invertedcoriolis
@InvCoriolis
Followers
409
Following
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Media
704
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Elitist gatekeeper of medicine (aka actually cares about patient safety). 🦀
Joined December 2023
Don't wanna be here?
Send us removal request.
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Pinned Tweet
You can teach a monkey to play the piano, but it will never compose a symphony.
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Just wanted to say, I was on a plane at the weekend and I can confirm that the staff flying the plane were in fact pilots and the staff not flying the plane were cabin crew. I did not see any members of the cabin crew take over from the pilots at any point.
That is all.
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It's not "elitist" to have standards.
It's not "elitist" to only allow pilots to fly planes.
It's not "elitist" to insist that engineers design bridges.
It's not "elitist" to mandate that lawyers pass the bar.
It's not "elitist" to insist that lifeguards are certified.
@Xeon4f145d96s1
This is pure elitist mentality.
You can't say you can make mistakes and we can't
Standardised national accreditation?
Undergrad, post grad PgDip/MSc, university exams and then the PA national exam set by
@RCPhysicians
and
@FPARCP
which will be overseen by the
@gmcuk
. We good.
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If you want to be a doctor, go to medical school.
Anything else is a fairytale
@LittlePersonDoc
Medicine is 5 years.
3 years undergraduate BSc + 2 years postgraduate masters level PA course = 5 years.
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Sorry but that's a hard NO. If a PA wants to become a doctor, they can apply to go to medical school - undergraduate or GEM. There is not other option.
Replacing one shortcut with another solves nothing. You can't avoid the nitty-gritty.
Dear 🇬🇧,
Enough is enough. It’s time to end the Physician Associate (PA) role in the NHS. Here’s why and here’s how.
When you need to see your family doctor, you deserve to see an expert clinician rapidly. But the
@Conservatives
believe otherwise and it’s a key component of
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"[The trust] did not respond to questions from the BBC regarding consent and medical negligence insurance."
Any patients who had a cholecystectomy here between 2015 and 2017 needs to request a copy of their notes and contact a lawyer if they were affected.
Class action anyone?
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💯 this. There are two routes to a medical degree:
1. Undergraduate Medicine
2. Graduate Entry Medicine
Anything else is snake oil.
To be clear, I don’t support a shorter conversion course for two reasons:
1. Graduate entry medicine is extremely tough in 4 years as it is
2. There is questionable consistency in course content & assessment across PA courses - so what do you include in a conversion?
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This nonsense about 'different knowledge, skills and expertise' has to stop. PAs have a small subset of the knowledge, skills and expertise of a doctor. There's nothing "different" about it
2/6 We will become a multi-professional regulator, but we’ll regulate doctors, PAs and AAs as three distinct professions. PAs and AAs aren’t doctors and they can’t replace them, as they have different knowledge, skills and expertise. Our Chair, Dame Carrie MacEwen wrote to all UK
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Sounds like somebody's been playing in the red column
@DrNeenaJha
I had a PA call me about a child with asthma to ask me if they needed admission or not. I asked that supervising GP examine the child, but supervising GP was not on site. PA advised me this was their “bread and butter”.
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"I don't see how going to medical school has anything to do with the word physician" - a PA
For a group of 'just 3000' there are far too many examples of a delusional rejection of reality and dangerous overestimation of ability.
@SecretPhysician
Here is PROBABLY her trying to gaslight the public with awful lies.
She claims that Physicians are not doctors and that she went to medical school.
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@Caesarnots96696
@amnerisuk
@LittlePersonDoc
@IncogAssociate
Hi - I’m a Doctors Assistant - we are Band 3. We exist to protect training time for Foundation Doctors. As a role, we do a lot of admin, drafting discharge letters, phlebotomy/cannulation/cultures, scribing on ward round etc.
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@AndrewMeyerson
@Conservatives
Sorry but that's a hard NO. If a PA wants to become a doctor, they can apply to go to medical school - undergraduate or GEM. There is not other option.
