Graeme Stewart
@dgraemestewart
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Proud to represent Sidemoor Ward on Bromsgrove District Council. NHS lifer. Professional MSer. All opinions my own. Retweets are not endorsements.
Joined April 2011
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Riddle me this. If a FY1/2 is first on call and the SHO/Reg slot is being covered by a PA. Who is the supervisor and who is the supervisee?
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@Ask_foradoctor
There seems to be a ‘type’ who is attracted to the PA’ing. Maybe it simply reflects the attitude of people much younger than me, but I doubt it. The med students/FYs, CMT, Regs I work with are as sensible, dedicated and sober as I ever was at their stage. So, just them then.
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Nice bookend to yesterday’s
#RCPEGM
. Got black cab from Euston to college. Cabbie asks me what’s up. Explain. Fella’s proper mad when I tell him. ‘So these guys, they ain’t got no qualifications then?’ ‘Well, not really’. ‘I see…like Uber then’!! 1/2
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Is there a Consultant sticking their head over the parapet to eulogise about ‘their’ PAs that doesn’t remind you of the worst Consultant you ever worked for?
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There’s a lot in the PA debate that grinds my molars and is much more important, BUT, when they invariably describe their course as ‘intense’? IT’S INTENSIVE, IN-TEN-SIVE, yeah? Except it’s not that either.
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@Ask_foradoctor
@StGeorgesUni
@RCObsGyn
Given that these are apparently date stamped, you wouldn’t need to be Inspector Morse to identify these patients. Surely these institutions where this has gone on easily have issued instructions to staff regarding desisting.
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The goings on at the
@RCPhysicians
following last weeks
#RCPEGM
are grim. A dysfunctional organisation now appears to be infull meltdown. Todays release of the raw data from the survey is another nail in the coffin of the organisation’s credibility. Wholesale resignations needed.
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I searched ‘Physician Associate’ on Instagram. I can never unsee that which I have seen.
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@emergingcannula
Probably not. Maybe I’ll earn a GMC referral. I always planned to do new things in my retirement…
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Top deflecting by
@KamilaRCGP
and
@rcgp
there. ‘No patient should be in danger of having their care jeopardised due to being cared for by unregulated, poorly qualified replacements for GPs’ Now that would be a topical, important article…
‘No patient should be in danger of having their care jeopardised due to IT issues’
Our Chair,
@KamilaRCGP
features in
@BBCNews
voicing her concern that NHS IT system failures have been linked to patient harm.
Discover our full story on our website. ➡️
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The failures of the PA project are now clearly apparent. This is down to a combination of venality, incompetence and political manipulation in organisations that should be defending medical standards and hence patient safety.
@gmcuk
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@LucyABeaumont
@KwajoHousing
I fully agree, the damp and mould we see in lots of social housing on my patch isn’t due to the shower in the bathroom or drying clothes indoors, and I’m fed up of those who sell it as ‘poor housekeeping’ it’s due to poorly built/maintained housing. It’s a national disgrace.
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@drmattuk
Taskification strikes again. There is much more to a procedure than being a mere technician. Unfortunately‘getting to do stuff’ seems to be the be all and end all for these dudes.
@wesstreeting
this is going to knock other NHS scandals into a cocked hat. We’ve kept the receipts.
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‘What do PAs bring to my MDT’? Answers own Q ( A:- Nothing). Room bursts into applause and shouts of ‘hear, hear).
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@Cleverclog67596
This is obscene frankly. a) making something like this into a tik-tok b) the breathless’OMG there was blood everywhere’, is disgraceful. People like this shouldn’t be anywhere near patients. There is no professionalism in this.
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On way back, got Uber. As I get in, bloke looks past me at College. ‘That’s a ritzy shopping centre mate, looks expensive’….
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Well, a first for me today. After 35 years plus of being a member of
@HealthySkin4All
I stuck my hand up at the AGM. Anyone guess what my question was?? Surprisingly, it was about PAs and whether, given the brouhaha at
@RCPhysicians
the BAD are going to take a view on scope of
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@11teadubya
I predict it will take a high profile court case to take the lid off this can of worms. Unfortunately, before this happens the
#bekind
mob will have paraded some poor doctor in training through the streets to be crucified.
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@GMCharlatan
Oh dear. Hands up all you lovely doctors who give yourselves an hour to catch up at the end of the day so you can fu-, sorry, knock off at 5 sharpish. Anyone, surely?
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@wesstreeting
@thismorning
Bollocks. Darzis last effort was a waste of time and money. He’s a tertiary specialist, it’s primary care that’s dying on it’s arse, what does he know about that? Bugger all I suggest. Refresh primary care by employing enough qualified GPs not pretend doctors. Sorted.
