Caesarnotsalad
@Caesarnots96696
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Physician associates must stop diagnosing patients, say senior medics
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@Dr__Sarmy
Is a shame that the money can’t be directed into funding more GPs who can do it all and pick up on other things & act quickly. Like earache that’s really mastoiditis needs same day urgent admission for IVs. Not delay via pharmacist
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Noticing a pattern where the only Drs who are really protective of the PA role are those significantly benefitting financially or career-wise
Take the financial bias out & all would just choose to employ Drs instead
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@Ask_foradoctor
I presume the child has survived, but also still very unwell
Some people think it’s just like Casualty
It’s so unprofessional but more than that
What’s happened for this disconnect between humans & the sanctity of life?
Feels like quite a deep loss - how far have we sunk?
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@DrEilidhMaria
Everyone paying subs to RCS needs to write to them to ask them why they are enabling this.
I know the answer is money..
Not on to undermine patient safety and Drs in training
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@Ask_foradoctor
Dear lord, I think the ED cons could’ve worked out steroids & x ray’s by themselves…….
What on earth is that PA actually employed to do?
Any FY1 could manage that (for half the cost) & actually prescribe/order the x rays
The ED cons could’ve done that in a couple of min 🤦🏻♀️
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This is sooooo weird
WTAF are Health Education EoE playing at?!?!
Pay less educated, less knowledgeable, less safe PAs more £ than a Dr to do same job?
With just a 2y masters?
& while a 1,000 just graduated Drs, due to start the same job are told not enough space for them?
So despite almost 1000 final year med students being given placeholder jobs, PAs are being given a foundation programme with a £500 study budget not to mention 43k+ starting salary. How is this defensible?
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This is the madness of where the money goes in the NHS.
Why don’t they want to pay Drs properly?
Why are they pushing non-doctors at the expense of safety & finances?
Non-doctors paid up to £154/hr to cover doctors during strikes, while F1s earn just £15/hr
Doctors don't get these rates when covering for sick colleagues
Bribing non-doctors to work outside their scope risks their registration
How is this safe for patients?
@EastLancsNHS
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How they can have PAs in jobs on medical rotas when there are real Drs, much safer and cheaper than PAs who are without a job?
I’m pretty sure this isn’t what the public pay their taxes for…
Taken from the MedReddit
If this is a legitimate email, I have no words. It is absolutely unacceptable for a single UK medical graduate to be left without an F1 post (the only way they can gain full registration).
The UK medical community needs to raise hell about this
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@doctor_dru_
Is horrible cos you’d need to repeat the assessment, overnight and not be seeing other patients who need you.
PA is a waste of time & money
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@Ask_foradoctor
How’d you get med reg equivalent knowledge in a 2y post grad when it takes a med reg at least 10y & post grad exams.
The PAs would need be absolute geniuses….
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@GMCharlatan
Doing ward round documentation is what real Drs do the majority of the time because there’s so much of it that it’s difficult to get away for clinics/procedures - despite needing to do clinics/procedures for training to become consultants of the future
No need PAs do procedures
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What a joke - a one year Masters in Medical science for PAs so they can call themselves Dr…
Patient safety nightmare
Patients need to know when they’ve not been seen by a real Dr that’s been to real medical school
@MedRegoncall1
@vcg239
Found the profile
They have a “doctor of medical science”title - 1yr degree awarded by University in Virginia 100% online while working in London
Looks like a deliberate tactic by to co-opt a “Dr” title
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@iDrSunny
Is soooo weird when real GP training takes:
-5y med sch
-2y foundation
-3y GP training inc 2 x professional exams, +++ workplace based assessments to ensure sufficient skills & knowledge to keep patients safe
On what planet does a 2y PA w/o medical degree = safe to see patients?
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@adamfare1996
Gentle explanation is what’s needed & keeping other people safe
Also keeps the autistic child safer because they run the risk of retaliation
Don’t need to demonise
Definitely have to stop that behaviour though - isn’t safe
Autistic kids can 100% learn not to hurt others
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@DrAmirKhanGP
Please don’t tell them they know EVERYTHING about gastro now. They will believe you!
