@@jibjub2121 most of us are content without the locums. The other lot are facilitating and exodus to other countries. We won't starve. It's the British ppl that will bear the brunt at the end of the day, innit
@@jibjub2121 If you laugh at qualified doctors who have studied for years to keep you alive, it's time to go and take a look in the mirror. You were raised wrong.
A personal assistant has no right under any medical or supervisory position to do examinations or give explanations of illness to anybody. They haven’t stood the test of seven years training to become a doctor. How utterly and totally reckless human lives how far down as this country got to go before, it’s totally and utterly broken
Everyone in the health service has made a mistake, one PA makes a bad mistake (and that’s tragic) and everyone is up in arms. Countless doctors have made mistakes. PA’s have their specific jobs, they are not replacing doctors, however as everything else in life, they will be taken advantage of.
@joeblog-yw9tn. Our old family doctor ( who was there when I was born) would have been horrified. He and his sort were brilliant at diagnosis ,with 5 minutes conversation. Talk about efficiency! Now they look at their smart phone and hand over a prescription. Job done ! It’s a travesty of a great tradition.
Physician associates are qualified. They undertake an intensive 2-yr post graduate degree and attain (traditionally) a PG-cert or (more recently) an Msc. All physician associates must also be listed on a mandated register to practice, pay professional registration fees and maintain a continuous log of clinical development. Other than currently lacking the legal grounding that full regulation provides -legal regulation will start as of dec '24 - in every other sense PAs are regulated. As employed members of the NHS they are also held to the same standards of professional conduct that every other HCP must adhere to.
@@mikedonnarumma5337 can’t get a driving job without one though ! you have the unqualified doctor if you want but don’t force me to have to follow your dangerous example
Can you imagine the same concept applied to other professions? Eg a pilot associate? Yes the pilot associate could handle the autopilot in a routine flight and communications with ATC, but in am emergency? Or a scientist associate? I had to get two degrees and years and years of experience before I could call myself a professional scientist. Yes of course a trainee could do some very valuable work for me in the lab or in terms of say a literature search, but it’s me who makes the big calls, writes the papers and grants. It’s a muddying of the waters, it’s a recipe for chaos and problems, confusing roles. Train more doctors and nurses, invest properly in the health system
Dude,nobody involved in medicine or PA profession thinks they are doing a doctors job so the comparison is invalid, they can see more straightforward cases with regular supervision.
@scarred10 mate, I'm in the know. The GMC is very concerned about PAs. It's a recipe for disaster and so-called supervision is already showing signs of being patchy. Train more actual doctors and nurses, fund the NHS properly, not sticking plaster solutions destined for chaos
@rnanerd6505 So i suppose you're fully opposed to nursing associates then.. or assistant radiographic practitioners? Were you even aware that those roles existed? .. i doubt it. im also certain that you are not aware that plenty of existing qualified healthcare professionals INCLUDING nurses train as PA's in the hope of clinical progression and bring those skills with them. You sound clueless!
@@scarred10 1. The concern is that as the NHS is collapsing they *will* be asked to do more of the things that doctors do, and 2. If they need so much supervision, does that not ring alarm bells? Would he you have your airliner piloted by a pilot associate with only 2 years’ training with the captain supervising or would you not prefer to train more captains? But more fundamentally: who’s to say what’s a “routine case”? The point is that a GP, with years and years of training, can spot the non routine from the routine, do you think a PA with two years of “training” is able to do that?
@@JP-tb3tq I sound clueless? I refer you to GPC England. A nursing associate etc is a totally different thing. Inform yourself about the real concerns of doctors, and of patients. Also, what are your credentials? Since you question mine…
In my experience the issue is that PAs are conducting examinations and then doctors are signing their work as 'supervisors' without actually reading the documents. It's the equivalent of bringing your car into the shop for maintenance, only for one of the tire guys to eyeball it for a minute without even lifting the hood, then tell the trained car repairman with an engineering degree that the car is fine, then said repairman signing a document that he thoroughly inspected the car and found it was in perfect shape.
@ObsidianKnigh. It’s not a short term solution. It will inevitably become “normal”. The government finds it cheaper to import foreign doctors than to educate our own. Why would there be a shortage ? Truth is, education is being cut back severely on purpose - 2 reasons. 1) to make vote-winning tax-cuts. 2). An educated electorate isn’t so easy to manipulate.
How can PAs work on the same level as junior doctors whereas junior doctors study 5-6 years of an intense course versus PAs who do 2 years of messing about
They are supposed to be working under the supervision of doctors, whether that is what happens I don’t know, maybe they are putting too much pressure on Physician Associates.
Theyre not "messing about " for 2 years, but what they study and DO as a job can never compare to a doctor, so why are they seeing patients in GP surgeries and other parts of the hospital ? Its total nonsense. Being a GP is hard enough as a doctor, having to synthesise huge bundles of information from any medical speciality in 10 mins without immediate access to bloods or imaging is very difficult, they dont always know the answer......now imaging doing that when you arent evern a doctor
of course they are - they hardly do clinical sciences in the 2 years - its most like a 2 year apprenticeship in the hospital - they get used to the admin side of things that junior doctors do such as requesting blood tests and scans and chasing results but they are not ready to make clinical judgements@@psps2034
It infuriates me to know PAs would EVER compare themselves as equivalent to a doctor of any grade and even trick patients into thinking they are a doctor, even if they dont actively say they are. It is a total insult to doctors.
@@mizlopi Unfortunately, many instances where this has happened, actively misleading patients. Starts from the very beginning, with PA students introducing themselves as "medical students.
