Thomas Jacques
@mrthomasjacques
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ENT | Rhinologist | Rhinoplasty Surgeon 👃🏻 @StGeorgesTrust @croydonhealth @cadoganclinic , London
London, UK
Joined February 2009
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Can the
@gmcuk
explain why PAs are charged £200 for registration? If the costs are different, how are the costs different? If it’s income, then why are junior doctors charged £455 still?
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Doctor. Not junior doctor.
He is a cardiology registrar, quite near to being a consultant, and probably the primary decision maker for a lot of very sick people. Basic salary = £51,017.
#NewProfilePicture
: Meet James, an ST5 junior doctor who has been working in our cardiology ward at St Bartholomew's Hospital 🩺
To the new cohort of junior doctors joining us this week, thank you for helping to provide care to our community and welcome to
#TeamBartsHealth
💙
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@piersmorgan
I really don’t like anti-vaxxers. But unvaccinated is not the same as “anti-vaxxer” necessarily. And it may sound like a good bombastic soundbite Piers, but refusing NHS care is totally ethically wrong.
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If you can’t get through medical school, you can’t become a doctor. Sorry, it’s hard for a reason. All attempts at widening access to medical careers should be focused on helping *appropriate* people get into *medical school*. Can’t believe it even needs to be said.
I agree re properly funding GP, obvs.
What I’m a little baffled by is the negative response to a pathway from PA to doctor. Are the same people who bash PA’s for not being doctors (duh!) now also objecting to a way to make this possible and overcome their previous concerns?
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Physician Associate
Associate Specialist
Only one of these is a senior doctor practising independently (yes I know the title is now obsolete).
But put yourself in the shoes of someone who knows nothing about medical careers. Would you know? Titles matter.
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@dr_nigel_lane
@NHSEngland
“I’m fine, so everyone else is fine”. “Pay erosion has affected everyone equally”.
Both incorrect statements.
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@afneil
Post people are dying of hypoxia due to type 1 respiratory failure - they are dying of COVID-19. Some patients with other active medical issues catch CoV and die, but most would not have died were it not for CoV.
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@IsabelOakeshott
IO parroting the party line here. Funny how journalists start to say the same sort of thing in unison, isn’t it! Funny how there’s no analysis to back this up based on projected deaths from covid if there had been no restrictions.
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@Xeon4f145d96s1
Seriously. The custom printed envelope cost more than the teabag. What an embarrassment.
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@jessdoe2000
@MHA_92_
@simondoyle87
People with similar/fewer qualifications, responsibility and training frequently start on salaries of 60-100k elsewhere, in consulting, law and tech. The salary would absolutely be justified. You are just blinkered by low salary expectations across the board.
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@AdamBienkov
@EmmaKennedy
You sure they didn’t mean the NHS *is* a Blockbuster video rental store in the age of Netflix?
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@nhscaroline
@AnjanBa91282506
@veggieequallife
It’s probably a good thing you aren’t held to the same professional standards as us “elitists”, eh Caroline.
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@WelshGasDoc
No one likes getting woken up, but we chose this job. When I’m on call, I’m the on call surgeon. The juniors are helping me with *my* on-call, not the other way around.
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Note to colleagues: government happy to increase pay in the 100-150k bracket since they get about 60% of it back in tax.
A new pay offer is now on the table for consultants in England.
Find out more about the offer and what comes next:
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Physician Associate with distance learning degree that isn’t a PhD.
Now listed as some sort of ersatz “Doctor” complete with title, on an official NHS website. Just unbelievable.
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@schadhayes
@shaheenkhazali
This “manel” is a problem. But the problem isn’t that experts need to have personal experience of a condition. It’s that the female experts are being excluded. It would be equally problematic if it was a prostate cancer panel.
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@dr_nigel_lane
@NHSEngland
Also, you reckon patients on wards are looking at your tweets? It’s insulting that you think colleagues can’t read between the lines of your statement. It isn’t even subtle.