Do make sure to let them know how you’ve barely covered the surface of the most common conditions. Being aware of unknown unknowns is v important
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@IVfacts
@DudleyGroupNHS
The PA course looks really easy from the PA posts, dissertations & question banks & the 100% pass rates
If mocks are publicly available or even on their passmed type equivalents would be useful to see how 1st yr med students do
If they pass why not give them the stroke bleep
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@DocDoLi
@Vocal_GenX
It might not seem immediately obvious to this Mum, but Drs are protecting the service which has helped her son, so that it still exists for kids who suffer with the same illness in the future.
Nobody would want to deprive the kids of the future of good healthcare
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@veggieequallife
I always ask the persons name and job title so can accurately record in patients notes.
Thought this was standard practice?
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@Ask_foradoctor
Never get over how a PA w/2y degree can work like this, while in the next room, looking similar, seeing the same patients a real GP needs to have 10y experience, inc 3y in Gp specialty training & 2 x arduous exams?!
The standard is so different
Absolute patient safety lottery
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@ExplosiveEnema2
@UMAPsUK
@parthaskar
@DrAsifQasim
@DrLKVaughan
@iDrSunny
@mmamas1973
@RoshanaMN
@UKGastroDr
@TomStocks1982
@Doc_IonaCollins
@DrSteveTaylor
Patient safety & standards in medicine = monopoly & competition?
Is all very capitalist speak
We’re not talking about trains, this is real people’s lives
PAs can compete for med sch places, not jobs they’re not safe to work in
Patients aren’t guinea pigs/lab rats!!
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@bmj_latest
Is this worth doing when there currently aren’t enough foundation jobs and are bottle necks at each level of training for doctors?
Sounds like a way to screw more desperate students out of more money with no jobs at the end
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@DrEilidhMaria
And HCAs are invaluable in their role, it’s a really important role that is highly respected.
Being an assistant isn’t a bad thing.
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@OrthoFA
@RCHTWeCare
“Highly skilled and qualified experts”
It literally is a joke.
They’re none of the above after a 2y post grad.
If PAs are described as highly skilled experts what would newly qualified drs (much more highly skilled & knowledgeable) be called?
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Dangerous PA project, replacing Drs with 2y post grads with minimal skills & experience
Mainstream media silence except for Emily Chesterton’s parent’s
No accountability from Med leaders - because they’re fulfilling the government’s agenda
@parthaskar
@NHSPracHealth
@NHSE_WTE
@mmamas1973
@DrAsifQasim
@doctor_oxford
@DrLKVaughan
@UKGastroDr
@RowanHarwood
@ShrillaB
@OrthopodReg
@RoshanaMN
@DrSteveTaylor
No accountability because they are fulfilling the government’s agenda.
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@Dr_BellaR
The issue is that male nurses are presumed to be Drs, and male Drs are presumed to be Drs.
Female clinicians are all presumed to be Nurses.
It’s sexism.
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@IncogAssociate
PAs have so much less training than Drs, less experience, exams are not the same high standard.
Human error occurs but so much more so when we have less experience & knowledge.
It’s an argument for higher standards, not lower.
It’s not a race to the bottom, or is it?
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@HannahAshwort17
She’s stating fact though Hannah - if you were a doctor and know what Eilidh does then you’d likely be saying the same
🍹🍹
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@MikeLivschitz
@DouglasKMurray
You are missing important bits like the apartheid and the thousands killed before 7/10 by Israel. The evidence is all out there. Don’t be scared to look at it if you have true confidence in your beliefs. You’d only be scared if you think your beliefs are based on lies
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@ClareGerada
*Please do not attempt to mislead the public into thinking PAs are the medical generalists that GP needs*
As a Dr you know they come with significant patient safety risks with only 2y training vs >10y for your average newly qualified GP
Patients deserve better
#Askforadoctor
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@ObserverUK
Massive conflict of interest.
Why on earth the observer published this?!
Do they do no due diligence?
The only Drs who support the unsafe PA role are those with money +/- ego caught up in the whole disastrous PA experiment
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@SohiubN
@HeidiBachram
It’s not antisemetic to oppose genocide. Especially when it was atrocities carried out on mostly Jewish people that prompted Never again. It’s giving the highest respect to those who lost their lives to ensure Never again for anyone.