You are half right. Cost is coming before patient safety. What you need to understand is that more doctors would be better, but we actually have an abundance, but many do not want to work in primary care and many also do not want to work in the NHS. General practices are not NHS, they are private entities, contracted by the NHS to provide primary community care. What you’ll find is that the GP contract that was agreed to some years ago heavily favoured GPs in the fact they do not have to work unsocial hours. No evenings, no nights, no weekends. Many GPs do of course, but not as part of their core hours, this is done as overtime with very very lucrative financial reward. Doctors working in primary and urgent care have the system over barrel and basically dictate the rules. The status quo at the moment is, pay us more or we will go elsewhere (another country). So they get paid more. Some have demanded £140ph to work weekend shifts last minute, because they know if they offer to work last minute they can their way more often than not… because services like 111 need the clinician when they are routinely short staffed. Do you know how this is being tackled?? Upskilling the existing workforce of nurses and allied health professionals - who might I add can be just as competent. Hey may not complete a 5 year medical course off the mark, but they typically do a 3 year BSc and go on to work many years with continued on the job learning, CPD and up skulking, before they get to a position in which they ‘take the job of a GP/doctor’
@@cynthiamorris1874those Doctors still have a medical degree and have had to pass a registration exam (PLAB, now will be called the UKMLA) that assesses their competencies to make sure they are operating at a similar level to other doctors graduating from UK medical schools. They are still an order of magnitude above PA’s in competency.
@@premojha979 A three year course is not the same as a 6 year course though. The only PA’s I know have done a 3 year course in either something like diagnostic or therapeutic radiology, or nursing, BSC (Hons), leading to a MSc (Hons), then leading to UK Faculty of Physician Associate National Examination. I have never heard of anyone with a degree in languages becoming a PA, unless they did a medical/science undergraduate degree as well. However that may well be true, and I would not be happy with it. However I think people are now making statements that are not true. A terrible mistake was made, but don’t forget many doctors have also made mistakes.
I never get to see a GP I am always fobbed off with a Physician Associate. They never read my notes first I always have to go through my Cancer notes since 2021 when I was diagnosed so my 10 minute appt is taken up while they read my notes. They can't give prescriptions until you have to wait for it to be signed off by GP which can take 3-4 days to arrive at your nominated pharmacy. All I want to see is a normal GP that has read my notes and will listen to how I am feeling.
There’s 10-15 minutes to see a patient and document this, which includes time to call you from the waiting room. You can request to see the same doctor to ensure continuity, which may mean a slightly longer wait. Reading all of your notes each time is not needed when there’s continuity. Also- ‘reading all of your notes’ is an untenable task for each clinician as it’s too time consuming for each consultation.
There is a big drive by NHS managers to employ physician associates, paramedics etc and get them to replace GPs. NHS managers offer money to GP Surgeries to employ these under the guise of reducing GP burden, but the aim is to replace GPs. It's dangerous and has to stop to protect patients. Doctors are strictly overseen by GMC but these allied professionals moon lighting as GPs/doctors don't have any regulation. It's a wild wild west.
Paramedics do have regulation though. They are regulated by the HCPC in the same way doctors are regulated by the GMC. You wouldn’t want a paramedic treating you for emergency care if they weren't regulated.
Paramedics are regulated by the HCPC like doctors are regulated by the GMC. You wouldn’t want a paramedic treating you for emergency care if they weren’t regulated.
@@VNavale Paramedics are perfectly capable of dealing with minor illness/injuries when they deal with major illness/injuries as well. When ambulances go out to patients they don’t just go out for ‘emergencies’, some people call 999 for cut fingers, a cold, headache because their blood pressure is high e.t.c. No their not GP’s that’s not the point either of us was making initially, they are paramedics they are able to assist some patients which they do and well. Your argument was they aren’t registered my answer is they are and they’re qualified to be providing the care they do. Plumbing and electronics are two different professions altogether, paramedics and doctors are both healthcare professionals which both receive evidence based education relating to medicine. Paramedics have been in GP practices for some time now and from my understanding deal with simple cases for patients leaving GP’s to deal with more complex cases. If you’ve ever been to a minor injuries unit or minor illness unit or walk in centre you should know they tend to be nurse led meaning there is no doctor on site. They exist for the purpose of treating ‘minor problems’ they seem to work well and patients for the most part seem satisfied with them, even GP’s seem to as well telling patients who can’t get appointments to see them instead of their GP which is strange if they don’t like them that much? Though this often results in overloading of such places and impacts patient safety especially when complex cases are missed/ignored by GP’s and then told to go to such centres where nurses often arrange ambulances to take such patients to A and E’s because their GP didn’t see them and they knowing they aren’t competent are unable to assist such patients. I think the GP’s need to work on more than just bashing others maybe themselves, because they also impact patients safety. Many GP’s use online systems which require patients to tell GP’s what’s going on with them. If an appointment is booked GP’s fail to read all information within a request, rush their patient and promptly end a consultation without providing much advice or whether there are any questions or additions. All bad practice but it happens this results in vital information being missed as the patient may forget to mention something as they have already written it down expecting the doctor to have read their notes. Some GP’s don’t follow up their patients when they have gone to hospital or had a blood test and such yet again bad practice my question is, if the excuse is they are really busy how at the moment can we at the least ensure patients are safe if their are not enough doctors presumably?
This is crazy, we are basically treated by unqualified doctors, how can they treat someone with terminal cancer and other related conditions? Patients are vulnerable in the first place .
The country needs more doctors . The country needs more doctors specialising in GP. The country needs more doctors who have jobs to end up becoming a consultant. The country does not need to train more PAs, i.e. people who are not doctors. There is NOTHING a PA can do which a Doctor can't do. A doctor of any grade is infinitely more skilled and trained than a PA. A PA will always answer to and be under the supervision of a doctor. A GP has studied for 5 years at medical school to become a doctor and THEN worked for a further 5 years as a fully qualified doctor and completed highly prestigious royal college exams to become a GP. How on earth can that compare to someone who isnt even a doctor seeing patients at your local GP surgery?