Replacing one shortcut with another solves nothing. You can't avoid the nitty-gritty.
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@profjimspeaks
@doctor_oxford
@NHSEngland
Jim you half-arsed the job. Scope of practice, regulation and governance should have been in place well before any boots hit the ground. But you and your cronies were too busy chasing personal glory to do a proper job.
You are (partially) to blame for this.
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'Professional discrimination' is something you just made up. Could homeopaths claim 'professional discrimination' against the entire scientific community?
Profession is not a protected characteristic (see below).
Also, PA is not a profession.
Get a grip
@StGeorgesUni
, jeez.
We have recently seen discussions across social media about upcoming graduation ceremonies for our Medicine and Physician Associate programmes.
Read our full statement in response to these discussions here:
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Absolutely ridiculous
@UniofNewcastle
Refuse to supervise 🫸
Refuse to train 🫸
Refuse to engage 🫸
Image:
@r1chardf1tzg3r1
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🚨The gaping holes in the swiss cheese of the PA project🚨
Poor grades -> Weak Bachelor of 'Science' loosely associated with healthcare -> 2 year unaccredited medical model school with 100% pass rate -> Neurosurgery/undifferentiated pts/A&E Resus etc.
Stop the
#PAProject
now
Med student:
Straight As at A Level, including sciences
High UCAT score
Extremely competitive interviews
5yrs
New grads earn £32k
Compulsory FY programme
PA student:
Poor A Levels
Poor quality degree
Course admits anyone
2yrs
New grads earn £45k+
Work independently in GP/A&E
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Rapidly expanding is exaggeration?
20 years ago: 30 PAs
10 years ago: 300 PAs
Now: 3000 PAs
This expansion is not just rapid, it's exponential. The
#PAProject
has multiplied like a virus and needs to be paused for a review.
#flattenthecurve
@cmwilliams99
@EduMed_UK
Rapidly expanding is a severe exaggeration and typical scaremongering.
Be better than these trolls.
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Police don't care, (incorrectly) say talk to the GMC.
GMC don't care, say talk to FPARCP.
FPARCP don't care, say we can't do anything if they're not registered on the voluntary register.
Trust doesn't care, happy to sweep literal crimes under the rug until found out by an FOI.
I'm still amazed by this
Illegal prescribing of Class A, B, and C drugs. Yet who is it protecting patients?
The Trust 🙈
The Police 🙈
FPARCP/GMC 🙈
An anonymous pizza online ✅
What sort of crazy topsy turvy country are we living in!?
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Important point. These contracts requiring PAs to see undifferentiated patients only exist because if they did not stipulate this, there would be no economic value.
But how do we square this with the fact that every patient seen has to be seen again by a GP afterwards?
@IncogAssociate
@KadeFlowers
@VishwajeetP4t3l
As I understand it, PCNs are mandated to allow you to see undifferentiated patients if they are to benefit from the lucrative ringfenced ARRS. Without it, what could you do that another GPST can’t do is the question you’re avoiding here. You cost the same to the taxpayer patients
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Why the PA project wasnalways doomed: it was being led by people with bigger eyes for ambition than brains for critical thinking.
"Condition X is difficult to diagnose even with years of training. This justifies allowing someone with a fraction of the training to have a go".
@iDrSunny
And as I am sure you know (or maybe you don’t) this is a commonly missed diagnosis even by experienced drs in GP, ED, OPD.
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@ShareCabling
@nhsbourbon
That's great for her but if she's acting beyond the role of assistant and doing tasks that require a doctor she is part of the problem. Hopefully the place she works is not making her do this!
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True leaders don't deceive colleagues into thinking they're doctors like Jamie S. True leaders don't commit academic perjury like Jeannie W. True leaders don't obfuscate like Colin M.
Please seek help, you've been brainwashed.
A true leader drives essential change without undermining and disrespecting the mental health, confidence, or identity of innocent people.
This individual does not embody the qualities of a leader; instead, they exhibit the traits of a dictator.