Israel doesn’t represent all Jews.
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@MedRegoncall1
Not sure be happy with them working at any of those levels
They’ve not been to medical school, are not Drs and not safe to work as Drs
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@TheBMA
@DrPhilBanfield
@DrLatifaPatel
Thank goodness for this little signal of hope letting the light through.
Is like living in a parallel universe at the moment
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@XelenX1
@Mary_Tom11
@DBDouble
@medicalmodelbri
350 anaesthetists 3yesrs into training didn’t have jobs for year 4 because training places not funded.
Simultaneous increase in Anaesthetic associate roles (PA in anaesthesia of all specialties… 😬)
Is a carefully curated replacement of Drs
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@vasconcell75240
@Ask_foradoctor
GP is a speciality - that’s why there is specialty training and specialty exams - you can’t work independently in GP as a Dr without fulfilling the RCGP requirements for CCT.
Is 3y of portfolio (after 2y foundation) & 2 x high standard & difficult to pass exams (£1200&£500)
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@NHSSTW
This is weird when GPs are out of work, PAs can’t work independently, they are not safe without supervision?
2y post grad degree in very basic medicine, after a normal degree from any background doesn’t = highly qualified in the world of medicine
A 3rd yr med student has more..
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@rcgp
I so much want to replace the word “careful” with “honest”
Honesty & integrity very much needed right now in medical leadership
The PA disaster is a stain on the leadership of RCGP for it to have gone so far, & had negative effects on patients & GPs
Please no more gaslighting
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@FrankCoffey26
Parents of those who’ve died because PAs were placed in jobs out of their depth would disagree
It’s happening all over the country
Harm or substandard care will be being done right now
Not cos PA not hard working, but because they’re woefully undertrained for the job
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@IncogAssociate
Not when they have to be supervised
They need to stay supervised for patient safety because they don’t have a medical degree or specialty training
Better to let trainee surgeons do it who will have the knowledge & skill set to do it safely & independently by the end of training
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@IncogAssociate
@TheSooperCynic
All Gp regs introduce themselves as Gp trainee
It’s really important for patient to consent to any assessment, examination & treatment that they know who/what they’re letting into their private info & personal space
Foundation - hi I’m the junior doctor
That’s v basic
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@Ask_foradoctor
I think we all felt that sinking feeling, is quite emotional & makes you want to cry.
The poor child fighting for her life.
They could have died, they might still die.
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@SaleyhaAhsan
@TomKat56184663
The midwife vs Dr divide/enmity I saw as a student and a Mother put me off ever working in O&G. Actively discounted any rotations working in O&G.
Needs sorting out nationally
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@sallyanna25
@EmergMedDr
If a foundation year 1 doctor isn’t qualified how on earth is a 2y PA graduate?
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@IncogAssociate
It’s not elitist to care about patients & medical ethics.
If Drs can’t stand up for patients & raise the flag who can?
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@EDPractitioner
Nearly every single ANP/ACP are worth their weight in gold. Qualified by experience and knowledge and selected for being excellent in their jobs. Also have a v firm handle on limits of their own knowledge & competence. Completely different kettle of fish to PAs.
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@Leedsviv
@DrSteveTaylor
And this is the actual point of PAs. A pawn in the governments game to reduce standards and promote 2 tier healthcare. Is sickening. Poor patient
#askforadoctor
(if there’s even one about)
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Poor SGUL med students - not being taught by qualified Drs despite paying so much in tuition fees & being silenced/worried about getting in trouble before they’ve even started work as Drs
I’d want a refund of my fees
The PA project is a horrible, dangerous mess
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@MichaelC7389
Wow, such a position of responsibility despite such little medical training, which is so odd when there’s no shortage of actual Drs applying for Paeds jobs
Why on earth use less well experienced/qualified people? Especially for child protection where so important to get it right
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@iDrSunny
Is as if Drs raising concerns for patient safety is seen as the geeky kid in school trying to ruin the cool kids’ fun.
These are real lives & someone needs to take responsibility & stand up for patients (& the Drs who’re can be held responsible for the PA mistakes)
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@meyne_helen
@jabberwock951
RIP Emily Chesterton
Died from PE - PA saw multiple times
& didn’t ask for help.
