Do Doctors Hate Physician Associates? | 2024 | Doctor Reacts

Today I'm talking about the debate surrounding physician associates (PAs) and junior doctors working in the NHS.

00:00 Intro
00:16 What are PAs?
01:41 How do you become a PA?
02:02 How do PAs work?
02:30 How are PAs and doctors different?
04:26 What are the pros of PAs?
07:30 What are the cons of PAs?
13:25 Why are doctors unhappy?

WHO AM I:
I’m Triya, I graduated from Oxford Medical School and I’m currently a junior doctor in London. I make videos about life in London, Oxford, medicine and more.

Links

#nhs #juniordoctor #physicianassociate #medicalschool #premed #medicalstudent #medschool #doctor #physicianassociate #physicianassistant

Suggested further reading:
Malone R. The role of the physician associate: an overview. Ir J Med Sci. 2022 Jun;191(3):1277-1283. doi: 10.1007/s11845-021-02661-9. Epub 2021 Aug 5. PMID: 34351601.
Halter M, Drennan V, Wang C, et alComparing physician associates and foundation year two doctors-in-training undertaking emergency medicine consultations in England: a mixed-methods study of processes and outcomesBMJ Open 2020;10:e037557. doi: 10.1136/bmjopen-2020-037557
Glen E. The physician associate role remains poorly understood BMJ 2023; 382 :p1996 doi:10.1136/bmj.p1996

[goc]

I can very clearly recall the headlines:

“UK doctors protest at extension to nurses' prescribing powers” in 2005

“BMA meeting: Doctors vote to limit the number of medical students” in 2008

The PA profession is safe, thriving, and expanding in so many countries, including the US, Canada, Netherlands, New Zealand, Republic of Ireland, India, Israel, Bulgaria, Myanmar, Switzerland, Liberia, Ghana, etc., but in the UK, "they're not safe." PAs are not good, but the thought of their existence keeps me awake at night because they are taking our jobs, training posts, and filling our rotas. The most striking aspect of this orchestrated, dreadful campaign and vile bullying of Physician Associates in the UK was how old-fashioned professional jealousy and protectionism, disguised as "patient safety concern, " sparked intense hatred and bitterness towards a comparatively small workforce of less than 5, 000 individuals. Isolating and attacking a whole group of healthcare professionals who are doing their best in this manner is disgraceful on many levels, to put it mildly, but the public is not foolish enough to understand that this revolting campaign has all the hallmarks of selfish ambition for PROTECTIONISM disguised as "patient safety concern."

The Physician Associate (PA) is: “a new healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and/or general practice team under defined levels of supervision.” (DOH, 2006).

Another country where this protectionism is in full play in 2024 is:
“South Korean doctors strike in protest of plans to add more physicians." “The junior doctors are protesting the government's plans to train more physicians." (BBC News, February 20, 2024). Ever heard of Tiny Island Syndrome?

References:
Cole A., (2008). BMA meeting: Doctors vote to limit number of medical students. BMJ. 337:a748

Day M., (2005). UK doctors protest at extension to nurses' prescribing powers. BMJ. 331(7526): 1159.

Department of Health. The competence and curriculum framework for physician assistants. London: Stationery Office; 2006. (Accessed 30 May 2024)

[PaulAlsop-kj]

As an advanced paramedic I've stopped plenty of Jr Dr's from making big mistakes, respect is earned by all not just expected!

[prp]

Let's face it, the UK is bankrupt, it has a massive population with many diseases, entitled people, and few doctors. Problems will arise, such as this one. I left the UK in 2004, my local doctor had no diagnostic equipment except a blood pressure monitor and a weighing scale. Pathetic. Why don't these people, who clearly earn high salaries, invest in ct scanners and mri scanners?? That way, these high earning people will diagnose the problem early and save lives??? What is the problem with this country?? Everything is run down and Victorian. No wonder there's a huge problem there. Glad i left and certainly will not be returning to re live the nightmare.
Imagine visiting a local doctors office and finding a blood pressure monitor and weighing scales only in 21st century UK.
To say that a ct scanner is " too expensive " is a poor excuse. Even poorer is to state that a medically trained professional is incapable of using and interpreting the results. Pathetic excuse. There must be training schemes in place where these people can enter the 21st century and learn about how to use any scanner. If these people do not learn then lives are at stake because time is of the essence.

[ThePushUKLifestyle]

Sorry can I just ask you whether you have actually gone on the FPA website for Physician Associates to read CRYSTAL CLEARLY their SCOPE OF PRACTICE? Or do you and the other doctors who hate the idea of Physician Associates just create videos to continue to promote hate on the profession that is here to stay. Junior doctors need supervision from their seniors too likewise Physician Associates. You should start by doing a thorough research before spreading further false information to the general public for the sake of speaking up on "patient safety" when there are doctors who have missed diagnoses on similar cases as some PAs who have been dragged down.

By the way, the very first title given to PAs was actually Physician ASSOCIATES before it was changed to assistants and BACK TO ASSOCIATES. if you had done a thorough research, you would have known about the name and of course the PA SCOPE OF PRACTICE that has existed since DAY ONE OF THEIR INTRODUCTION IN THE UK 20 PLUS YEARS AGO.

