Kade 🧑🏻🔬🌌
@KadeF96
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NHS Clinical Scientist (Biochemist) 🧑🏻🔬. Also bit of a space nerd 🌌 Like/repost/follow ≠ always agree.
Joined November 2018
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Anybody (including news outlets) is more than welcome to use this footage because beautiful and rare events like this deserve to be shared!
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The one thing I have particularly noticed in the debate on PAs role(s) and scope of practice in the NHS is I very rarely see PA advocates talk about patient safety. All they do is talk about their feelings and how doctors are "protectionist", "elitist", etc. The ONLY thing that
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To gove credit where it is due, this was only possible because of a tweet from
@tw__astro
which explained exactly where to look at exactly which time. Follow him, he is amazing.
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@AJamesMcCarthy
You're already a star Andrew, but this is really going to propel you into the astro hall of fame and it is so exciting to watch! 🌌
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@Adam_Skeen
@IncogAssociate
Your post is not the win that you think it is,
@IncogAssociate
.
All you've done is highlight Adam as an exceptionally self-aware professional who has changed his mind on these old posts since being exposed to... actual medicine.
Great response,
@Adam_Skeen
.
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@Dr_Done_
@mrjamesob
"It doesn't matter that I haven't studied medicine".
Out of all of the concerning things I have heard come out of AHP's mouths over the past few months that makes me terrified for patient safety, I think this is the worst. This is exactly what the
@gmcuk
should be coming down
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@AbrahamVelaDib
@FactProtocol
@stats_feed
No, because it's literally the game that you play with your feet and a ball. That's pretty clear :)
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I think some of the people with extremely valuable opinions on the topic of PAs seeing undifferentiated patients are people who have done medicine after completing PA studies. I would be very surprised if any of them think that they are comparable and that it's a shortcut to
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I have received a very high number of requests from 'distributors' who want to pay me for the high res video but insist it will still be non-exclusive. I have no idea how this works. Would they make money from my video? I want everybody to have access to this FOR FREE.
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@Notafizician
@c3convertase
No, that's quite literally not how science works. The null hypothesis (that there is no value) is the default stance that requires sufficient evidence to reject. Evidence that you still haven't provided which is step one in this whole conversation. Deflection, deflection.
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For those asking, this was recorded in Brighton, South coast of England. Sorry, I should have said that in the original tweet!
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And I have been rightfully corrected that this is in fact a meteor and not an asteroid. Apologies, I got so excited my brain just pressed SEND IMMEDIATELY without thinking.
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There have been many questions asking if I could hear anything. I did not hear a thing! I am not sure if people in France heard anything, but it was silent over Brighton, South England.
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@Astro_FarmerBob
@planet4589
Thank you! Honestly so shocked it came out so nicely! I'm definitely meant to be sleeping now as I have work in five hours but nope... it's not going to happen
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@vasconcell75240
@Ask_foradoctor
If you aren't aware that GPs absolutely are SPECIALISTS in seeing patients in primary care (i.e. undifferentiated patients), then although you're entitled to your opinion of course, your opinion lacks substantial credibility and applicability as it's just, quite simply, wrong.
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The fact that it has become controversial to suggest that only surgeons should perform surgery is just beyond me. Why are there so many people wanting to be a doctor without putting the full amount of work in? And how has this been allowed to happen?
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@IncogAssociate
@VishwajeetP4t3l
1st point - we need more GPs in post.
2nd point - more GPs = can have longer appointments
3rd point - YES! If first time undifferentiated patient, they should see a GP. If it's a BP/diabetic review, NPs do this already.
Genuinly, thanks for engaging but still not answered.
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@Notafizician
@c3convertase
Please don't claim oppression as it is a huge disservice to people who are actually oppressed. PAs cover absolutely nothing that doctors don't cover to a much higher standard, so how do PAs contribute to the MDT? Interested in valid points.
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@AlexCrane33
@c3convertase
@Dennisw99863685
In providing medical care for patients, yes they are. Pharmacists are superior at pharmacy, scientists are superior at laboratory science, nurses are superior at nursing, physios are superior at MSK injuries, and doctors are superior at medicine. Shocking, I know 😱
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@BrazilQuitter
I agree, "it hasn't been proven to be unsafe" is a flawed argument. Any change or addition to the current system should have evidence that it is better (or at least not-inferior) to the current system BEFORE it is implemented.
Failure to do this risks maximum patient safety, and
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@c3convertase
@Notafizician
How can there be evidence? We all know that PAs do not learn anything that doctors learn in much more detail. So how could they possibly contribute unique value? Any benefit I have seen has simply been because they're an additional person, but then just have... more doctors?