Despite classic PE symptoms treated for “anxiety” (shortness of breath from clot on lung) AND “calf sprain” (blood clot in leg).
Didn’t click that these occurring together & worsening was odd?!
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@Samantha_nhn
I really never know why patients aren’t more important.
In real medicine patients come first. There isn’t a Hippocratic oath anymore but there’s a clear code of ethics and
#1
is First Do No Harm…
Patients pay taxes and deserve properly trained actual doctors
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@medicalmodelbri
Wow, it’s like RCGP, the rigorous GP speciality training & v expensive/hard to pass exams don’t exist.
People misunderstand generalism and think it’s easy when it’s actually one of the riskiest parts of medicine
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@IncogAssociate
@makepumps666
@TheSooperCynic
If there was likely to be any confusion caused yes, definitely
Otherwise the patient isn’t truly consenting to be seen by you or give you any information, let you examine them etc
Is basic respect
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@DrSteveTaylor
GPs were told PAs were safe without really knowing the content & standard of training on the PA courses.
Now details are coming out & seems patient safety and common sense gone out the window
Patients, Drs, GP surgeries & PAs all at risk when PAs make avoidable mistakes 1/2
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This sounds pretty ominous:
“first step towards further changes to our regulation of doctors in the future”
I genuinely dread to think what these further changes are.
Does anyone know?
Regulation of PAs and AAs will be a first step towards further changes to our regulation of doctors in the future.
🗞️ In this blogpost, Jen Agbanoma, our Programme Manager for Regulatory Reform, explains how these wider reforms will bring a range of benefits for patients and
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@juliaisobela
Piers is exploiting her
Can argue Gadd has exploited too but Piers is a definite 💩head
Unsure why real life Martha gained more attention than real life Darrien?
Fiona did out herself & has been interacting with the public I guess?
Despite criminality of stalking she’s vulnerable
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Doctor remains responsible for any PA errors
Need to be very sure you’re not the person accidentally supervising them
You’d think it would be only their trained supervisor supervising them but Dr Zaw was a registrar - ST3 level clinical fellow & was struck off re PA supervision
@doctor_katie
@rcgp
@DrSelvarajah
@parthaskar
@DAUK_GP
@KamilaRCGP
@TheBMA
@drcolinm
@ChrisHopsonNHS
@DavidGWrigley
The MDU is clear - when delegating care a Dr remains responsible
Presumably if clinical supervision is not taught by the delegating authorities they are responsible for the failure to provide adequate training to those asked to supervise other roles
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So misleading - GPs are Drs
“Generalist practitioners” have barely any experience with patients and very little knowledge as compare to a real Gp.
@KeeleUniversity
@rcgp
@RCPhysicians
@ActAsOneBDC
Might it now be possible for
@rcgp
@KamilaRCGP
to write to
@KeeleUniversity
to call out their use of the term “Generalist Practitioner” for the PA students they produce please?
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@drmattuk
@Valeria_Watt
@helen_barnowl
The Dr was called away urgently. The professional thing to do would be to log them out. Not fraudulently use their login, especially for tests you’re not qualified to order.
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@DrRosemaryL
Too many unknown unknowns with non-doctor roles.
Is very scary for doctors but worse for patients
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@DrSteveTaylor
PAs make mistakes not because not caring or hard working or because not clever enough, but because a 2y post grad degree with 100% pass rates doesn’t confer anywhere near the knowledge & skills in sufficient depth, breadth or high enough standard to treat patients (real people)
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For consultants
In GP this week, as GP reg, & had 2 distinctly lovely referrals/A&G type interactions with cons - respectful, chilled, patient centred & casually educational ✅
V refreshing
Is it useful to feed this back anywhere? If so how?
(Did say thanks at the time)
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“Innovation”??
Replacing Drs with a barely qualified, unsafe new staff group…
At the same time as starving the NHS of funding for actual Drs, causing Drs to be out of work
Utter nonsense!
Patient safety nightmare - do they not know? Or just not care?