Some PA’s work and keep on training for years and THEN lecture others on specialised knowledge they have, even some trainee doctors sit in on these lectures. There is too much generalising going on here. Most PA’s work in hospitals alongside doctors, in such places as A@E so they are working with doctors not instead of doctors.
@@cynthiamorris1874 What do you mean by trainee doctors? Medical students or doctors? The knowledge the PAs acrue is by virtue of having worked on the same ward/in the same dept for a long time. That still doesnt compare to the generalist knowledge of a doctor ,whether or not the doctor specialises in something or not. Yes, the PAs work in A&E which I odnt understand cos how can they possibly have the same body of knowledge as a doctor to see undifferentiated patients? They havnt worked as a doctor prior to their job, so they will never be able to pick up on subtle features in the history the way that a doctor can.
@@psps2034 I have NEVER advocated that PA’s are on par with doctors. I have NEVER said they have the same medical knowledge as doctors. Of course PA’s can work in A&E, just as nurses work in A&E. It’s a shame that they earn a little more than junior doctors for a short time, it seems for many on this thread that that is what it’s all about.
@@cynthiamorris1874 Nurses dont do the job of a doctor. PAs are , however, doing the same role of a doctor where they are seeing patients and treating them. You have acknowledged that doctors havse more knowledge than a PA. Therefore, with this in mind, how can you with an honest heart advocate PAs to see patients hand in hand alongside doctors knowing the care a patient received by a doctor will be better due to the greater knowledgebase?
@@psps2034 I have no idea really what you are talking about, PA’s are qualified to do the job they are trained for and that is working under the supervision of a junior doctor or a GP. You are aware that you can be seen by a Nurse Practitioner in a surgery or health centre, the same rules apply, there. If it is deemed a doctor is needed then that will be the course of action taken.
I'm a doctor who left the NHS long time ago but still keep in touch with my colleagues who are in the NHS. Having seen the decline and now with PA"s replacing doctors I will dread getting treatment in the NHS now.
It is not commonly realised that the GMC has changed drastically in the last 20 years. It used to be run at the senior level by experienced doctors who had moved to medical administration. This has gradually but clearly changed to having senior highly paid managers in these positions. There are a couple of doctors with honorary titles but the overall management and direction of the GMC is not controlled any longer by qualified doctors. The GMC and the BMA are both now very "woke" organizations with a profound left wing bias in their output. (in my opinion). However the GMC is a very powerful organization in terms of licensing and control of the medical profession, as they can use legal powers which the BMA does not have. Managers know this very well and use what sometimes amounts to kangeroo courts to discipline doctors. This is very little reported by the mass media and I don't see this situation improving in the slightest. The GMC's governance restrictions are one major reason for doctors of all types retiring early, when they could have continued on a part-time basis for many years. This isn't really possible any longer for many. This is also why they are being forced to employ non-doctors to clinical roles which they are not well trained for. Once the GMC became a non-professional organization, this was likely to happen. The senior doctors in the GMC warned of this at the time that reforms were forced through.
A law firm might be called 'named partners ... and associates' - when you get an appointment to see someone who is not a named partner, you assume you're still, at minimum, seeing a *lawyer* !
Imagine going to a restaurant, and being told that the Chef's Associate is cooking your meal. But that person only has 40% of the training, and basically anyone was let into their course
@@maielego1354 Of course it is misleading. The whole thing is misleading, just call it what they are: "Cheaper than qualified people" Poundland Healthcare.
The GPs job is diagnosis. This demands a very high degree of competence and range of experience. And commitment. Once a diagnosis is made, the choice of medicine and treatment is secondary. In one practice I never saw a doctor, or had a call from one in 4 years. I was phoned by associates only - even during a critical stage. My condition worsened without my knowing why. Incidentally, no-one will be blamed. No professional body had any over-sight or prior responsibility. No chain of command exists. Doctors’. Unions should have been up in arms. They are sabre-rattling now - but what were they even doing during the Tory years ? The miners would have been campaigning at least. Harassing the government. They had paid officials, for that job, every other trade union.
@@jibjub2121please look at the competition ratios for GP training. There is a 2 for 1 competition ratio. So there is currently thousands of doctors who would love to be a GP but there is no training posts for that. Blame the government
@@gareth6326 search competition ratio of GP and you will find thousands of Drs applied for this post but only a few will be appointed because it is cheaper to hire a PA!! To see a Dr in the future you will soon have to pay. The government is hiring cheap professionals to substitute Drs.
When I was consulted for the first time over 6 by one of the doctors,he totally dismissed my symptoms 4 months later I was given a diagnosis of full blown cancer with no cure. imagine it?
Luke is absolutely correct. There are many doctors in this country who are qualified in a different country and having much experience. They should get a chance to practice under consultant as the knowledge clinical training is much far better then of a PA
We also have to consider differences in health concerns between different regions/countries. Some doctors may have a lot of experience which is not relevant here.
@@bigbarry8343 That's why foreign doctors have to take the 2 step PLAB exam that tests theoretical and practical knowledge before they join the system. So, foreign doctors do learn medicine relevant to the current scenario in the UK on top of what they already know.
Physician Assistants is what we call them in the US. They’re fighting tooth and nail to change it to “Associate”. They also like to call themselves “medical providers” and like calling doctors the same making them seem the same. I did not go to “medical provider” school. I have a doctorates degree in medicine. Took me 10 years of training after undergrad school to be able to practice as an attending physician. I would have been scared for the patients had Id been thrown out there after my second year of training.