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@josefpoulton
@ISM_JD
Plus the borderline patronising “but the nurse is really in charge!!”. Nurses don’t need this faux-complimenting. Lead consultants are in charge of medical care in a department. Senior nurses are in charge of the nursing staff.
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Because before you’re 31-ish years old, it doesn’t really count, right? You’re just waiting for your real life to begin. Never mind the fact that you’re being paid less than the people you are forced to supervise and prescribe for.
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@dr_nigel_lane
@NHSEngland
You are making a point that your salary is “high” and you’re happy with your lifestyle. The fact you’ve chosen to implicitly criticise colleagues participating in IA makes my first point.
You seem to believe that pay erosion has affected everyone - which isn’t true.
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Today I made a new diagnosis of cardiac/renal EGPA, and re-diagnosed “sinusitis” as trigeminal autonomic cephalgia, all based on first principles I learnt at medical school.
#nittygritty
#MedTwitter
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We’ve got your back. Today’s junior doctors aren’t worth 25% less than my generation. It’s high time the government stop taking the profession for granted, and safeguard high-quality NHS staffing for the future.
Junior doctors have voted YES to strike action in England.
This is a giant step forward for junior doctors and
#PayRestoration
. Thank you to everyone who worked so hard for this. Keep an eye out for next steps.
#BMADoctorsVoteYes
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@AllisonPearson
@cpeedell
And yet you feel it’s reasonable to ignore and implicitly denigrate the struggle that average people with cancer have day in, day out. “Lesser mortals” who have to somehow hold down a job whilst having cancer. It’s nauseating, cap-doffing, ignorant.
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@dr_nigel_lane
@NHSEngland
Ha, right. That is so utterly unconvincing.
“I can live on my salary which is 3x average”
— and what? What is the point of saying that?
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@tjp7118
@piersmorgan
Ridiculous comment. We have mentally ill people in the UK too; they just don’t have easy access to guns.
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@sisaacturner
@veggieequallife
But there are only so many operations going on each week. Surgical trainees need to do as many procedures as poss because they’re training to be surgeons. They have minimum numbers to achieve (at the very least!). PAs do not. There should be no competition for theatre time.
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Called it.
@quackophage
Thanks for bringing this to our attention
We are very sorry - this job description was posted in error
Clinical & educational supervision are GMC recognised roles, & a non-registered member of staff including a PA cannot provide clinical supervision
The advert will be updated
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Hang on. So if you have MBChB, or even if you did a year of medical school and had to quit for any reason, you are banned from the course? Is that sort of gatekeeping legal?
What's the actual point of training to be a doctor now? I look on LinkedIn and find multiple PA jobs which are paid better than I would be as a Dr. I look at doing getting a PA qualification - those with medical degree aren't allowed to apply?!
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@AllisonPearson
@cpeedell
It’s a phrase that calls out “lesser mortals”. The obvious response is “who does she mean?”. You know this!
Using it as a segue into concern about the NHS is cheap. Perhaps you might want to delve into the disparities between the quality of PoW’s care and that of lesser mortals?
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@BMA_James_Steen
“Shut up and complain via channels where we aren’t embarrassed, and can ignore you”
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GPs of
#medtwitter
: If a child gets sent home from school with suspected chickenpox (it isn’t, he’s fine and it looks nothing like it), is it normal practice for them to require a GP to “clear” the child to go back to school?? No wonder you’re so busy…
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If you can’t get an ITU bed for your major operation, it’s because people are still choosing not to be vaccinated.
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@redknightsman
@Femi_Sorry
Firstly they don’t have a right to protest on private property. Also he was pointing out the irony (lost on the idiots present) of protesting about lockdowns in a fully reopened shopping centre.
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@AyoCaesar
DM taking advantage of the fact that people don’t necessarily know the difference between a medical student and a junior doctor (or at least the people who read the Mail).