This is why I hold my colleagues in contempt on every PA job they sign off-on
The government motive is as clear as daylight and there are colleagues in our own ranks justifying why it’s OK to have a PA in their department. It completely undermines the junior workforce
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@DrSteveTaylor
Physicians associates aren’t Drs, they’ve not been to medical school. They do a 2y course and is no where near as rigorous as medical school, much lower entrance requirements & near 100% pass rate. Is a huge patient safety issue. There are real GPs out of work atm.
#askforadoctor
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@PhilipSteart
@Dr__Sarmy
They are & if the money was allowed to be used to employ more GPs it would be better for patients. Pharmacists are brilliant. They’re not Drs. GPs are trained in generalism - ie spotting patterns in the whole body. This focus on 1 problem will lead to things being missed/delayed
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@DrNeenaJha
@JimBethell
Gp is a really dangerous area of medicine, managing the risk, so many patients, short appointments and complex or multi system presentations.
The wait for 2° care is so long that Gp do more and more. Diabetes, COPD, asthma, heart disease & often combo of the lot are Gp now.
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@MedRegoncall1
The person telling the story seems shocked re the massive gap in that PAs knowledge & patient safety concerns
BUT doesn’t seem to realise that they would be responsible for the PA error - if the PA didn’t ask for review or their hx didn’t suggest r/v
The Dr could lose licence
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@dannyjnwong
Not just anger but a huge waste of public money and a huge risk to patient safety.
It makes no sense other than to reduce the impact of industrial action, punish Drs & promote 2 tier healthcare - those who can pay can see a real Dr
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@ClareGerada
The answer is to divert funding away from ARRS into funding GP posts
There are enough GPs coming through since training numbers increased, too many are now struggling to find work or facing redundancy
The problem you describe has been carefully curated & can be reversed
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@SecretPhysician
How are they assisting with duty?
Examining the same day patients who can vary from simple cold/sore throat, needs home care, to chest infection needing emergency admission.
Why oh why don’t they just employ an actual Dr?
(Because ARRS is financial coercion to employ nonDrs)
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@JanjuaAdam
Is petrifying following the year of horrendously expensive exams, £1180 each time & often not passed first time.
To not have a job at the end to pay off these exams as well as mortgage, bills etc
What they’ve done is cruel as well as godawful for patient safety
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@DrAsifQasim
@ClareGerada
If GPs salaries were allowed to be paid from the ARRS scheme reimbursement, surgeries could employ more GPs
Patients would get to see real Drs which they all seem to want
GP has to mean actual qualified General Practitioners (10y min training)
Not PAs with a 2y post grad
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@Mike88881221
@PrimaryCareNHS
@parthaskar
@medicalmodelbri
@Parody_RCGP
100% esp when exams which ensure ST3 (after 10y medical training) are safe enough to practice independently, are so hard.
Patient safety is everything
Really scary to be facing working with PAs & “supervising” them - can’t risk my licence being responsible for their mistakes
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@HelenRSalisbury
@DrSteveTaylor
Why are exams & training for Drs so stringent & expensive when for PAs they’re so short, easy or non existent?
There isn’t just danger in prescribing or ordering X-rays/scans (that PAs can’t legally do)
Lots of danger in inadequate assessment & diagnosis
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@DrEmmaNash
@DrSteveTaylor
Something has to give
You’re the only Mum your kids have so they have to come first.
Is so difficult being torn because you’re also a rare commodity for many patients whose health & wellbeing rests a fair bit on your shoulders (no hand over in GP)
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@trishgreenhalgh
Poor Emily Chesterton, RIP, diagnosed by a PA with a “calf strain” & “anxiety” repeatedly over several consultations when really it was a PE.
We only know because she died from it.
The PA project is entirely inexcusable
Condolences to Emily’s family
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@Nigel_Farage
There’s already the foundation programme which is 2y
There aren’t enough training jobs for Drs applying
Money is being spent in funding non-Dr jobs instead
Listen to Drs re the real issues and you’d be the wiser for it
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@DrAmirKhanGP
@lorraine
That’s how to be a TV doctor. So impressed.
Factual, caring, clear and succinct. So much good in such a short clip. I only saw because I’m off work and unwell today - would love to see you on more prime time TV.