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Here's a little diagram to make it clear
@InvCoriolis
@JimBethell
@TheBMA
@gmcuk
And you have no understanding of physician associate training, assessment or clinical competence… yet we all are.
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And yet the very day after
@gmcuk
say this look what happens:
So the trust who inappropriately hire a PA to cover a locum should be reported to... *checks notes* the trust who inappropriately hired a PA to cover a locum?
Wtf do we need
@gmcuk
for?
4/6 Any rota or team which expects or instructs a PA or AA to replace the role of a doctor should be raised locally. Like any other member of staff in the health service, PAs and AAs can only do what they have the training, experience, and knowledge to do.
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@iDrSunny
Not a GP, but it seems there's already a nice list of assistant-appropriate tasks set out in the scope of PA practice doc
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@drcolinm
Hey Colin, thanks for that - but we know how things stand at the moment already. Just in case you missed it, the question is actually "Are the GMC laying the groundwork for future PAs to take the MLA?"
Please clarify. Cheers!
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@medicalmodelbri
@TheBMA
@RobLaurensonD4P
@BMA_James_Steen
@parthaskar
@DrNeenaJha
@doctor_oxford
What, you mean like they were *SUPPOSED TO DO*?
These people have no insight at all...
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@IncogAssociate
Lmao, you forgot apples Vs. oranges
This is why you didn't get into medical school
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@cjsnowdon
@Anisocyte
@JimBethell
Yeah I stand to gain: I stand to gain access to a health service that actually delivers the accepted level of safe medical care that I expect in a 1st world country.
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No unique skills. Finally.
@medicalmodelbri
@ClearThinker66
@Shamz_141
@InvCoriolis
@VishwajeetP4t3l
When were PAs marketed as bringing unique skills? We simply serve as an additional pair of hands to aid the NHS in meeting its demands.
Not everything that presents to primary care needs to be seen by a GP.
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Why can't cabin crew be called pilot associates?
Many aviation terms can easily confuse passengers. Should we consider changing their names?
Runway vs Taxiway
Altitude vs Attitude
Ground Speed vs Airspeed
Flaps vs Slats
Spoilers vs Airbrakes
Yaw vs Yoke
Aileron vs Elevator
🤷
Ah, the classic community notes.
Many terms can easily confuse patients. Should we consider changing their names?
Ureter vs. Urethra
Reflex vs. Reflux
Electrocardiogram vs. Echocardiogram
Glucagon vs. Glycogen
Cervical
Ileum vs. Ilium
Carotid vs. Parotid
Creatine vs. Creatinine
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"He has demonstrated a conflict of interest" [citation needed]
PAs and their enablers must be shut down.
At all levels of engagement.
Without further delay.
There is no lie they won't peddle and no level to which they won't stoop.
11 'complaints'-all from PA colleagues to
@RCPhysicians
Reviewed by RCP
Decision:
"No current grounds to proceed with investigating these complaints further"
An excerpt from one of them
My concern is about safety based on lack of scope/regulation etc
Don't make it personal.
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@Xeon4f145d96s1
It's only demoralising if your whole sense of self-worth and identity is tied up in pretending to be a doctor.
As a balanced, healthy individual you don't have that issue. Incog on the other hand....
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@IncogAssociate
@LittlePersonDoc
Except those first 3 years in zoology don't count.
So you have a 2 year "degree" which is only about as difficult as a couple of a levels.
And the cohort taking it isn't exactly of high academic calibre either.
Mickey mouse qualifications
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@IVfacts
I thought PAs weren't supposed to be used to cover for Drs strikes? Which trust is this?
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@IncogAssociate
Thanks for pointing me to the donation link, Incog. Hope this puts UMAPS out of business.
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@gmcuk
This nonsense about 'different knowledge, skills and expertise' has to stop. PAs have a small subset of the knowledge, skills and expertise of a doctor. There's nothing "different" about it
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@JimBethell
@TheBMA
@gmcuk
Pipe down WhatsApp Jimmy. You shouldn't run your mouth when you have no understanding of the issue.