Hi, i'm a 41 year old nurse with a graduate diploma in clinical care nursing in Australia, i'm thinking about doing the PA program in Ireland but with what I'm hearing now, I'd say why not going back to physicians assistant like in the US, if American are making it work so do you! In Australia we do have a huge lack of GP's while we only have 5 or 10mnt with the gp and pay a full amount of time. We used to have 45mnts, now, you get to the GP office and they are just asking: what can I do for you today? That's just not it, and the pharmacist can do the same these days, I don't know if it's only in Australia but the system can't keep going like that on top of getting into medicine (universities) is incredibly hard, too expensive, and the medical association takes so few of them every year, so no wonder why we have long time waiting list and by the time you got in it's either you don't need a gp anymore or your situation has worsened. My husband has been on a waiting list for 20years to fix up his foot (cause of cuisidal attempt) now they talking about an umputation and we only saw overseas doctors mainly from india, and we can't see another one cause we have singed a contract years ago that he is on a list in the mean time they changed their mind and WE can't refuse. It's just not it, the public is suffering you have got to do something
It's not just GPs . I was almost palmed off on an oncology PA years ago. Total lack of transparency as well. Only got suspicious when that person said something that didn't sit right. It's all about cost saving.
The longer it takes for the public to wake up and push back on this issue the better. This is a disaster in making and clear cut playing with patients’ lives
See when you're entitled to a prescription and they tell you buy it. It's because they aren't qualified to give prescriptions. Found that out a few yrs ago. A blond lady was telling it all. Can't remember what platform I saw it on
Not quite, but it might be an indicator yes. Obviously there are loads of meds GPs can prescribe that are available over the counter, so it's no different in cost or time for the patient to just buy it themselves.
It's the same with schools employing Instructors and in social work - social work assistants - they made the professional bodies that oversaw professions and safeguarded protected titles that proceeded to water them down due to money and cost.
@drakeybryter. Let’s face it. We are now a Third World country. And when did it start ? Who has been in charge all this time.? You all know perfectly well.
I understand that the acute shortages of GPs are due to very limited GP training spots available, while the funding for PAs is made available (even though PAs command higher salary than junior doctors in the first 4 years). In fact, only 1 in 3 of medical school graduates who applied to train as GP is accepted. The proliferation of PAs while underfunding GP training spots will result in even worse GP availability, with PAs supported by standarised AI run from India with high cost of living arbitrage opportunities, will become the norm in this country.
I think Adam was the most qualified person to speak in the programme having experienced being a PA and a medical student. I guess it’s hard for doctors and PAs to fully knowledge role and responsibility as most NHS trusts don’t have a scope of practice for PAs. I feel equally bad for both PAs, who feel they work beyond their capacity with no development plan, as well as for Junior doctors who feel they do more work and get paid less. Certainly more discussions are needed.
I think more time requires data entry of patients in Surgery center . So help can be provided to gps for this help. It might decrease time spent on each patient. All assessments should be done by the GP. However there are lots of GPS sitting home waiting to get an offer for a job.
Bottom line, if I have anything more than a cold I want to be seen by A DOCTOR. Not a nurse, not an associate anything, the person who is actually qualified to make the assessment, not a pretendy doctor
Your beloved labour helped destroy the NHS in Scotland via dodgy PPI schemes yet starmer still takes to the media to attack the Scottish NHS. Dishonourable man, not to be trusted. What nation are you loyal to and why?
This presenter putting words in the caller's mouth. 'you don't think physician associates have any use at all?'. No physician associates are probably useful as physician associates and trained doctors are useful as doctors in the field they were trained in. It's not rocket science. Standardised practice exists for a reason. In large part to safeguard those in need of whatever services are required, but also to best maintain the standard and integrity of whatever practice is being used. People are trained for what they intend to do. Would you want a car mechanic performing spinal surgery on you or a spinal surgeon tinkering around with your car engine? No because they don't meet the standard specialist knowledge to perform that role as a professional. Maybe don't assume you know better than an established process that knows exactly what it has to do to deliver the best service to people and just trust that the people who know these institutions from the inside probably know more than you on how they operate. My word the hubris. I expect he has a journalism degree. I wonder if he likes it when 15 year old influencers claim they are his peers in the field of media commentators.
But no one has defined specifically what PAs should be doing to say they are 'useful as PAs'. The NHS has become a wild west where some PAs are just filling in forms and helping with administrative tasks on the wards and others are performing C-sections with no supervision. As with many things in the NHS, safety concerns are being swept under the rug and staff members careers are being threatened if they whistle blow.
@@justadude8369 again utter made up nonsense. Where is the evidence that PAs are performing unsupervised sections? Other than in your crazy little mind?
Unfortunately this logic doesn’t stack up, because physician associates don’t possess any skills that a doctor doesn’t have, yet lack most of the knowledge gained in a rigorous medical training programme
@@jibjub2121 Its inferior to a medical degree in every way. And yet PAs are paid more than doctors. Every pound spent on PAs is a gross waste of taxpayer money which could be used to recruit more doctors, nurses, pharamacists, physios, paramedics, OTs, radiographers etc all of whom are established professionals who work synergistically with doctors. A doctor could not do the work of a nurse, physio,OT etc because they are different discliplines. PA is not a discipline and the role could be performed (at a higher level) by an actual doctor.
There's a very simple change the government could make to instantly improve this situation: allow GP Practices to use the money alloted for PA's to also be used to employ GP's. It's a no brainer. Why isn't the press all over this?
The BMA have always extremely protective of their turf, they were against nurse prescibers and really against nurse practitioners. We need a bump up in medical personnel, otherwise the NHS Will be understaffed for nearly a decade while new doctors are trained up. Also there seems to be an assumption that doctors never make a mistake! That is clearly not true.