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@Cleverclog67596
Do you know who are taught to the level of foundation year 2 doctors? Foundation year 2 doctors. That is all.
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@MalbyDeldrick
@ollieburtonmed
@BMA_JuniorDocs
How is a highly qualified doctor requesting to be paid a good hourly rate when they are responsible for your life a scam? Remember that these are EXTRA HOURS on top of a 48 hour week. The scam is their £14 base rate. The source of the money makes no difference.
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@Notafizician
@c3convertase
Treat me like I'm 5 years old. If this good quality evidence is there as you say, you should have no problem providing it?
Absolutely, that's something called the null hypothesis - that there is no value. Where is the evidence to reject this default stance?
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@doctor_dru_
Unfortunately, this country absolutely despises doctors. The British public have no CLUE just how expensive healthcare is, and they would implode if they realised how much they would pay just for a doctor's time elsewhere. This, plus the wrong 'rich' stereotype, doesn't help :(
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@physicianassoci
Patient reviews are FAR less important than patient outcomes. PAs are more likely to just give patients what they want due to lack of knowledge and experience. Patients love investigations, which can be dangerous. Good medicine is often not popular medicine.
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@DrNeenaJha
@therawlucy
@Ask_foradoctor
Neena is right on point with this. Non-doctors who are consultants are consultants IN THEIR FIELD, and it does not make them more like a doctor in any way, shape or form.
For example, we have consultant clinical scientists who must pass the same postgraduate consultant level
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@IncogAssociate
@VishwajeetP4t3l
Or a GP could see and manage both of those? For example, prescription(s) may be appropropriate depending on the nature/severity/cause of the atopy, which a GP can manage themselves.
Who triages patients to see you or a GP?
Again, thanks for engaging (genuinly).
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@VishwajeetP4t3l
@IncogAssociate
What does professional discrimination even mean? I think if PAs and regulatory bodies actually started to answer the good questions (e.g. what do PAs add) rather than claim hurt egos as a defence and ignore patient safety, we wouldn't be in this position.
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@Notafizician
@c3convertase
Where is this evidence? I haven't seen it. I am willing to do a 180 and change my mind if there is credible evidence that PAs bring something unique to healthcare and MDTs. Everybody is biased - it's all about changing opinions based on credible evidence, which I haven't seen.
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@VishwajeetP4t3l
It is not up to everyone else to prove that PAs are unsafe because it should never have even got this far. The evidence that they're safe should have been in place BEFORE they were introduced.
The burden of proof always lies with the person making the claim, and the claim (with
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@Ask_foradoctor
This is not even an argument. I would like to see the evidence behind that statement that is not shrouded in huge red flag conflicts of interest. We need people who look out for PATIENTS and not them selves.
Anybody truly looking out for patients would come to the conclusion
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@VishwajeetP4t3l
Why don't you unblock Dr Bansal so that you can ask the question directly to him and he can respond to you? He has responded already.
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@GMCharlatan
Agreed. Perhaps even the issue with this though is what even is a 'common' situation? I use this example a lot as I know it very well, but 'common' back pain due to MSK injury can be expertly managed by incredible physiotherapists, or it could be metastatic cancer requiring
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@RakheeLb
@MadhoorRamdeen
This is all true, but patient understanding and safety comes above all of this. Nurses have a right to say "I am Dr X" if they have a PhD, but in a healthcare setting, this should be quickly followed by "I am a nurse", just like doctors do. It's not OK to leave at "Dr X".
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@DrAnimeshSingh
Every time I have asked this,
@IncogAssociate
never answers the question and just quotes a previous post about it being difficult to get an appointment with a GP. I have never seen a genuine answer to this question, because there isn't one.
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@bolt76833
@iDrSunny
Andrew, please don't be so unhelpful in this debate. In what universe is this bullying? Asking for evidence to any statement is basic logic, and is imperative when patient safety is concerned. Would a journal be bullying authors if it doesn't publish papers making claims that
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@IncogAssociate
@iDrSunny
@cjsnowdon
Perhaps it's better to answer the actual question rather than meaningless and pointless personal attacks?
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@IncogAssociate
@VishwajeetP4t3l
OK, so as a response to that, I'm assuming there are great answers to the question of what PAs add to the healthcare table that additional doctors would not? I genuinely hope there is an answer and am not being sarcastic. Help me understand what many of us are missing?
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@DrEilidhMaria
So refreshing to hear a doctor say this! Completely agree. It's also easy to forget that 5% of 'healthy' pts will have a result just outside of the 'healthy/normal' range due to how the ranges are statistically created, which now needs to be followed up and explained to the pt :(
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@guardian
White working class people - who can be also be very disadvantaged - are excluded from these opportunities simply because they're white. Is simply skin colour and being able bodied the best and fairest identifier of people who need support like this moving forward as a society?