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💯 As far as general practice goes, PAs have no place
@quackophage
Physical associates receive no accredited GP training , no RCGP recognised qualifications. And their PA degree is unaccredited. They are just PAs who assist GPs not 'registered GP physician associate'
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@james_bedford
Have no doubt you make decisions with good intentions & wellbeing of your patients and team at heart. Your juniors are lucky to have you.
But still doesn't change the fact that shortage on a Drs rota needs more Drs, not PAs. Gov, Royal colleges and GMC have failed us all here.
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@DHSCgovuk
You should focus on convincing the 1000s of Drs we have already to stay in the UK.
Let me do your job for you:
1. Resolve the pay dispute
2. Increase training posts
3. Stop rotational training
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"Is there a medical professional on board able to assist us?"
I'll take £500 for 'words that were not spoken'
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The absolute state of the GMC in 2024 when they have to put statements like this out because nobody trusts them to do their job or act with integrity anymore... 🤡
🧵1/6: We want to help patients and the profession understand more about our work to prepare for the regulation of physician associates (PAs) and anaesthesia associates (AAs). We've put together this thread to answer the main questions you've asked about this on social media this
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It's not "elitist" to demand that fire safety inspectors are qualified.
It's not "elitist" to require veterinarians to be qualified vets.
It's not "elitist" to require dentists to have a done dentistry.
But is it "elitist" to require a medical degree to do the job of a doctor?
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Refuse to supervise 🫸
Refuse to train 🫸
Refuse to engage 🫸
If you don't re-examine and take a history from a patient a PA has seen, you can get struck off.
Don't train.
Don't supervise.
Don't entertain PAs.
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@SaraTon08500527
@carolvorders
And that's after more years of training and with deeper knowledge of pharmacology and medicine than PAs!
Just imagine the carnage if any old Joe could go round writing prescriptions.
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@Cleverclog67596
Jesus Christ. A medical student doing this would be up in front of
@gmcuk
before the end of the week.
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@bduric_
Sorry Bea your past sentence is in the wrong tense. "The NHS has turned into a laughing stock".
Drs in Aus are quote-tweeting UK medX to raise awareness and stop their system being infected with the rot we have here.
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@IncogAssociate
@ItsnotrightUK
You realise this is an argument for more GPs right? Not an argument for the continuation of the PA scam
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@IncogAssociate
Try reading the community note on your original tweet and you might understand why your argument is trash....
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@IncogAssociate
Lol, royal college of clowns is still - at the end of the day - full of clowns
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@DrNeenaJha
TL;DR (because we know some people are partial to shortcuts): Medicine is very complex and the diagnostic process of a GP is beyond the ability (and arguably the comprehension) of those who have not gone through med school and GP training. There are no exceptions to this rule.
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@SarahLudford
Lol then maybe you should turn up to your seat at the House of lords when stuff like this is being discussed eh Sarah? Your brilliant peer
@natalieben
did a lot of good reading into and work on this topic. Time for you to start searching.
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@thomaswoodcock
@BBCBreaking
But they do have Mickey mouse qualifications and they are literally doing criminal things like prescribing medications and ordering ionising radiation investigations.
Are you detached from reality mate?
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@IncogAssociate
Why can't cabin crew be called pilot associates?
Many aviation terms can easily confuse passengers. Should we consider changing their names?
Runway vs Taxiway
Altitude vs Attitude
Ground Speed vs Airspeed
Flaps vs Slats
Spoilers vs Airbrakes
Yaw vs Yoke
Aileron vs Elevator
🤷
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@MDShield
Yikes! Way to self-detonate your business spending all your money on fighting PA malpractice while Drs leave you.
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@IncogAssociate
@gmcuk
But she's right though. PAs need to be supervised so closely that it actually increases the workload of the doctor that is supervising. This has been the response in multiple surveys on the issue across many royal colleges.
It's not derogatory, it's an accurate metaphor.