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PA now med student w/an incredibly valuable perspective on the PA problem
It’s not personal to criticise the PA role, or bullying, it’s patient safety
Promotion of PA by NHSE is politically motivated, no care for Drs or patients & it’s adding to the destruction of the NHS
I’m a former Physician Associate now at medical school. After 4 years more training, with more responsibility on day 1 of work, I will be taking at least an £11k pay cut from what I’d be earning as a PA.
Going from PA to Doctor should be a promotion, with pay to reflect this.
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1K
3K
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@iDrSunny
And it doesn’t matter if they did.
It’s still not enough to count towards medicine
Grad entry medics have biomed degrees & still need a long medical degree, pass finals, foundation & speciality training.
My biomed degree was a drop in the ocean compared to real medical degree
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@OrthoFA
Medical students would be severely reprimanded & threatened with expulsion if ever doing it again
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People wouldn’t let someone with 1/5th of the training of a qualified plumber anywhere near their house.
God knows why anyone would risk their health seeing a PA vs qualified GP?
Even worse why are the authorities prioritising this dangerous role over Drs & paying PAs more?
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@Xeon4f145d96s1
First do no harm needs to be reinforced much more clearly in PA courses
And professionalism, honesty, transparency etc
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@DrEilidhMaria
Paying for yourself to go skiing when you’re single and have no children should be within reach for a junior doctor
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@GMCharlatan
If speaking the truth and raising patient safety issues is a threat, that makes them some kind of bond/marvel style baddies.
Truth and patient safety shouldn’t be a threat to anyone, that should be what we’re all working towards
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@medicalmodelbri
@LocumPA_Ltd
Zero ethics
So much wrong
They’re the medical equivalent of cowboy builders
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@FV_mad_as_hell
@medicalmodelbri
On the job training isn’t going to replace 5y med sch, 2y foundation & 3y internal medicine & 5y neurology specialty training (inc stringent exams)
On the job training -> avoidable mistakes occurring in/happening to real people
Patient safety nightmare
No need for PAs
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@medicalmodelbri
@rcgp
@KamilaRCGP
@NHSWTE_NEY
@DrNeenaJha
@doctor_oxford
@drcolinm
@mmamas1973
@djnicholl
How does the PA recognise the complex when they literally don’t know how much they don’t know because they’ve just not been taught/haven’t heard of vast swathes of medicine, let alone recognise the signs & symptoms?!?
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@MedRegoncall1
If a PA can do this then an FY1 is more than qualified
Maybe could provide an income for all those without a job come August
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@LBC
@mrjamesob
It’s not personal to PAs who no doubt are hard working.
It’s just that the role itself is not safe.
It’s been brought in by people who do not have patient safety as a priority.
Drs have to stand up to protect patients & the NHS.
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@AmandaB55744931
And that’s what the “supervising GP” knows about your examination/ability to walk too as they were clearly not there
Drs have to “be kind” to PAs or get into trouble
If you don’t tell the practice manager or GP they won’t know
Everyone needs to report to build up a full picture
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@DrNeenaJha
And it didnt use to be that way.
“Austerity” cutting beds, worsening conditions so there’s been an exodus of senior experienced staff & regular throughput of new staff who stay a bit then also can’t stand the conditions & leave.
NHS failure has been curated
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@isitsleepytime
Ah he was an FY1 who started work early because of the pandemic & this was during the Dec 2020 wave.
He fell asleep at the wheel when driving home after night shift.
Now suspended from work.
It’s difficult because sometimes the tiredness comes on quickly.
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726 doctor shifts covered by PAs (non Drs with 2y course only) in 6 months..
They’re not meant to replace Drs because they’ve not been to medical school, don’t have the knowledge, skills or experience to be safe for patients
Patient safety nightmare
Rip off for tax payers
There is no agenda to replace doctors with physician associates.
This is just one hospital.
This is just one 6 month period.
Credit u/sildenafil_prn
@MedReddit
.
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@doctor_dru_
If people only want super wealthy Drs…
I thought it was the opposite - people wanted clever and kind kids from their local communities to train to be their Drs.
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@medicalmodelbri
@TheBMA
The PAs can’t help not knowing what they’ve not been taught.
They’ve not been taught 5y intense medicine, had 2y foundation dr & then 3y intense GP training
They’re not psychic & there’s a lot they just don’t know/wont recognise
Absolute patient safety nightmare
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