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Apologetic but complete BS. I can’t believe this. Your finger doesn’t slip and write an email with a conniving attempt to shame striking doctors. Procedural error? No.
@DrMinaIp
@BMA_James_Steen
We are so sorry. An article was anonymously sent to the Trust &, as a procedural error, it was wrongly shared with juniors. We have apologised directly to our junior doctors and cannot reiterate that apology enough. We are so very sorry for any upset caused by a genuine error.
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This sort of thing is going to store up huge problems for the future. You’ll always need highly skilled consultant surgeons. You create them by letting *real doctors* do the simple operations many many times. What’s the benefit of this nonsense?
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@dgfull
@Microbedoc2
@Jo_McGinn
@AlisonGeorge10
@veggieequallife
@Dr_Done_
@BMA_James_Steen
If you don’t draw a line somewhere, the system will create a situation where there IS no real difference, and a less-well-trained workforce diffuses into all aspects of medical care, from diagnosis to treatment. That won’t be to the benefit of patients.
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@dgfull
@Microbedoc2
@Jo_McGinn
@AlisonGeorge10
@veggieequallife
@Dr_Done_
@BMA_James_Steen
One day when the PA has packed the nose, transfused the patient, given TXA, put in a Foley catheter, and they’re STILL bleeding… you’re gonna want to call someone who’s had my level of experiential learning.
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Jesus wept.
An alternative way into medicine without all that nitty gritty science! Bleugh! Who needs that.
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@KatPaton13
But they’re paying into a hospital budget which then enables the provision of NHS care in general. They’re not then taking “an NHS bed” - they’re paying for a proportionate slice of that bed (and staff). They’re also taxpayers.
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@NoStaticAtAll
Our juniors have already prepared video tutorial refreshers on prescribing / TTOs / stuff we’ve forgotten. It’s called teamwork. Disruption is the point of a strike, not public support.
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I wonder if they realise how obviously disingenuous this language is. Doing just enough to liken them to doctors and reassure the public, without actually calling them doctors. “Trained to a medical model” is meaningless weasel words.
We are proud of our team of physician associates and the critical work they do to support our doctors and nurses and provide continuity of care to patients. A Physician Associate is a generalist healthcare specialist trained to a medical model. Learn more:
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@timricketts_
We are mugs, but is the HCA doing an extra/bank shift, and you’re quoting your unenhanced hourly salary rate? If so you’re kinda comparing chalk and cheese.
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@JimMFelton
Not everything is racist. But obsessing about the percentage of babies born to foreign parents is definitely racist.
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@8lelly8
@ronansetron
@Naomimiii
@KatPaton13
Senior colleague here. Ludicrous statement. Everyone should act respectfully and professionally without the need for a bizarre ritualistic (and one-way!!) offer of snacks. You need to update your understanding of doctors’ working conditions too.
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Why does a scheme exist that incentivises practices to employ PAs over other types of clinician? Could someone inform me how it works with employing training-grade doctors?
This is also important for those asking why it's difficult to see a GP - the answer is that practices are financially incentivised to employ fewer doctors and more of other types of staff via a scheme called ARRS - it is *much* more expensive to employ a doctor than us ARRS staff
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@Weetigger1
@thegradmedic
Do you really think this response is helpful/mature/professional? Would you speak to someone this way in real life?
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@HSJEditor
@theRCN
But the BMA represents only doctors. That’s not an “omission”, that’s just sticking to their turf.
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@wonderwall1973
For a person of that level of qualification, specialisation and responsibility, that is not a good salary at all. It’s a question of perspective and I’m not sure what yours is. It’s less than a tube driver for example. And it’s ~25% eroded by inflation.
