Samantha
@Samantha_nhn
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The average medical doctor has between 15,000 and 20,000 hours upon completion of residency. You need 650 hours to become a certified dog groomer, and 1500 hours to become a cosmetologist in my state. 500 hours of "shadowing" is abysmal and quite pathetic.
🧵
#NurseTwitter
"The NLN continues to strongly oppose the increase in required clinical practice education hours to 750 from 500 for Nurse Practitioner (NP) graduate programs. This increase has created a burden on nursing programs that may cause some of them to close ... (1/4)
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I'm quite tired of physician assistants claiming that patients do not get a "second rate service" when a physician is replaced by a physician assistant. The sheer arrogance in thinking that a 2-years masters program is equivalent to 10-15 years of medical training is shocking.
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If a medical doctor as much as dared criticize the behavior of nurses like this they would never hear the end of it, and would likely get in all sorts of trouble with hospital administrators because they are not kind, inclusive and team-oriented. Nursing culture is so toxic.
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Physicians are told they cannot perform the duties of nurses due to lack of training, while simultaneously being told nurses can fulfill the roles of physicians without attending medical school. The gaslighting and anti-intellectualism among progressives are troubling.
Am so concerned by
@ShaunLintern
's report in
@thetimes
about a GP practice entirely run by nurses (no doctors at all).
It claims that advanced nurse practitioners "can do everything a GP can."
But that is not true. ANPs haven't been to med school & are differently trained. 1/3
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Physician assistants continue to compare themselves to vulnerable minority groups. Practicing medicine is a privilege bestowed upon individuals following a rigorous medical education. Nobody is entitled to practice medicine, and depriving you of this ability is not oppression.
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The skillset of a physician assistant is a subset of the skillset of a doctor. In other words you don't have an overlap of skills, but rather a watering down of skills, which lowers the standard of patient care.
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It genuinely astounds me how physician assistants position themselves as an oppressed minority group. You don't have a right to practice medicine. Doctors that disagree with your ability to practice medicine are not bullying and abusing you.
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When the writers of the TV show friends have a better understanding of the importance of clarity between roles in a hospital than nurse practitioners and physician assistants. Someone who does not hold a doctorate in medicine is not a doctor in a clinical setting.
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57% of physician assistants did not know that somatic cells contain the same DNA. More than 10% did not know that genes are found inside cells and that genes are part of DNA.
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This nurse applied to certified registered nurse anesthetist school with one year of experience as a registered nurse. He now calls himself a "doctor", and in two years he will be administering anesthesia without physician supervision. This is absolute madness.
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How are juniors doctors making as little as $18 an hour? A CNA makes $21 an hour in my hospital group, and $40 an hour if they pick up extra-shifts. It takes 6-weeks to become a CNA versus 5 years to become a junior doctor in the UK.
The junior doctors operating on your appendix are paid just £66.55 between them. For a potentially life-saving procedure, which lasts about an hour.
Is this a fair price to put on high quality healthcare?
#PayRestoration
#JuniorDoctorsStrike
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Physician assistant is the only role where the ability and competence of practitioners is measured by "feelings" and self-reported competence rather than rigorous national examinations and formal training programs. Exams with 100% pass rates are not meaningful examinations.
👏🏾 Dr S Lad
'...most concerning is the angle of attack
@TheBMA
are taking against our PAs...'
Read more:
#PhysicianAssociate
#regulatePAs
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Because of the simple fact that PAs have a larger scope of practice than medical doctors. They are generalists and specialists at the same time. Want to be a neurologist one day, and a cardiologist the next? Make your dreams come true to becoming a physician assistant.
Nurses can do shifts as HCAs.
Consultants can do shifts as a registrar.
But doctors can't do shifts as PAs.
I wonder why? 🤔
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The introduction of midlevel providers is undeniably an attempt at disloging the monopoly that physicians have had on diagnosing and treating patients. They are not an addition to a physician-led team, but an intended replacement for physicians.
The entire UK public needs to watch this.
Your health is a pawn to use against doctors and trade unions.
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A nurse that graduated with a nursing degree decides to pursue a family nurse practitioner degree less than a year later. The FNP program in question is completely online with only 6 days of in-person sessions. This person can then practice medicine without physician supervision.
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If medicine is so complicated that even people with 10-15 years of formal training make mistakes, what chance does a physician assistant with a 2-year master’s degree stand?
The tragic, sad and unfortunate incident SHOULD NOT have been USED in the way that it is in the campaign aimed at smearing, insulting, belittling and bullying Physician Associates. It is being used again, and again, and again.