I used to believe the information from the doctors against the profession until I read it MYSELF. Stop spreading FALSE/HALF STORIES.

[tsikanh]

How is it possible that after 20 years that this job exists, there is still such little clarity around their role?! Why is it left for so long unregulated?

[Sonia-igfj]

I like the way you have included both sides of the argument - I think it is important to be respectful to both professions and the value they bring :)

[hypnosstratagem]

For the US: I think that PAs are the response from the free market to the artificially created shortage by groups like the AMA. I think they should have basically all of the rights that physicians have and if they do a bad job, they get sued out of existence. Self-correcting problem.

[tommardel]

Im currently a student radiotherapist and i am interested in studying to be PA when I graduate and I'm not sure how to feel as I think it would be a good career for me, medicine is a very inaccessible career for many people, especially postgrduate study, if u arent rich its almost impossible to achieve. But i also don't want to go into a career where i am stigmatised and looked down on by my peers.

[tinam]

In a nutshell, PAs should not and must not be allowed to do the jobs of doctors.

[Mulberry]

As a patient here is my take on PAs, they are crap, simple as that, that is from my experience. Sure they are nice people, but when you go in the room with a PA you know they are not as knowledgeable and trained up as Doctor. PAs and medical centres do not tell the patient they are seeing a PA, the latter looks like a doctor and acts like a doctor and when you ask them they give confusing answers. PAs from my experience do not like not been compared to doctors, they give that impression. So not telling a patient they are not seeing a doctor, the medical centres not telling the patient they are not seeing a doctor is damn dangerous. I have mental health issues and i have told PAs i have some problems and it was dismissed. When i told a doctor this morning it was not dismissed. Over 4 weeks ago i developed a serious painful rash all over my body. I do not mix with any one, so i cannot for the life of me know where i got it from. My Doctor said you can get bad rashes from stress, yes i have a lot of stress in my life, depression and money worries does that to you. So like i said i had a serious rash, i was very ill, i could not tell the " doctor" what was wrong with me I just lifted up my t- shirt, it was then i found out to my horror i was seeing a PA.

Do not get me wrong she was very nice but extremely lacking, fair play to her she got a doctor to come and see me. When they saw my condition all was shocked, i put it down to stress. So i was given treatment by the doctor and he told me if it i have any problems with the rash come back. About 3 weeks later i went back and said i have a rash and sore between my fingers. I thought the rash was coming back, i saw a PA, this time i knew and she said you need some cream to help remove the sore and the spots to stop the itching. Yes this PA was one of two who saw my previous condition and she assumed it was the same, wrong big time. I went to the doctors this morning and asked the Medical centre not to give me a PA but an actual doctor. I walked into the the room showed him my hand and he said instantly anything between the fingers is assumed to be scabies. So i suffered an extra two weeks +one with a painful hand and it was spreading to my other. I then check my feet and it was on their but i never got any itching down there except on my legs at night but I never though about it.

So what's the point of my post? PAs are human beings, but they pretend to be doctors, they do not tell patients they are not doctors, and the medical centre colludes with them. When asked they use obfuscation to confuse the patient, and that can lead to a big life threating problem if one thinks they are ok because after all the pain in the leg is just a sprain not a blood clot. There is no way a MSs is equal to a doctors MD or training just none. I know what a Master level is and how intensive it is. I have a Masters Degree and i did mine in one full year 12 months straight after a honours degree. So in my view PAs are dangerous they are not experienced or knowledgeable, you can tell when you meet them. A doctor because they are trained at a hight standard gives off aura of competence. No i have never thought a female doctor i have met is a nurse. PAs do not have the air or competence but act like they do, as the saying goes a little bit of knowledge can be dangerous - in this case PAs are.

[medstudent]

We just don't want PAs. They always need to be supervised. which creates extra work. And can be used to drag down physicians salaries. Only clinic management profits form employing PAs instead of using real doctors.

[reesee-dhbf]

why is patient safety being flagged up time and time again. if you think about it PAs are discussing all their cases with reg / consultant and not making independent decision.

By your faulty logic, if you give a very junior FY1/FY2 an extremely complex to manage ON THEIR OWN without a senior input, the patient is safe and patient safety uncompromised by default just because they are doctors and they went to medical school? DONT MAKE ME LAUGH.

by your faulty logic, FY2 are baby doctors and even if they make a mistake its okay because they will LEARN as as they go along and with years will gather more knowledge and experience. but if a PA makes a mistake they are incomptent, they are unsafe and all the negative shit.

Can i point out what the biggest flaw in your logic is (and all the other doctor sharing your view) it is that you very ignorantly think PA's learning is capped at PA school whereas med students continue to learn and grow after med school and you are unable to comprehend the fact that PAs continue learn after PA school just like medical students.

also people thinking 3000 odd PAs taking away training opportunities from >300, 000 doctors- gotta take the L.

[anjusree]

But the names shouldn't be the ones deciding if they are parallel to a qualified doctor. It's literally going to do more harm than good

[dromaarmuhammad]

PA's should not be allowed anywhere near patients. A lot of patients have died off late because of PA incompetence