative values rather than prioritizing patient safety. It’s essential that we focus on progress and patient well-being rather than clinging to traditional hierarchies

[MisterPete]

I agree with everything here. There could be use for the PAs such as taking measurements or readings but certainly not diagnosing. Also they should probably change the title to physician assistant.

[TT-fnxb]

I know nothing about medicine. But I have read around this subject. I wonder why the government decided to start the PA’s on such a high salary, knowing how little doctors are paid. Some people have asked in the comments section that we should be asking why doctors are paid so low rather than questioning the higher wage of PA’s. But doctors came before PAs so the question really should be the other way round. As I said, why is the pay for PA’s so high when the responsible bodies know that doctors are paid a lot less? What does that say about the value placed in GPs versus the value being placed in GPs. And why are they making the PA role more desirable than the GP role based solely on pay?

[Mimi]

Nurses are important as well and not only the MDs are special in the medical field.

[Sonia-igfj]

I agree I think there should be clearer guidance for supervision especially for newly qualified PA's - I have seen a GP practice who offered a preceptorships scheme which involved specific training for a newly qualified PA in GP. I think in primary care it is very dependent on the supervision - as you can imagine even for a F1 you would want to be supervised closely. There are some senior Dr's who are putting PA's in difficult positions. I have seen highly competent PA's working in a practice for years and have been promoted accordingly. It is dependent on the PA/ amount of supervision contact. I am hoping when regulation occurs - they will be stricter guidance for newly qualified PAs.

Regarding GMC - hardly any patients know what a GMC number is. I think regulation is a much needed step forward. I don't think its blurs any lines - a PA should always ensure they introduce themselves - in my experience this has been the case. The GMC have confirmed the choice of regulator will not be changed. This was agreed in around 2019 - however the debate has heightened in the last year.

Although very unfortunate, I disagree with individual cases - as Dr's make mistakes too. I don't think it is fair to generalise to the wider profession. There are many cases were Dr's were involved in never events.

Agreed working within the right capacity + supervision needs to be ensured!

Dr's 1000% need to be paid more but that is not the fault of PA's. Other allied roles - speech and language therapists/ nurses also earn more than newly qualified junior drs. PA's are paid fairly - junior dr's are paid incredibly unfairly fpr years. Definitely I agree all HCP's should be respected :)

I personally do not thin there is a plan to replace Dr's - there are approx 3000 PA's in the UK + over 300, 000 Drs. I think there is a role for PA to positively contribute to patient care - as you mentioned longer waiting times, increasing ageing population etc. There is alot of work to be done - I think roles like ACPs/ PAs can help. The other issues will help ease tension - if Dr's were just treated alot better as they deserve!