Thankfully with the government changing, we there will be mlre jobs and funding for doctors. PAs are not the answer. There are plenty drs... just not the jobs
I mean, this actually goes to show how Ill informed the public are…. Paramedics have been working in general practice surgeries for several years. Some practices have more than others, and yes, it does make sense… do you know the curriculum of a paramedics training, what their remit and scope of practice is? Do some research and come back with a more informed argument, where you may or may not then agree with your sentiments. Certainly, more doctors would be great. But would you rather a GP or a paramedic turn up to your house when you are in a healthcare emergency? Who do you think GPs call? 😅
@@therona23823yeah the standard of debate on this is absolutely dreadful. Many of the public have no idea how the healthcare system actually works. They’ll moan about the state of the nhs, then vote Tory and complain about any attempts to remedy the situation. Maybe the British public will get the healthcare they deserve, and with their criticism and the current state of the nhs, maybe they’re getting what they’re deserve after all. My advice to doctors, PAs, ACPs? Leave this country as it’s only going to get worse. Go to a country that appreciates you.
@@therona23823My partner is a GP and says their remit and scope is to decide if the patient needs hospital treatment and if so stabilise the patient until they can get hospital treatment (by doctors), the latest being the only reason a GP would call paramedics. On the other hand, while on duty she's also had paramedics calling her from the field, asking for the best course of action to take as they were not able to decide what to do with their patient. Bit ironic that you wrote about how ill informed the public is.
Blame your government for undermining and underfunding the medical profession. PAs (having worked with them and had them shadowing) are terrible diagnosers but can be useful in checklist thinking. By definition GPs deal with UNDIFFERENTIATED illness, PAs cannot without training can’t do very much and get paid better than junior doctors.
Broad brush and anecdotal evidence. How can you brand thousands of people the same after working with half a dozen? I thought as a clinician you were meant to have a basic understanding of statistics and inferring from incomplete data? Bit of a concern actually
@@jibjub2121 i’ve worked with and trained over a hundred PAs and the ‘training course’ is not fit to have some come out the other end to diagnose without supervision. My data comes from the LMC feedback that I am a part of. As for anecdotal evidence i’ll wait for someone to do the published science. As for the salary you can see the evidence on nationally published pay scales.
Plenty of Doctors about. Infact a recent article in the BBC noted 4 in 5 GP locums are looking for work. About time they worked permanent contracts. Locum Drs have been getting paid over a thousand a day for years. I know one locum Dr that worked in the same practice for 10 years. A lot of them are hopeless and just come to collect their pay cheque. Most GPs refer onwards to specialists. I work in healthcare and I can tell you now. A lot of GPs are hopeless. The referral letters are incorrect, they refer to incorrect pathways and don't follow up results.
There are some fantastic physician associates. But these are the ones who have prior medical knowledge…it’s right that people applying need to be vetted to have appropriate prior degrees and knowledge. I’m an advanced nurse practitioner who did a 2 year masters. But prior to that I did a 4 year degree in nursing and worked as a nurse for 7 years before I did my advanced training. It means I’m completely knowledgeable and competent to consult in many area’s independently the same as a doctor, with doctor support if needed. I think the PA pathway just needs to be tightened and ensure previous clinical knowledge and experience
@ageeordieboy. No need for all that malarkey ! Let’s just get back to what we had 20 years ago. And let’s face it : today’s “masters” aren’t worth a carrot. Same as in the US.
@@ilikeeverybody7581 I have many skills and competencies absolutely equal to a doctor. 4 year degree, 7 years post qualification experience and an intensive 2 year advanced practical medical qualification. You then go on to be mentored and supervised. I can hold my own against many a doctor. I’ve solved cases that doctor colleagues haven’t. Unless you yourself work in this field….you know jack about it.
@@ilikeeverybody7581 my knowledge, training, experience and skills are comparable to a doctor. I prove it every day of my working life. End of story. Unless you work in this area, you are the one talking nonsense.
@@ilikeeverybody7581 We are following the US in this. Here, having an MA, really meant something once. But the crafty government have been handing them out like sweets - cutting the cost of intensive study. They aren’t maintaining the value of the qualification. They are undermining it. Shame on them.
If the U K was investing in the population, by way of reducing poverty, this whole emotional conversation might get somewhere. Preventative measures to reduce poverty would reduce the need for Associates and give G.P.s more time to get to know their patients, as well as reduce the level of inpatient hospitalisation. The ROOT cause of all of this is the creation of Poverty by previous governments. Managing energy in creates bonuses and savings within years and all around. You have to look at the whole picture to solve anything. That should be taught to all school children. Arguments in isolation are useless. The media tends to prefer soundbites. Grow up U K !! Pathetic.
Not just. Three years basic training, five years clinical experience and most have additional, specialist qualifications. Even then, they don't diagnose and treat.
You go to the doctors and they can’t tell you anything, it’s as though they don’t know what they’re doing… it’s scary, or they ask YOU what do YOU think is wrong .. like ☠️ it’s really weird. I don’t trust them.
@misstgirl. The GP is irreplaceable. His specialism is diagnosis - the basis of absolutely everything. He has vast experience, and he can see connections that even the patient isn’t aware of - in quite a short time. No PA or nurse can give that guarantee. Lose the GP and you will drag things out - and endanger the patient. Checking on a smart phone is criminal by comparison.
It is part of medical training. When training to take a medical history part of that is to ask about the patient's ideas, concerns and expectations. Often reassurance can be given that the terrifying diagnosis the patient found on google is not accurate.
Pretty disgraceful, going after and leading attacks on a profession they know doesn’t have a union and can’t fight back. They wouldn’t dare do this to nurses. It’s disgusting. Many people became PAs to help, and they’re just getting slandered and insulted. What happened to clap for carers?