@TheBMA
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The nurse practitioner states that she "only wanted to help" and "never intended to harm" the 19-year-old patient who died of a pulmonary embolism. The reality is that this nurse was never trained to practice medicine, and practicing without a license is harmful to patients.
NP working independently kills 19 year old honors student majoring in pre-pharmacy named Alexus Jamel Ochoa-Dockins
Pts heart struggling due to PE and NP admin adenosine to slow heat down even more
Read devastating depo here:
#StopScopeCreep
#MedTwitter
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There is no way a medical doctor can adequately supervise 5 midlevel providers. The supervision in this case is merely a formality to allow the physician assistants to practice de facto independently.
GP surgery with sole GP and 4 PAs and one TRAINEE ACP
"Medically trained generalist healthcsre professionals"
"Working with dedicated medical supervisor but are able to work autonomously"
GP putting profits before patients
@Dr_Done_
@DrGoblin3
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You do not have a right to practice medicine. It’s regrettable that bursting your bubble in which you have convinced yourself that you have a right to practice medicine without a medical degree causes hurt and suffering. It is however necessary.
It is imperative that stakeholders and those involved in the campaign against MAPs, take onboard the findings of this study and change their approach.
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Physicians are sleep walking into their own destruction. I can't believe I have to state the obvious, but look across the pond where the project is a decade ahead of you. Medical doctors are absolutely being replaced by nurse practitioners and physician assistants here.
PAs to support doctors - YES
PAs to replace doctors - NO
What's so hard about this?
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The term "multidisciplinary team" has become a buzzword employed by virtue-signaling activists who want to dismantle standards and dilute competence. How are physician assistants trained as "generalists that can practice in any specialty", while physicians are not?
Here, she explains what a PA is in her own words .
They train to the medical model
Generalist independent dependent specialist autonomous but supervised non - doctors
Hope this makes sense
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Lets make a prediction. In the coming decade the GMC led by Colin will propose to merge physician and physician assistants into a single homogeneous group of practitioners. They will carry the same badges and wear the same lanyards, and thus be indistinguishable to most people.
Listen closely
Hear
@drcolinm
sell GMC registration for PAs/AAs as a way to keep a close eye on scope
In reality, they’re becoming the regulator to make sure nobody has a chance to LIMIT scope
I’m just waiting for us to collectively decide we’ve been pushed too far.
🐍 🐍 🐍
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@PPaauk
For the longest time physician assistant groups argued that the scope of physician assistants should be determined by the supervising physician. Now the supervising physicians have come together and agreed upon a scope of practice. You should be happy as you advocated for this.
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Nurse practitioners and physician assistants are not replacing medical doctors they said.. This hospital in Wisconsin replaced all their anesthesiologists with certified registered nurse anesthetist (CRNA) with two years of graduate education.
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Can people stop with the "worked for 20 years in the NHS" nonsense? 7 years ago there were 300 physician assistants working for the NHS. In a country with 1150 hospitals and 56 million people. They were not meaningfully part of the workforce until quite recently.
I don’t think it’s fair to criticise
@ExplosiveEnema2
for sharing RCP communications or RCP stamped documents pre-EGM when all the RCP President has to say about their past communication is that it was “optimistic”.
It’s not been lost. It’s been shown for what it is and was.
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A nurse practitioner working in hepatology that has never rounded on patients before, and have no formal training in gastroenterology or hepatology. Need a subspecialist consultation? You will get an undereducated nurse with "cheat sheets" instead.
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Leaders in the medical community need to be able to explain to prospective medical students why it is worthwhile for them to study medicine. Why spend 13 backbreaking years becoming a physician when you can become a physician assistant in 4-5 years?
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This family nurse practitioner advertises herself as a doctor and is performing liposuction in her office. Complete absence of anything that remotely resembles aseptic technique and far outside of her established scope of practice. This is quackery..🦆
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I’m just tired of physician assistants at this point. Bunch of charlatans.
Physician Assistants have successfully lobbied politicians to rebrand their profession to more easily deceive patients. Oregon will become the first state to permit the title Physician “Associate”
Patients deserve informed consent & transparency should come first
#StopScopeCreep
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Physician assistants in the US are going down the path of charlatanism. Following the completion of their master's in PA studies they can complete a one-semester "doctorate" that grants them the title "DM". Awfully close to "MD" don't you think?
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What do physician assistants add to the team that could not otherwise be provided by a medical doctor or a nurse? I have yet to hear an answer to this question.
Our PAs do a different job, not a watered down version of a doctors job. And it’s really helpful. Thank you PAs.
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Flight attendants interact more with passengers than aeronautical engineers and pilots do. I suppose you would be fine with the flight attendants building planes and flying commercial airliners?