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@Kazhazdaz
@JoelDMendez
@sxde_
@CWPT_NHS
“I can see non-white people when I walk around, therefore racism doesn’t exist 😆”
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@dgfull
@Microbedoc2
@Jo_McGinn
@AlisonGeorge10
@veggieequallife
@Dr_Done_
@BMA_James_Steen
And this also ignores the educational aspect of the provision of procedures. Education is a finite resource, and has to be safeguarded for the training of those where the buck will one day stop.
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@alrightPET
@TharushaGunawa4
@MedReddit
It’s always an option to refrain from comment when you don’t really “get” an issue. “Elitism” in particular is a lazy criticism levelled at doctors for any kind of sticking up for themselves. Rest areas are also not zero-sum. A doctors’ mess isn’t the bloody Stewards Enclosure.
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@MotionWorksPT
@cham0037
@ShantiAkers
Not evidence based, and increased resistance only applies to N95 masks, not surgical masks or ordinary face coverings.
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@iapharmacist
@KatPaton13
Is this a joke? What do you think medical school is for, if not the definitive course in the diagnosis and treatment of disease (of which prescribing medication is a large part)?
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@Plyons251
You can get a microwave for like £100. Bake sale sounds like a bit of an onerous way of dealing with this?? Where are the mess fees going? I don’t know where you are but it wouldn’t take much of a consultant whiparound to buy a microwave. It’s not a Sage coffee machine 😐
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@AfrykanBwoi
@BBCFergusWalsh
She’s participating in a trial. They’ll be monitoring her for adverse effects. The general public have no right to her private information.
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@dogandbaglady
@DrNeenaJha
That’s a very sweeping statement with very little insight. £200k is well underpaid for a senior leader of such a large organisation, and with about 250 acute trusts in the UK that makes CEO wage bill about 0.025% of the NHS budget. See the issue with your statement?
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@DrLou83
I would email the facilities director about it, copying their clinical lead. Hospital management has leverage over the conduct of the parking firm they employ, and can often get unreasonable tickets cancelled for staff. Don’t ignore it. Tell company you don’t accept the charge
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Medicine used to be an elite career for highly motivated people.
So the PIA applicant ranks were released…
I feel sick all over again
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@WelshGasDoc
@BBCRadio4
@KingsCollegeNHS
And everyone knows how the already-hesitant will latch on. All they need is that one rogue voice, in a position of authority, who agrees with them, and confirmation bias does the rest.
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@dr_crosse
No - your tweet is unprofessional and frankly threatening. You need to strongly reconsider how you’ve approached this. Mehul was making an entirely reasonable point about efficiency and operate at the top of your scope as a senior clinician.
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@piersmorgan
However silly the question was, he had the option of taking the high road and making an altruistic donation as planned. But he didn’t, preferring instead to kick up a stink that achieves nothing.
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“English voters are mostly white, and want someone who looks like them! I couldn’t go and be the PM of India, could I?”
“So, you’re a racist, then?”
“No, you’ve completely twisted my words!”
- the Tory membership, ladies and gents…
'Rishi Sunak isn't even British!'
Sangita Myska eviscerates this racist caller who says Tory party member won't vote for Sunak because 'he doesn't represent Britain'.
@SangitaMyska
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The sad thing is, some Trusts have “Chief Registrar” roles, and I’ll be damned if they’re not paid with brownie points instead of money.
I'm hereby putting my hat in the ring for Chief SHO for my trust. I would like a 35% pay uplift for this role. I think that's incredibly reasonable
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@IsabelOakeshott
@KwasiKwarteng
@trussliz
Circular argument. Anyone who disagrees, you term “the Left”. So therefore, the greater the anger, the better the policy? Make it make sense, please!
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@RoshanaMN
As it so often case - it starts with good evidence and good intentions (clean hands good, dirty hands bad). But then it creeps and creeps until it becomes “we can now control everything you wear on an arbitrary basis”. Doctors are at fault for not fighting back soon enough.
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@trentconsultant
It’s not “nothing” to do with individuals. Two things can be true simultaneously. If I decided to have a crack at being a cardiologist tomorrow, I’d be breaching GMC guidance and would be rightly sanctioned. Why do PAs supposedly lack agency?