@@Robertsmith001 not to mention the doctors unions are bullying PAs because they know they don't have a union and can't fight back, that's the definition of bullying. Also, stop liking your own comments its cringe
Most of the GP’s I’ve seen recently just look on google or the NHS website and just read it off. It’s all fake doctors now. Completely pointless going.
@@ZoeSummers1701A I think the quality of healthcare in the States is high, if you can afford it. If PA’s had the correct education they would be an asset. Many of them do have the correct qualifications.
@@cynthiamorris1874 American doctoring is a racket. Just talk to ordinary Americans. Your contracts force you to pay for tests and things you don’t need.
PA position is problematic. They act like doctors, dress like doctors, 2 years of training/studying on a crash course masters, they earn more than junior doctors (even though they have several years experience). I do think the government wanted to cut corners to make up for the lack of doctors and nurses… but i feel like this position will cause issues in the future. Nurses are even more trained than PA’s but PA’s carry themselves as “junior doctors” which is misleading.
To become a GP you'll need to complete: a degree recognised by the General Medical Council which takes 5 years. a foundation course of general training which takes 2 years. general practice specialist training which takes 3 years.
True..but the way my GP(,s) have treated me(e.g.not referred me to specialists /consultants)the past 3 years...I cannot excuse sadly.=they never got to the bottom of my problem.They did here in Spain,albeit via private treatment,which isn't cheap,but didn't need a GP "blocking' my path. Obviously the NHS is in deep trouble....everyone knows that,here in Spain they know that as 3 doctors alone say they used to work for the NHS,and know the decline in service and customer diligence.
It's a class problem.. not an ability issue.. the doctors wont allow people from working class backgrounds to get up the ladder. Why not have a conversion course to make up the alleged difference?.. of course that has been blocked by the Dr's, but happens all over the world, even as close as Scotland have the sense to offer a GP top up. Complete Class prejudice.
So much 'nonsense' that it triggered your reply😂, If it wasn't true the medical schools wouldnt all have quotas for accepting people from poor backgrounds. Thats not my nonsense opinion, its fact@@gareth6326
@bregan. I don’t quite understand your point. Fifty years ago we had a brilliant and wise family doctor. He came from a working class family in the poorest part of Glasgow. He was a cultured man - and courteous. So perhaps that’s what we are really talking about. Lack of the sensitivity and social intelligence that were very much the standard of those far-off days. Standards have dropped across the board.
this is long overdue, the medical profession has been holding the taxpayer hostage for entry into the profession for far to long acting like a guild of old, which is all they are basically
@@BradleyPitts666 The point is that if we had enough doctors in this country and paid them so they wouldn't go abroad, we wouldn't need this stop gap, second rate stuff.
The General Medical Council has effectively given up on any professional and ethical oversight.
Give it few more years, NHS will cease to exist.
That’s exactly what they ARE doing with physician associates though?
@@umeriqbal8269 thanks to the British public! Turkeys voting for Christmas
@@jibjub2121 As an immigrant myself i can tell you one thing, UK leadership has sold out this beautiful nation.
@@jibjub2121Tories love PA, that speaks volumes itself
PAs are not associate doctors.
They are noctors
@@docthomas8717 🤣🤣
Keep crying because PAs and ACPs mean you can't charge as much for locum shifts anymore 🤣
@@jibjub2121 most of us are content without the locums. The other lot are facilitating and exodus to other countries. We won't starve. It's the British ppl that will bear the brunt at the end of the day, innit
@@jibjub2121 If you laugh at qualified doctors who have studied for years to keep you alive, it's time to go and take a look in the mirror. You were raised wrong.
A personal assistant has no right under any medical or supervisory position to do examinations or give explanations of illness to anybody. They haven’t stood the test of seven years training to become a doctor. How utterly and totally reckless human lives how far down as this country got to go before, it’s totally and utterly broken
If you compare how many 'mistakes' PAs have made leading to death of a patient compared to doctors you will be very surprised
Everyone in the health service has made a mistake, one PA makes a bad mistake (and that’s tragic) and everyone is up in arms. Countless doctors have made mistakes. PA’s have their specific jobs, they are not replacing doctors, however as everything else in life, they will be taken advantage of.
Physician Associate is their designation, not personal assistant.
@@cynthiamorris1874they are assistants to REAL physicians
reroute the tax payers dollars from immigration and funnel it into NHS....
If it’s not safe to drive with no licence then how can it be safe to practice medicine without being fully qualified ?
@joeblog-yw9tn. Our old family doctor ( who was there when I was born) would have been horrified. He and his sort were brilliant at diagnosis ,with 5 minutes conversation. Talk about efficiency! Now they look at their smart phone and hand over a prescription. Job done ! It’s a travesty of a great tradition.
not having a driving license has nothing to do with how safe your driving is
Physician associates are qualified. They undertake an intensive 2-yr post graduate degree and attain (traditionally) a PG-cert or (more recently) an Msc. All physician associates must also be listed on a mandated register to practice, pay professional registration fees and maintain a continuous log of clinical development. Other than currently lacking the legal grounding that full regulation provides -legal regulation will start as of dec '24 - in every other sense PAs are regulated. As employed members of the NHS they are also held to the same standards of professional conduct that every other HCP must adhere to.