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Nurse practitioners are not held to the same standard of care as physicians in malpractice lawsuits. This is because they are not medically trained and thus can not be expected to know what physicians know. In fact, physicians are not even allowed to testify against them.
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@gmcuk
Why should they be regulated by the GMC when they are not medically-trained? Pushing the expansion of non-medically trained assistants is not keeping patients safe, but lowers the quality of care that patients receive.
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That settles it then? If the GMC has no interest in regulating the scope of practice for midlevel providers, then surely that should be delegated to the BMA and the colleges? Looks increasingly likely that the BMA guidance is the beset way forward.
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We are told that opposition to scope creep is rooted in sexism and misogyny. The actual sexism here is devaluing the importance of physicians and medicine as an institution the moment women started to dominate medicine.
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@doctor_oxford
@gmcuk
A UK medical degree will not be worth the paper it is written on if these changes are implemented. The credential will loose all credibility internationally and relegate the entire British health sector to a third-world standard.
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@NurseChristell1
I haven’t seen the true spirit of nursing? I worked as an ED tech for years during undergrad to get clinical experience for my medical school application. Nurses were the first to tell me how toxic the culture that surrounds nursing has become.
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The average medical student is more intelligent, more resilient and higher performing than the average PA student. This is an undeniable reality created by the competitive nature of medicine. Why are PA students assumed to be more competent than medical students?
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This is the mechanism by which healthcare and medicine is getting decimated in the US. There is no meaningful reason why a PCP should refer a patient to a nurse practitioner working in neurology with no formal experience or training in neurology.
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A conversation between a medical doctor and two physician assistants!
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Junior doctors should be working between 80-120 hours per week and get paid less than physician assistants that work 36-40 hours per week. This makes so much sense!
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It is blatantly obvious that this is coordinated! Medical doctors have been sheltered from the politics of capitalism for so long that they have become naive. Most decisions are carefully coordinated by executives in accordance with long-term strategic planning.
Less well trained doctors & more PAs (who are even less well trained)-this is not the idle speculation of Twitter, but the view of the Chair of NHS England. Hard on the heels of
@drcolinm
piece on medical school, it’s beginning to look coordinated
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@ShadyBeautyMD29
How does that justify unprofessional behavior like this? If a medical student does not know the answer to something for whatever reason (we have no insight into their private life), you should address them directly, not humiliate them on a public forum.
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What are physician assistants teaching? They do not have a PhD and thus would not be qualified to teach an introductory science class at an university, nor do they have a medical degree so they can not teach medicine. What is there to teach?
We’re taught a bit of everything therefore we are generalists which makes us perfect for seeing undifferentiated patients in GP ‘
@rcgp
is this safe ?
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How come they are able to learn what takes medical doctors decades to learn in less than 24 months? What superpowers do they possess that the rest of us do not have access to?
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Is two years of graduate nursing education sufficient to administer anesthesia without physician supervision? Most of the nurses I know acknowledge that it takes almost a decade to become a competent nurse, let alone someone that will be running codes.
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@ChrisWoodPhysio
What you are watching here is a person that commits medical assault, while misinforming the entire population ablut the role of physician assistants. We feel bad for the patient, not the unqualified person harming them.
#BeKindToPatients
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@NHSEngland
If I as a patient go to the A&E I expect to see a doctor. If I am evaluated by someone that does not clearly identify that they are not a doctor, I would consider this to be medical assault due to my inability to provide informed consent. Does the NHS endorse medical assault?
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@emma_icb
The decision making of the physician can only be as good as the information conveyed to them. Having non-medically trained assistants evaluating high-acuity undifferentiated patients is completely inappropriate.
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Look at this curriculum. This is literally just undergraduate level courses without any formal examinations like the USMLE. Complete charlatanism.
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@drcolinm
@davidianpyle
@drdernial
@wendyburn
Why should they be regulated by the GMC? They are not medically trained.
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@Dr_Done_
Physician assistants are literally replacing medical doctors, and doctors continue to be gaslighted by regulators, politicians and the colleges by statements like "PA will not replace doctors". If the NHS refuses to care about standards, the institution is not fit for purpose.
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@Dr_Done_
One of the biggest challenges that comes with the introduction of physician assistants is the continued undermining of the professional credibility that medicine as an institution has spent centuries to build. It is a legitimate threat to the profession and public health.
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@TheSalariedPA
No amount of years will be enough if you are not medically trained. You need the medical education as a base to safely and efficiently practice primary care. It might well be the case that you are personally able to practice safely, but that might not be the case for others.