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For the first time in 35 years I got Mrs S to take a snap as I left the house to go to
@RCPhysicians
, like a back to school pic. She is rather bemused. I think I’ve scrubbed up not bad.
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So, what’s occurred here? It surely can’t be over the vote the other day. My money says that there’s some impropriety that is still to come to light. In politics when they end comes, it comes quick…
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@MedRegoncall1
@NHSuk
@PharmacyFirst
Would you have a consultation with your GP in the waiting room? Of course not. If they are going to roll out this unproven, inefficient nonsense patients should get the same privacy they do in any other setting. And they shouldn’t have to ask for it, it should be the default
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@DrLKVaughan
That is piss poor, but still infinitely better than what
@gmcuk
have up their sleeves. In my medical finals the patients and questions were similar to those I encountered a few years later in MRCP, except by then I was expected to know the answers.
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@DrAsifQasim
@gmcuk
@drcolinm
@NHSEngland
@RCPhysicians
@rcgp
Old saying in politics. ‘When the end comes, it comes quick.’ The consensus is falling apart. Tomorrow RCP leaders get a chance to do some leading.
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@DrLKVaughan
@RCPhysicians
I’m going. I rushed to get my place, thinking that in person attendance would be oversubscribed. You can still sign up to go in person until Monday. I would encourage as many FRCP as possible to attend. This isn’t just the next ‘initiative’, it is a potential paradigm shift.
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@medicalmodelbri
@TheBMA
@RobLaurensonD4P
@BMA_James_Steen
@parthaskar
@DrNeenaJha
@doctor_oxford
It is indeed a mess. Not one of the
@TheBMA
or doctors making. This is all on
@gmcuk
@RCPhysicians
@NHSEngland
and those doctors who have used this as a vehicle for their own advancement. Message seems to be that Physician Assistants are unhappy to, er, assist physicians.
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Teams. Essentially not an issue. No plans to contribute to defining scope. Membership were invited to flag up issues that they encountered.
So, BAD seems to be behind the curve. I shall take up their invitation to highlight issues. Please DM me with any examples you come across.
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@DrAsifQasim
@RCPhysicians
‘I’ve never worked with/trained/any way interacted with PAs, so I’ve no opinion’ RCP- Great, I’ll put you down as a ‘yes’ then…
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@mmamas1973
This is the issue. For every PA working well beyond any reasonable scope of practice there is a consultant giving the green light. The reasons are several but none of them good.
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@LukeAmos__
At the risk of beginning to sound repetitious, every PA on a rota at registrar/consultant level is there because a consultant has gone ‘Yeah, whatever…’
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@mmamas1973
If/As the colleges stumble toward defining scope of practice, the only document we’ve got is that provided by the BMA. I would strongly advise colleagues, especially trainees, to adhere to it. If the sh!t hits the fan it’s the only bit of paper you’ve got to wave at the GMC.
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@TheBMA
Disappointed by the poor turnout for the motion in the HoL tonight. Even more disappointed by lack of support by
@LabourLordsUK
. For shame.
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@TomStocks1982
@DrSarahClarke
Problem is, nature abhors a vacuum. That’s why
@BMA
are stepping in to give guidance. The colleges have failed to do this, leaving Trusts, DHSC, senior doctors with COI issues to encourage some MAPS to write their own ticket. It’s on you.
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Chapeau to
@RCPEdin
for cutting through the bs coming out of other RCs, regulators and government bodies and issuing this clear, concise and unequivocal statement.
@gmcuk
@rcgp
@RCPhysicians
@NHSEngland
need to have a look in the mirror.
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@Doc_LawrenceL
This is what they’re taught. See also:- medical model, generalist practitioner.
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@GMCharlatan
Phew! That’s quite a read. It reinforces everything ‘my juniors’ have told me about their relationships with PAs when they do the medical oncall. We still don’t have them in our department and it’ll be over my dead body. Worst thing, every PA has some consultant enabling them..
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@JDF_Keswick
@NHSEngland
@wesstreeting
Another one for the intray.
@NHSEngland
hosing money up the wall.
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@NHSHandSan
This is basically the ‘sermon’ that I give our medical students at the end of their week with us:-
1) Remember YOU’RE the talent
2) The NHS needs you more than you need it
3) Get as many qualifications as quickly as you can inc FMGEMS so you have choices.
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@he1entweets
@Dr_BellaR
Being a professional involves knowing your limits, whether knowledge based, physical or mental. These can be transient, as I suspect they are here, or long term requiring a career change.
@Dr_BellaR
has demonstrated excellent professionalism. You, not so much…
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@NtotheHizzo
@LittlePersonDoc
There are plenty of doctors. Problem is the government have suppressed the number of training places and have put financial incentives in place for GP surgeries to employ non-doctors rather than doctors. There are lots of trained GPs who can’t find work.