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@Xeon4f145d96s1
(Disclaimer: Not defending views of the account in the bottom which are reprehensible, just pointing out the dissonance in the GMC response)
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It's not "elitist" to require pharmacists to be licensed.
It's not "elitist" to require a gas engineer to be 'Gas Safe'.
It's not "elitist" to expect financial advisors to be licensed.
It's not "elitist" to insist that teachers are certified.
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@IncogAssociate
@Ask_foradoctor
@LittlePersonDoc
I'd take the swimming badge over the Mickey mouse degree
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@IncogAssociate
Lurking around the corridors of a medical school for 2 years doesn't make you medically trained.
😂
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Med X: 'PA's are unsafe, they don't have insurance or indemnity'
Also MedX: 'Let's stop people working in roles they are not qualified for'
MAPs: 'Noooo let me play Dr, now that I can get indemnity they can pay out for all my screwups'
FTFY, you're welcome
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@VictoriaAtkins
Too bad you haven't done anything to that effect then, isn't it Vicky?
Also, looking for support from the Daily Fail 🤣 shows how low you are
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@IncogAssociate
Lurking around the corridors of a medical school for 2 years doesn't make you medically trained.
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@cjsnowdon
Nothing wrong with the title of assistant at all. It's a clear and accurate job role.
What's your problem with dieticians?
Also, where is your advance directive stating that you will only be treated by PAs? I'm still waiting for that, coward.
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Being anon or not doesn't affect the strength of the argument presented.
Your views would carry a lot more credibility if you could construct a proper rebuttal
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@dr_shibley
It shouldn't be necessary because all PAs should be clearly stating they are not doctors when introducing themselves. This is the official line from the Faculty of PAs.
But given some of the behaviour we've seen, you can see why some want a badge.
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@trishgreenhalgh
@RCPhysicians
if you do not act with transparency and integrity, people will vote against your recommendations. It will be the end of the royal college
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@parthaskar
@RCPhysicians
@mmamas1973
@doctor_oxford
@trishgreenhalgh
@AntonEmmanuel2
@DrLKVaughan
@UKGastroDr
@RowanHarwood
@EileenBurns13
@DrAsifQasim
@RoshanaMN
Excellent use of "chicanery" 🫡
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@IncogAssociate
@gmcuk
PAs and AAs are *not* safe to practice in their currently deployed roles and no amount of corruption will change that.
Just like no amount of cosplaying will ever change the fact that assistants are *not* medical professionals
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Donated already and already earmarked part of the June paycheck for a second donation.
If you haven't done so yet, get on it!
We are commencing a legal case against the
@gmcuk
over their regulation of Physician Associates.
We need your help to fund it.
Writing letters didn't work. Time for action.
#telltheGMC
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@Cleverclog67596
"a whole medical profession" lol. There is one medical profession - Doctor of Medicine. Everything else is AHP at best, quack at worst.
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Jim you half-arsed the job. Scope of practice, regulation and governance should have been in place well before any boots hit the ground. But you and your cronies were too busy chasing personal glory to do a proper job.
You are (partially) to blame for this.
@doctor_oxford
@NHSEngland
Well I am a huge advocate for PAs and was one of those who wrote the original guidance, ran one of the largest programs, and chaired the national exam. But if these posters are true, I am equally horrified!!!
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@pulsetoday
Yeah sorry but no. No homeopathy degree that spent 2 years in clown school is having a say in what they can and cannot do.
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@IncogAssociate
@iDrSunny
@parthaskar
@TheBMA
@NHSE_WTE
@FPARCP
@RCPhysicians
@DrLKVaughan
@UKGastroDr
@RowanHarwood
@DrPhilBanfield
@mmamas1973
@DrAsifQasim
@trishgreenhalgh
@doctor_oxford
@OrthopodReg
Don't work beyond your competence and none of it is a problem 🤷🏼
It's easy really, hope that helps 👍
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@RCPhysicians
@HilaryWMedic
"The past six months have been highly damaging for the college"
No. What's been damaging is allowing morally bankrupt, academically shady, financially motivated gong chasers to usurp the institution and promote quackery for personal gain. The past 6 months are the consequences.