@@mikedonnarumma5337 can’t get a driving job without one though ! you have the unqualified doctor if you want but don’t force me to have to follow your dangerous example
@@joeblog-yw9tn your scraping the bottom of the barrel now joe, chucking in any thing ,plus fabrication for a win,
Can you imagine the same concept applied to other professions? Eg a pilot associate? Yes the pilot associate could handle the autopilot in a routine flight and communications with ATC, but in am emergency? Or a scientist associate? I had to get two degrees and years and years of experience before I could call myself a professional scientist. Yes of course a trainee could do some very valuable work for me in the lab or in terms of say a literature search, but it’s me who makes the big calls, writes the papers and grants. It’s a muddying of the waters, it’s a recipe for chaos and problems, confusing roles. Train more doctors and nurses, invest properly in the health system
Dude,nobody involved in medicine or PA profession thinks they are doing a doctors job so the comparison is invalid, they can see more straightforward cases with regular supervision.
@scarred10 mate, I'm in the know. The GMC is very concerned about PAs. It's a recipe for disaster and so-called supervision is already showing signs of being patchy. Train more actual doctors and nurses, fund the NHS properly, not sticking plaster solutions destined for chaos
@rnanerd6505 So i suppose you're fully opposed to nursing associates then.. or assistant radiographic practitioners? Were you even aware that those roles existed? .. i doubt it. im also certain that you are not aware that plenty of existing qualified healthcare professionals INCLUDING nurses train as PA's in the hope of clinical progression and bring those skills with them. You sound clueless!
@@scarred10 1. The concern is that as the NHS is collapsing they *will* be asked to do more of the things that doctors do, and 2. If they need so much supervision, does that not ring alarm bells? Would he you have your airliner piloted by a pilot associate with only 2 years’ training with the captain supervising or would you not prefer to train more captains?
But more fundamentally: who’s to say what’s a “routine case”? The point is that a GP, with years and years of training, can spot the non routine from the routine, do you think a PA with two years of “training” is able to do that?
@@JP-tb3tq I sound clueless? I refer you to GPC England. A nursing associate etc is a totally different thing. Inform yourself about the real concerns of doctors, and of patients. Also, what are your credentials? Since you question mine…
No lack of gps , there are many GPs unemployed
The government paid for PAs but wouldn’t pay for GPs. .
As they should be , poor quality GPs are the biggest reason for death of patients
In my experience the issue is that PAs are conducting examinations and then doctors are signing their work as 'supervisors' without actually reading the documents. It's the equivalent of bringing your car into the shop for maintenance, only for one of the tire guys to eyeball it for a minute without even lifting the hood, then tell the trained car repairman with an engineering degree that the car is fine, then said repairman signing a document that he thoroughly inspected the car and found it was in perfect shape.
@ObsidianKnigh. It’s not a short term solution. It will inevitably become “normal”. The government finds it cheaper to import foreign doctors than to educate our own. Why would there be a shortage ? Truth is, education is being cut back severely on purpose - 2 reasons. 1) to make vote-winning tax-cuts. 2). An educated electorate isn’t so easy to manipulate.
It's not legally or professionally advisable to sign off the work of another in nursing or medicine.
@@deliciouslyk3437 Yes. Unfortunately it happens a lot in the U.S.
How can PAs work on the same level as junior doctors whereas junior doctors study 5-6 years of an intense course versus PAs who do 2 years of messing about
They are supposed to be working under the supervision of doctors, whether that is what happens I don’t know, maybe they are putting too much pressure on Physician Associates.
Junior doctors have also been WORKING as a doctor for anywhere between 1 and 20 years !!
Theyre not "messing about " for 2 years, but what they study and DO as a job can never compare to a doctor, so why are they seeing patients in GP surgeries and other parts of the hospital ? Its total nonsense. Being a GP is hard enough as a doctor, having to synthesise huge bundles of information from any medical speciality in 10 mins without immediate access to bloods or imaging is very difficult, they dont always know the answer......now imaging doing that when you arent evern a doctor
and ur point?
@@psps2034
of course they are - they hardly do clinical sciences in the 2 years - its most like a 2 year apprenticeship in the hospital - they get used to the admin side of things that junior doctors do such as requesting blood tests and scans and chasing results but they are not ready to make clinical judgements@@psps2034
I have seen a PA whose background degree was sculpture and arts 🤣🤣🤣
Doubt
@@jibjub2121We doubt you
When you make an appointment ask to be seen by a GP!
It infuriates me to know PAs would EVER compare themselves as equivalent to a doctor of any grade and even trick patients into thinking they are a doctor, even if they dont actively say they are. It is a total insult to doctors.
Not one PA would do that. Why are you so insecure to think that they would do that?
@@mizlopi Unfortunately, many instances where this has happened, actively misleading patients. Starts from the very beginning, with PA students introducing themselves as "medical students.
@@nirmalparakkal8005 prove it
@mizlopi they do actually. There are may videos with them saying they are the same as SHOs
Very scary situation 😢
Non doctors have displaced GPs and taken their jobs, as they are seen as 'cheaper! Cost is coming before patient safety and quality of care.
Doctors from overseas with 3 years training are now being employed in this country.
You are half right. Cost is coming before patient safety. What you need to understand is that more doctors would be better, but we actually have an abundance, but many do not want to work in primary care and many also do not want to work in the NHS. General practices are not NHS, they are private entities, contracted by the NHS to provide primary community care. What you’ll find is that the GP contract that was agreed to some years ago heavily favoured GPs in the fact they do not have to work unsocial hours. No evenings, no nights, no weekends. Many GPs do of course, but not as part of their core hours, this is done as overtime with very very lucrative financial reward. Doctors working in primary and urgent care have the system over barrel and basically dictate the rules. The status quo at the moment is, pay us more or we will go elsewhere (another country). So they get paid more. Some have demanded £140ph to work weekend shifts last minute, because they know if they offer to work last minute they can their way more often than not… because services like 111 need the clinician when they are routinely short staffed. Do you know how this is being tackled?? Upskilling the existing workforce of nurses and allied health professionals - who might I add can be just as competent. Hey may not complete a 5 year medical course off the mark, but they typically do a 3 year BSc and go on to work many years with continued on the job learning, CPD and up skulking, before they get to a position in which they ‘take the job of a GP/doctor’
@@cynthiamorris1874those Doctors still have a medical degree and have had to pass a registration exam (PLAB, now will be called the UKMLA) that assesses their competencies to make sure they are operating at a similar level to other doctors graduating from UK medical schools. They are still an order of magnitude above PA’s in competency.