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“Hey, why can’t we tax the richest/big industry more?”
“Well, if you do that, they’ll take their skills and hard work elsewhere. We have to incentivise hard work to retain the best talent!”
“And what about doctors..?”
“Nah.”
@MrTimLane
It costs £250,000 of public money to train a UK doctor and UK has been importing IMG’s for decades .They form up-to 1/3 UK working doctors. Time for UK trainees to be obliged to work in UK after qualifying for say 5 years before being eligible to immigrate.
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@zackferguson
“Doctors, surgeons and consultants” is not a phrase uttered by someone familiar with medicine.
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@cham0037
@MotionWorksPT
@ShantiAkers
Wearing a mask doesn’t alter your oxygen / carbon dioxide saturations. Yes it’s uncomfortable but what you said makes no sense.
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@CraigNikolic
As a frequent datix handler I enjoy (politely) rebutting these sorts of things. It’s small minded and retaliatory.
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@ChrisWoodPhysio
The argument “medicine is imperfect and very challenging” is exactly the reason why people are anti-PA, and concerned by this PA’s statements likening herself to a doctor. PAs do not have a defined scope of practice, so they’re basically practising medicine without the quals.
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The suggestion that doctors need to bring other healthcare professionals food in order for them to *do their job* is probably more demeaning to nurses than it is to doctors. When a doctor asks for something to be done for a patient, it’s not a favour that you’re doing them.
@Naomimiii
@KatPaton13
Right. Thank you for proving the point about issues with hierarchy in the NHS. My advice is be respectful, bring the nurses and HCA’s food and you may have an easier time. But with your current attitude I wish you all the luck with getting any help from anyone
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@TomStocks1982
Omg are we just ignoring the meanings of English words now?? Apprentice doctor means you will become a doctor after some time. Facepalm.gif
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@DoctorJLam
Correct me if I’m wrong, but I thought we aren’t allowed to refer directly to NHS secondary care from the private sector, bypassing the GP. So what should we do if a patient is self funding, needs ongoing care, but can’t afford it?
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@MedCrisis
@Bob_Loveridge
They’re virtue-signalling. And/or they’re deliberately trying to denigrate the ethics of their colleagues. And they’re demonstrating their privilege in many cases - easy for it to be “not about the money” if you have other sources of money.
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@SaraTon08500527
That’s a straw man argument, no-one said “only”. The BMA doesn’t need to be the sole arbiter of PA scope of practice for it to be able to advise its members. It acts on behalf of doctors, who are the lead authority on standards in medical care (whether you like it or not).
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The “K” stands for “thousand”, Nadine… 😂
@BobRobPolitico
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@Dr_Done_
@Xeon4f145d96s1
Fake doctorate too. DMSc = Not a PhD - just allows PAs to stick “Doctor” in their job title gobbledegook.
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This job advert is incorrect and due to a clerical error. It should show the current specialty trainee payscale. Our current postholder in this post is paid £70,250.
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@jordanbpeterson
Which pharmaceutical stock price dropped prior to onicron’s announcement? What a laughable thing to say.
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@fesshole
Not sure deliberately treating your family less well than yourself is anything to be proud of.
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@ShaunLintern
@DHSCgovuk
I’ll be the first to criticise people picking unnecessarily at your choice of wording — but this isn’t a “deal done” at all. The unions will have been obliged to recommend the proposed deal to their members. It’s very likely it will be rejected.
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@timricketts_
She’s an experienced nurse - why do you think you should get more than her? I’m not saying this to be argumentative - just to point out that this is not the way to go about exemplifying our poor pay.
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@veggieequallife
Insecure people very quickly fall back on tropes like this I’m afraid. “You’re not better than me!! Snob!” Even when you’re not asking for anything remotely special. It’s not a you-problem.
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