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@JimBethell
@rcgp
Pipe down Jim. You shouldn't flap your trap on topics you have no authority to speak on
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It's not "elitist" to require chefs to follow food safety standards.
It's not "elitist" to expect electricians to be certified.
It's not "elitist" to ensure architects are qualified to design safe buildings.
It's not "elitist" to expect mechanics to be trained and certified.
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@ExplosiveEnema2
@gmcuk
@drcolinm
@AlisonGeorge10
@DrAsifQasim
@DrLKVaughan
@DrSteveTaylor
@iDrSunny
@UKGastroDr
@parthaskar
@AliJaneMoore
@Doc_IonaCollins
@RoshanaMN
@gmcuk
has a funny old selection process of what they respond to on X. I wonder if this will count as a topic important enough for them to comment on.
If they choose not to, they can just give up being a regulator for Drs today.
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@Xeon4f145d96s1
"Surgical Physician Associate" needs to be retracted. Don't know the source of this bio, but someone should kindly let them know and let
@RCPhysicians
know too.
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@anarchomed
Not sure about the reviews being done without supervision but definitely a step in the right direction RE the new patients
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@IncogAssociate
@cmwilliams99
@EduMed_UK
Rapidly expanding is exaggeration?
20 years ago: 30 PAs
10 years ago: 300 PAs
Now: 3000 PAs
This expansion is not just rapid, it's exponential. I know you struggle with advanced concepts Incog but for those that don't - this is not safe. Not in the slightest.
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@Jo_McGinn
@UMAPsUK
@BMA_James_Steen
Exactly this lol.
@TheBMA
update says this is not the scope of supervision doc, which will be coming out soon separately. Rather, this is the RECOMMENDED SCOPE OF MAP PRACTICE doc.
Love it!
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@gmcuk
Why is this in contradiction to what has been said before where Dr Z was held responsible for not repeating the work of a PA?
You can't gaslight us
Remember doctors, they’re ‘competent’ at nothing - you cannot assume!
If a patient dies and you relied on their assessment, the GMC will not be understanding.
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@kingkon83115966
@JimBethell
@TheBMA
@gmcuk
At least I have an understanding of anatomy, physiology and pathology that constitutes medical training.
PAs don't.
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@IncogAssociate
Delusional. It has always been that the GMC is not the right place for regulation and rather it should be the HCPC.
But that doesn't fit your little narrative does it?
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Refuse to supervise 🫸
Refuse to prescribe 🫸
Refuse to engage 🫸
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🚨🚨🚨Homeopathy, English Lit, Anthropology, Banking, Geography, Zoology ➡️ 2 year course ➡️ "GMC registered medical model professional"🚨🚨🚨
These are NOT substitutes for medical school and a PA can NEVER be a substitute for a doctor.
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@GMCharlatan
"5+ years: Considered for partnership"
wut...
That's like considering an FY2 for partnership (in terms of years of training, obviously still NOTADOCTOR)
LMFAO, I want some of whatever these guys have been smoking because clearly it's a helluva trip 😂
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@BMA_JuniorDocs
@VictoriaAtkins
time for you to cry and throw all your toys out of the pram again.
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What a mess...
@RCPhysicians
to blame for inappropriately housing PAs within their college in the first place and failing to set proper scope. People crying about the BMA 'not consulting with stakeholders' are quiet about RCPs lack of respect for other colleges and specialties.
@DrNeenaJha
@trishgreenhalgh
@NHSEngland
@NHSE_WTE
@RCPhysicians
@NHSEmployers
@mmamas1973
@doctor_oxford
@JanetEastham
@DrAsifQasim
@DrLKVaughan
@RowanHarwood
@UKGastroDr
@AntonEmmanuel2
@rcgp
so here's a question- if the RCP come out and say PA shouldn't be seeing undifferentiated patients- do they adhere to that as RCGP- or will they be doing their own scope?
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