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@OliviaCresswe12
Your mother’s take is a massive red flag. I’m cracking on a bit and have a neurodegenerative illness, which is now beginning to really kick in. Not for one second have or would I expect my kids to give up their lives to care for me.
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@NorthMidNHS
@Annareporting
This is dreadful. The staff are gaslighting you, because of their inability to provide a minimum level of care. This is NHS 101, deny obfuscate, distract. Also making you and your neighbour feel like it’s you that’s the problem. When he gets out of there I would formallycomplain
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Over and out for the last time. One week shy of 39 years. Where did they go to? It’s been emotional…
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Practice, supervision, protection of training opportunities for residents and being on doctors rotas, and using their dermatology‘credentials’ to legitimise their side hustles.
The answer was that there are relatively few PAs in Dermatology and they are well integrated into…
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@stmarnockZ
@gmcuk
This is dreadful. I have never met a medical student/trainee who has ever demonstrated this sort of behaviour towards staff or patients. Also, the egregious use of threatening with the
@gmcuk
appears to be a recurrent theme with this professional group.
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@BanjoBlood16
We have just started triaging all our referrals. Any not from a doctor, or saying pt has been seen by doctor are getting bounced. Reason? Referral numbers were increasing +++ due to MAP referrals. Scenes ensuing…
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@emergingcannula
That is offensive. Problem is, when they don’t fill it because they’re having a laff, they’ll shrug their shoulders and wheel out the ‘shortage of doctors’ line, do sad face, then pad out the rota with someone trained in the medical(ish) model.
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@medicalmodelbri
I was wondering that. Weren’t there also the same issues in Leeds? Or was that requesting X-Rays?? If medical students were caught prescribing like this the excrement tsunami would be visible from space. Have police been involved? What with this being illegal and all.
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The results are in. I thought they weren’t out until Monday, but never mind. Overwhelming support for all 5 motions.
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@fleurelizabeth8
I am sorry to hear this. The deaneries behave as if all new doctors are 23 year old single guys who can sling all their kit into the back of their GTI at 6pm one day and rock up 400 miles away at 0900 next day good to go. Like it’s still 1985. They are a disgrace.
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@ElshadKarbasi
He stood as our local Tory candidate, but got turned down by the local members. There were absolute scenes and the local Tory chair tried to get the selection overturned, but at a second vote he got his arse handed to him again.
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@DrPerci
@Dr_BellaR
I am pure ragin’ at this. As well as the misrepresentation/lies/incompetence the thing that boils mine is that somewhere there is a consultant ‘supervisor’ who has gone ‘Nah, crack on…’ so that this PA knows they’ve been given the green light to behave like this.
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@drpaolandmd
@Ask_foradoctor
Nonsense. Show me where believing that qualified doctors shouldn’t be replaced by unqualified, unregulated individuals is ‘racist’.
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@LauraOwler
One could argue that developing a sense of your worth and being able to negotiate around it is a very valuable educational lesson.
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@PhilSmithIsBack
Every patient is easy, until they’re not easy. What makes a patient easy’? A sh!tload of experience, that’s what makes a patient ‘easy’. Not this ‘computer says no’ nonsense. It’s reductive medicine that disadvantages the old, poor, marginalised. Because they don’t complain.
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@medicalmodelbri
Again, what’s the deal with the consultant colleagues who have enabled all this bs? Firstly in NHS and then as asst to private dermatologist. They’ve clearly let this one write their own ticket. PRP, trichology? They might as well offer tarot card readings and seances. 2/3
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@EmergMedDr
Don’t worry. If water doesn’t provide adequate analgesia, they’ll take you up a step on the analgesia ladder…
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Post
#RCPEGM
, I have been for beer(s) with No. 1 son. He has borne the brunt of my opinions on the meeting. Highlights/ thoughts to follow…
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Another aside from
#RCPEGM
. Met these lovely ladies from
@MerseyPensioner
outside. Came all the way down to London to do some old school campaigning. Pleasure to meet you both, thank you for supporting safe medicine.
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@medicalmodelbri
If PA ‘hatred’ has made jobs dry up, it doesn’t say much about the rationale behind the whole project in the first place. If PAs were adding value they would be the last posts to go? Isn’t that how this neoliberal scam works?
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@trishgreenhalgh
This is very clear and entirely in line with the Nolan principles. We assume/hope that
@RCPhysicians
want the meeting to be run scrupulously and to the highest levels of accountability and transparency. Thank you to the senior Fellows who have got us to this point.
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@Parody_RCGP
This case is important, as it sets a legal precedent. Part of that precedent is what constitutes a ‘medic’. In this case it was taken as a ‘medical student or doctor’. Ok, it’s only in the Mags, but until a higher court takes a view on it, that’s the test that’s been set .