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@tw__astro
Thanks! It was only because of your tweet that I was there in time, so this is actually all you Tom!
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@IncogAssociate
@iDrSunny
@parthaskar
@TheBMA
@NHSE_WTE
@FPARCP
@RCPhysicians
@DrLKVaughan
@UKGastroDr
@RowanHarwood
@DrPhilBanfield
@mmamas1973
@DrAsifQasim
@trishgreenhalgh
@doctor_oxford
@OrthopodReg
I feel sorry for PAs who may experience what you describe as it's not their fault that they have been missold the safe PA role. However, your complete lack of mention of patient safety is deeply concerning. Where do your priorities lie? Your feelings or patient safety?
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Just finished reading The Art of Statistics by
@d_spiegel
. I have read many books about statistics and can honestly say that it is one (of two) of my absolute favourites! See my GoodReads review for more details. Please write another book Sir Spiegelhalter!
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@c3convertase
@Notafizician
Absolutely - it's very, very frustrating. It would be fine if they didn't keep claiming that they contribute to MDTs, but they regularly claim this with no valid evidence what so ever. Saying something just because you want it to be true doesn't make it true.
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@IncogAssociate
No, you haven't. The
@gmcuk
have even publicly stated that they "do not describe PAs as studying medicine", so your opinion on this is just that... an opinion.
Although you really want to say that you have studied medicine without actually putting the work in and getting
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@VishwajeetP4t3l
You have said to me twice that you're going to provide evidence for this very, very bold statement. Where is it? A claim of such potential implications requires quite the evidence to back it up. Please stop slandering until then.
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@IncogAssociate
@doctor_dru_
Go and get a medical degree and then you will be qualified to tell Dru to take a walk. Your arrogance and disregard for real medicine would be entertaining if it wasn't so terrifying. You really need to listen to the PAs who actually did real medicine.
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@Acruelpastime
@QueerMajority
The problem is that what people find offensive and funny is entirely subjective, even between people being joked about. If there is a line, by definition, someone has to police that subjective line. Who should have that power? What if one person out of 100 doesn't like it?
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@sandipcal
Agreed. Patients are often vulnerable and desperate for help. They deserve to know exactly who is making their medical decisions, and they have a right to seek alternative opinions if they feel they want to - which may become much more common now.
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@VishwajeetP4t3l
Well then stop saying it until you give the evidence. All you're doing is slandering and saying meaningless words until then. We are waiting whilst you make (currently) unfounded claims.
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@TheEMboardround
@PPaauk
@Statsjamiefact
@pa_StephenNash
@Adam_Skeen
Thank you, Adam and Adam. You are both in a unique position to comment on this and share much needed perspective and facts. How anybody can not listen to your view points is beyond me.
It really doesn't matter if some PA courses went into more detail than others. The fact of the
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Excuse the weird faces but listen to me go on about why I applied to the
#STP
. If you want to too... go for it! The training at
@SWLPathology
is excellent 🏨👨🔬
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@MmeDefargeKnits
@memnosoncos
100% real! I'd say I promise, but I'm not sure how much that's worth on the Internet?
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@physicianassoci
Good medicine is about giving patients what they need and what is actually good for them, which is often not what they want. Patients of course have the right to refuse treatment, but they do not have the right to demand things that are not for their medical benefit.
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@The_Clive_Smart
@wesstreeting
Yep. A huge pay cut over 14 years to the point where doctors are leaving the country in droves is all... political. You really read between the lines there.
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@IncogAssociate
@iDrSunny
This was a statement from the GMC directly. A message, post, letter, interview... it doesn't matter... it should be treated as legitimate regardless of the form. By extension then, are you suggesting that not everything the GMC - the literal regulatory body of medicine in the UK
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@ObserverUK
PAs are not villains, correct. But stating that they they train "for more than five years" is an objective lie. They actually only train for two years. Variable and unregulated bachelor degrees - which could be in something unrelated such as zoology - cannot count towards the
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@UrrJokin
@Nigel_Farage
Because you didn't pay £9,000 per year for your degree and likely got tonnes more benefits?
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@IncogAssociate
Just because you keep calling something elitism and protectionism, it does not make you right and does not retract from the patient safety concerns. You should be embarrassed.
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@medicalmodelbri
"They can work independently under the supervision of a consultant or GP". I don't even need to state how much of an oxymoron that is.
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@DrEilidhMaria
An ageing population makes patients more complex to manage. This is why we need more doctors to manage these complexities with increased funding for support services (including pathology) to help with this. You're right, we need more doctors, not relatively fewer.