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@DrAsifQasim
@NHSEngland
How is someone with a bachelor's degree in archeology that completes what is equivalent of a 2-year associate degree in physician assistant studies qualified to practice medicine? They have the same length of healthcare training as the least educated registered nurses in the US.
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@OReillyGem
I'm glad you are here as a non-medically trained journalist to help dismantle the NHS and patient care standards. Physician assistants misdiagnosing patients are not isolated incidents, but a consequence of their lack of training.
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@Dr_Done_
This is a step in the right direction. I doubt any patient would think that the title junior doctor is more senior than a physician "associate", which is clearly a problem. Changes are urgently needed.
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@gmcuk
The founding purpose of the GMC was to ensure that the public was protected from non-medically trained charlatans. You have betrayed your mission in the most dishonest manner, and are thus not fit for purpose. No medical doctors should listen to your advice.
#DefundGMC
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Any medical doctors or students considering applying for PA school? Its better pay, more flexible hours, unlimited access to training opportunities, no liability and you can change between specialties on a whim. Sounds like a great deal.
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Most nurse practitioner schools require 600 clinical hours of shadowing to graduate. Cosmetology school to become a hair stylist require 1400 hours in my state. Hair stylists have a stricter requirement to practice than nurses empowered to practice medicine.
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@InfoPars
How is this good news for physician assistants? All you are doing is blatantly ignoring the concerns of your supervisors, which will not only make them more reluctant to work with you, but may also antagonize them to the point where they refuse to work with your profession.
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The US has an immense problem with rogue nurse practitioners. There is no accountability, and medical doctors are reprimanded by administrators for speaking up. The worst offenders are the psychiatric NPs that pile on psychiatric medications like they are sugar pills.
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@AjEusuf
Don't worry. Hospital administrators and corporations are more than willing to fire all their anesthesiologists and replace them with CRNA's that are easier to control and cost less.
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@BridgetCairns
Good thing that physicians are not trained with the intention of becoming excellent at phlebotomy and operating machinery in the ICU. Physicians are trained to diagnose disease and prescribe medication. No nurse is better than physicians at being diagnosticians.
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@medicalmodelbri
@manLikeTeaa
PA students are evaluating undifferentiated patients, including 10-year olds with acute-onset visual disturbances? That sounds safe.
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@jbcarmody
Motivation is rock-bottom among medical students because a medical education is increasingly being portrayed as superfluous. You can become an independent "provider" by attending PA and NP school which are considerably less rigorous, time-intensive and expensive.
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@DrEilidhMaria
@JimBethell
All about crushing the physician lobby. Its a power struggle pushed by vindictive and vengeful politicians that hate doctors.
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Physician assistant association asks for regulation, but disagrees with regulation when the scope of practice is more restrictive than they desired.
NHS Employers acknowledges that today’s BMA guidance on scope for another professional group was developed without input from FPA or MAPs. MAPs are not BMA members. Employers responds to BMA guidance on the role of MAPs | NHS Employers
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@DrEilidhMaria
The claim that physician assistants are supervised is nonsense. In the US, both physician assistants and nurse practitioners practice "medicine" without a supervising physician even being present in the facility. Even if they are present, they are busy with their own patients.
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The dishonesty of the narrative is noted. There is a deliberate attempt to mislead the public concerning the educational background of physician assistants. An undergraduate degree in biology is not part of your "medical" education. You have 2 years of training, not 5 years.
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@DrNeenaJha
This is ultimately what separates physicians from non-physicians. Midlevel providers do not learn the science and principles behind physiology and thus are incapable of applying their knowledge to solve problems. Their education is based around algorithmic care.
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@WorthWords
@drokane
@DrLindaDykes
@FPARCP
@gmcuk
How are they going to be aware of their limitations when they are not medically trained and thus unable to recognize the complexity of the patient sitting infront of them?
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@converrsehighh_
Smoke bombs are entirely harmless. Throwing boiling water at someone causes third degree burns, which is a serious and excruciating medical emergency. Knowing the Russian system she will likely spend decades in a labor camp, so jokes on her..🤷♀️
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The future of healthcare! Patients dying at the hands of charlatans with little to no training.
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@NotAdoctor0000
They want to be physicians without the responsibility, hard work and stress that comes with being a physician. Being responsible for the health of another human being is stressful and there is no way to get around this. These people should be nowhere near patients.
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@thomasdolphin
The title physician associate is part of the problem. We cannot expect patients to know the difference between physician and physician associate. The term is deliberately misleading and thus unethical, because most pts are under the impression that they are seeing a physician.
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@Dr_Rajiology
And then you have the slimy doctors that are profiting from this practice. I wonder if this person would be fine with anesthesiologists claiming that its a misconception that you need a surgeon to operate on patients.