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@DrEilidhMaria
I don’t want to be unkind, but in what world is this whatever it is(‘decision’ aid??) not complete bollocks??
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@Ask_foradoctor
@gmcuk
This has been going on for ages in the aesthetic world. Anyone tangentially associated with ‘medicine’ can sign up for one of these courses. Your cheque cleared, congratulations you’ve passed. I’ve seen all their handiwork - midwives, nurses, paramedics. Come one, come all…
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@rcgp
@KamilaRCGP
With his love of homeopathy, he’ll be right at home with all the pretend ‘doctors’ you’re enabling.
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@gmcuk
@UofGlasgow
To medical student colleagues
@UofGlasgow
. Have a quick look at their recent publication re the future of regulation before you go, or one of tge excellent summaries on this site. Then ask questions, lots of questions . This is your future it is really important.
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@Xeon4f145d96s1
@mouseter_chef
@drcolinm
Say what now?? If this is true it’s an egregious abuse. Remind me again, who are they supposed to ‘protect’, apart from their own reputation.
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@Xeon4f145d96s1
@UKFPO
That is awful. No offence to Northern Ireland. If you join the military you at least know what you’re signing up for in terms of being moved around. Sounds like another national medical body that isn’t fit for purpose. What do you know!
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@medicalmodelbri
As a dermatologist, I don’t know where to start with this shit tbh. Over the years we’ve had a few GPwSI who’ve been around for a bit then f
@cked
off to do this nonsense, but at the end of the day they’ve been qualified doctors, so there’s that mitigation. 1/2
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@mmamas1973
@RCPhysicians
They weren’t exactly bigging up UK medicine before events of this week.
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@ZainKhanMed
Yeah. But you pick up the phone, ask for the oncall -ologist. Bloke goes, ‘Hi, Graeme Stewart, oncall-ologist, how may I help you?’ Are you going to ask’Are you a real doctor?’?
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@medicalmodelbri
@RCoANews
@AmandaPritchard
@JimBethell
@DrSarahClarke
This must surely be deliberate misrepresentation, and an offence under the Medical Act? Not to mention the rest of the word salad he throws out there to deliberately obfuscate what he is and isn’t.
@leicspolice
, I’d like to report an offence, under the Medical Act. Thank you.
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@medicalmodelbri
Again, with the f’n SoMe video. Are they teaching them to do this sh!t in PA school??
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With all the brouhaha around
#RCPEGM
, I almost didn’t remember to vote. Don’t be like me, get your vote in if you have one.
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Today, in non-medical tweets. My new backyard. Happy Sunday.
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@timricketts_
Well done dude. I remember passing the elation of passing this, albeit at the third attempt, a failure for which I blame the current Mrs Stewart whom I was attempting to woo at the time. 35 years on I have encountered a few cases of Fabry’s disease, so never say never.
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@DrAsifQasim
@JimBethell
Thank you. I think that tells you all you need to know.
@wesstreeting
- do you support the degradation of medical standards in this way?
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@parthaskar
@RCPhysicians
If this is the FPA getting their flex on, they need to be defenestrated. Covert threat of GMC referral is PA playbook 101.
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@medicalmodelbri
@NHSEngland
More nonsense. Medical students should be trained by those with most experience, able to answer any question.
It’s like the old joke about teaching piano and only having to be one lesson ahead of the student.
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@SaraTon08500527
Yeah, but Physiotherapist professional bodies would be quite within their remit to have an opinion on which of their roles RNs could safely perform.
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What’s racist today? Today, believing that it’s safe for patients to replace doctors with lower trained, unregulated replacements is racist.
@dgraemestewart
@Ask_foradoctor
this has certain racists undertones... the reason PA programs "attract" a "certain type" is because they can be lower barrier entries into healthcare.
Humans can be a*h+les as physicians or physician assistants. Examples of the former abound.
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@iDrSunny
@profjimspeaks
@NHSE_WTE
The disingenuity is astounding. I wouldn’t like to be the one to tell FYs that they haven’t’entered employment’. Mind you ‘indentured servants’ might be a better description.
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@doctor_oxford
@ShaunLintern
@thetimes
The problem with an 80% approval rating, is that it’s probably an exit poll? We do this at our place. They tend to measure the ‘experience’ in the day rather than the hard outcome, which can take weeks to become apparent. I agree it isn’t that great a ‘score’.
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This is the right decision by PRCP. One can argue that it should have come earlier, but whatever. I am looking forward to a robust election campaign with a choice of candidates putting forward clearly stated positions on how to tackle the issues that have got us here.
RCP president Dr Sarah Clarke has today informed RCP Council of her intention to step aside from the role of president following a challenging time for the college. Dr Clarke will step down as president in September following a transition period:
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