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@VishwajeetP4t3l
Agreed. Patients are becoming increasingly more complex due to an ageing population and increased mental health awareness. Therefore, we need more doctors in GP/consultant posts, and we need to retain them with better pay and working conditions.
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@parthaskar
@NHSE_WTE
This is sad. Despite the valid concerns regarding PA scope of practice, NOBODY deserves the stress of potentially being unemployed. The whole thing has been a farce from the start and responsibility has to lie somewhere.
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@DCanworth
@WorthWords
@Mary_Tom11
@DrNeenaJha
The fact that you believe this is extremely concerning for patient safety. Are you suggesting that 10+ years of education and training throughout a heavily regulated course, including a medical degree, is... worse than a two year unregulated non medical degree??
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@jkcyriac23
@gmcuk
Sorry, but in what way is this degrading?
@DrNeenaJha
did not say anything degrading at all, just pure facts. PAs do have less training than four years of medical school, and it is not controversial to say that they shouldn't be running clinics?
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@bolt76833
What I see is a doctor asking for evidence regarding a public statement. There is nothing personal or unprofessional about that. The only thing close to a disgrace is the personal attack that you delivered to him. You would likely benefit from a bit of personal reflection.
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@iDrSunny
Very, very true. I think an issue here is agenda for change Vs medical colleague contracts.
Agenda for change values MSc level education at band 7, which is appropriate in roles where an MSc level education is actually required. This is a bit of a shooting our selves in the foot
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@ESchillup
So glad that this amazing event can be shared and enjoyed by all! Have a lovely night.
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@Statsjamiefact
But surely the burden of proof of safety is on the people claiming they're safe? It is not up to everybody else to prove they're not safe, as it would take years to gather this evidence and could be putting patients in danger during that period.
What SHOULD have happened is
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@IncogAssociate
@VishwajeetP4t3l
'Atopy' can include potentially fatal asthma as well as HF, sorry if there was confusion.
Agreed. Are there official guidelines stating when that's required or is it at your discretion?
GPs accept the risk if they triage, as PAs do not cary any legal liability. Is this risky?
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@AbbieTBee
You can do this. Blood is blood. There is increased risk of poor sample quality (e.g. haemolysis), but providing the blood is not contaminated by flushing/discarding properly, and the sample is sufficient, it is fine. You can even use finger prick blood for (most) testing!
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@R38651855
@AbrahamVelaDib
@FactProtocol
@stats_feed
Not really the smartest though are you? You called a game football when you hold the ball? What's with that?
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So, COVID-19 has reduced my full time medical student boyfriend to a toilet roll chaser. You might be able to cancel medical school, but you can't cancel desperation.
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The main thing I got from tonights episode of
#Dynasties
is Blacktip is a bitch and Tate and her Alpha are babes
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@DCanworth
@DrNeenaJha
@WorthWords
@Mary_Tom11
Maybe SOME patients prefer PAs because they understand medicine less on average and are more likely to miss serious diagnoses in the short term (less bad news), overinvestigate, and/or just give patients what they want?
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@PPaauk
@Statsjamiefact
@pa_StephenNash
@Adam_Skeen
Of it's not generalisable because PA courses are not standardised. That's the whole POINT! Vast focus on the things you mention?? It's two years!! Unless you're all super humans and are being lectured 24/7 over that period, it's simply not true. Not the the extent that doctors
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@physicianassoci
@iDrSunny
Patients may choose to see you likely because you just give them what they want rather than what they actually need. If doctors would do/say something different to you and patients don't like it, that says more about their and your priorities than doctors' effectiveness.
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@CuriousGazelle
What on earth does what a doctor choose to wear in her spare time have ANYTHING to do with respect for doctors in British society?
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@turay7249
@ClearThinker66
@hawkins_carole
@rheumipainmask
@Xeon4f145d96s1
@iDrSunny
@gmcuk
Let's use an example to see if you still agree with your statement. There are approx 380,000 doctors in the UK. There are roughly 4,000 PAs in the UK. These numbers may not be entirely accurate, but the point is, there are (currently) many times more doctors than PAs in the UK.
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@AVeall
@iDrSunny
You should consider correcting your self here because NAs are absolutely not registered nurses, they're registered NAs. Is that not similar to calling a PA a doctor, which may mislead patients and is a safety risk? They have very different competence limits set by their training.
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@DrNeenaJha
Some people have argued for more protocol driven screening to be 'safe', but medicine is often not like that! Protocols find incidental findings, and can cause harm and panic, which are risks in themselves. Doctors are benchmark for striking this essential balance.
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