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@TheDA_UK
If physicians are serious about this they need to either strike or refuse to work with physician assistants until proper regulation is put in place. If you are not willing to fight and be a bit ruthless these politicians will steamroll over you.
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@mmamas1973
@MailOnline
Why should we not blame the physician assistants? Physicians and nurses are expected to know when they are in over their heads, and are deemed reckless and a dangerous if they are unable to recognize their limitations. Why does the same not apply to PA's?
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What does generalist even mean? How are you more of a generalist than an internal medicine physician? Why does it take 10-12 years to become an internist, while you are trained to that level straight out of university following a 2-year course?
I can’t even begin to figure out how he thinks that a 2 yr course makes him equivalent to a real doctor because he’s a generalist and doctors are specialists
@djnicholl
@Dr_Done_
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@DrNeenaJha
The problem with watering down the competence of primary care providers is that it puts an immense strain on specialist services. Primary care essentially becomes an inefficient triaging service that lacks the ability to manage even the most common medical complaints.
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Putting a third-year medical STUDENT on blast on social media for not knowing something is beyond unprofessional. Most people have made embarrassing errors or mistakes under stress while in training. This sort of behavior should warrant a formal sanction.
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@lukereynoldsorg
The nurse practitioner is triple board-certified in plastic surgery, anesthesiology and family medicine. The OR is a one-person operation in her clinic.
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@RoshanaMN
@drcolinm
@drcolinm
needs to be reminded that physician associate is not a title in the US. They are called physician assistants. If you goal is to make the NHS into the US healthcare system, the most expensive and inefficient system in the world, then god help us.
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@mmamas1973
If physician assistants are already performing c-sections, it is only a matter of time before they start performing general surgery without physician oversight.
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The average registered nurse salary, which requires at minimum a 2-year associates degree, is $39 per hour. Junior doctors are being robbed at these rates.
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This is why using the title "physician associate" while advocating for physician-led care and against scope creep is nonsensical. The title exist for the sole purpose of blurring lines and affording unearned credibility to PAs. Call them what they are.. Assistants!
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@oldoctanner
There are plenty of arrogant physicians with an inflated sense of self worth. With that said, in my experience nursing culture is far more toxic than the culture that exist around physicians. There is far more bullying and harassment between nurses than between physicians.
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@zaandur
Drug dealers are also a vulnerable group because unlike the pharmaceutical industry they are not regulated. Drug dealer rights are human rights! ✊
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A 23-year-old nurse practitioner with no bedside experience, no experience in neurology, nor any credentials that suggest that she would be successful in such a demanding specialty is now working without physician supervision. Imagine sending your family member to this charlatan.
23 year old direct entry ICU nurse practitioner with Full Practice Authority has no regrets!
#NPsLead
#StopScopeCreep
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@dx_mighty
I don't think this is a correct assessment. Physician assistants earn disproportionately more than other professions given their background and skill levels. It is beyond me why they should earn more than a pharmacist for example.
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If paralegals refused to do their jobs as legal assistant the role would not exist for long. Why should physician assistant roles exist when they refuse to be assistants?
@BoneJoint360
@benollivere
I worked with the PAs on his ward in Nottingham.
They refused to do discharge summaries. They routinely refused to do procedures like cannulas and bloods. F1s were left on their ward to do rounds solo with minimal support while PAs disappeared.
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@NathanTrout
Lets apply this same logic to engineers, pilots and astronauts. Perhaps they would be better performing if we recruited random people trom Tesco and Aldi to fly our planes instead? Don't want these people with narrow academic backgrounds. Diversity of competence! ✊
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@MallinsonT
@DrEilidhMaria
@Nadeem_Moghal
He has sold out! He knows very well that people that have completed a doctorate in medicine have far more training to prescribe than someone that has completed a 2-year masters program that is far less rigorous.
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Nurse practitioner refuses to do 700 hours of shadowing to become certified in critical care, but wants to take care of some of the most sick patients? These practitioners are a danger to patients.
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If the title physician associate is going to be used in healthcare to describe non-physicians, then the title associate physician needs to be phased out. It leaves too much room for confusion.
@tarkapayne
Hi Suzanne, just wanted to give you a heads up, so associate physicians are actually highly qualified doctors. physician associates, what the clip above is about, aren’t doctors at all.
of course that doesn’t stop them from going on doctor rotas or prescribing 😒.
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This post encapsulates everything that is wrong with midlevel education. Midlevel providers do not learn the science and principles behind physiology and thus are incapable of applying their knowledge to solve problems. Their education is based around algorithmic care.
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