@@premojha979 A three year course is not the same as a 6 year course though. The only PA’s I know have done a 3 year course in either something like diagnostic or therapeutic radiology, or nursing, BSC (Hons), leading to a MSc (Hons), then leading to UK Faculty of Physician Associate National Examination. I have never heard of anyone with a degree in languages becoming a PA, unless they did a medical/science undergraduate degree as well. However that may well be true, and I would not be happy with it. However I think people are now making statements that are not true. A terrible mistake was made, but don’t forget many doctors have also made mistakes.
What do you mean????
I WILL NEVER TRUST OR COMPLY WITH SOMEONE WHO UNDERMINES A GP
MORE FOOL YOU
I never get to see a GP I am always fobbed off with a Physician Associate. They never read my notes first I always have to go through my Cancer notes since 2021 when I was diagnosed so my 10 minute appt is taken up while they read my notes. They can't give prescriptions until you have to wait for it to be signed off by GP which can take 3-4 days to arrive at your nominated pharmacy. All I want to see is a normal GP that has read my notes and will listen to how I am feeling.
You've never seen a doctor that doesn't read notes? I've seen plenty of terrible doctors. It's about the individual not the role.
There’s 10-15 minutes to see a patient and document this, which includes time to call you from the waiting room. You can request to see the same doctor to ensure continuity, which may mean a slightly longer wait. Reading all of your notes each time is not needed when there’s continuity. Also- ‘reading all of your notes’ is an untenable task for each clinician as it’s too time consuming for each consultation.
There is a big drive by NHS managers to employ physician associates, paramedics etc and get them to replace GPs. NHS managers offer money to GP Surgeries to employ these under the guise of reducing GP burden, but the aim is to replace GPs.
It's dangerous and has to stop to protect patients. Doctors are strictly overseen by GMC but these allied professionals moon lighting as GPs/doctors don't have any regulation. It's a wild wild west.
Paramedics do have regulation though. They are regulated by the HCPC in the same way doctors are regulated by the GMC. You wouldn’t want a paramedic treating you for emergency care if they weren't regulated.
Paramedics are regulated by the HCPC like doctors are regulated by the GMC. You wouldn’t want a paramedic treating you for emergency care if they weren’t regulated.
@@harismohammad2005 They are regulated as paramedics, not GPs. You wouldn't want to do your plumber to do your electrics.
@@VNavale Paramedics are perfectly capable of dealing with minor illness/injuries when they deal with major illness/injuries as well. When ambulances go out to patients they don’t just go out for ‘emergencies’, some people call 999 for cut fingers, a cold, headache because their blood pressure is high e.t.c. No their not GP’s that’s not the point either of us was making initially, they are paramedics they are able to assist some patients which they do and well. Your argument was they aren’t registered my answer is they are and they’re qualified to be providing the care they do. Plumbing and electronics are two different professions altogether, paramedics and doctors are both healthcare professionals which both receive evidence based education relating to medicine. Paramedics have been in GP practices for some time now and from my understanding deal with simple cases for patients leaving GP’s to deal with more complex cases. If you’ve ever been to a minor injuries unit or minor illness unit or walk in centre you should know they tend to be nurse led meaning there is no doctor on site. They exist for the purpose of treating ‘minor problems’ they seem to work well and patients for the most part seem satisfied with them, even GP’s seem to as well telling patients who can’t get appointments to see them instead of their GP which is strange if they don’t like them that much? Though this often results in overloading of such places and impacts patient safety especially when complex cases are missed/ignored by GP’s and then told to go to such centres where nurses often arrange ambulances to take such patients to A and E’s because their GP didn’t see them and they knowing they aren’t competent are unable to assist such patients. I think the GP’s need to work on more than just bashing others maybe themselves, because they also impact patients safety. Many GP’s use online systems which require patients to tell GP’s what’s going on with them. If an appointment is booked GP’s fail to read all information within a request, rush their patient and promptly end a consultation without providing much advice or whether there are any questions or additions. All bad practice but it happens this results in vital information being missed as the patient may forget to mention something as they have already written it down expecting the doctor to have read their notes. Some GP’s don’t follow up their patients when they have gone to hospital or had a blood test and such yet again bad practice my question is, if the excuse is they are really busy how at the moment can we at the least ensure patients are safe if their are not enough doctors presumably?
This is crazy, we are basically treated by unqualified doctors, how can they treat someone with terminal cancer and other related conditions? Patients are vulnerable in the first place .
PAs don't. It's usually as a team led by a consultant
The country needs more doctors . The country needs more doctors specialising in GP. The country needs more doctors who have jobs to end up becoming a consultant. The country does not need to train more PAs, i.e. people who are not doctors. There is NOTHING a PA can do which a Doctor can't do. A doctor of any grade is infinitely more skilled and trained than a PA. A PA will always answer to and be under the supervision of a doctor.
A GP has studied for 5 years at medical school to become a doctor and THEN worked for a further 5 years as a fully qualified doctor and completed highly prestigious royal college exams to become a GP. How on earth can that compare to someone who isnt even a doctor seeing patients at your local GP surgery?
Some PA’s work and keep on training for years and THEN lecture others on specialised knowledge they have, even some trainee doctors sit in on these lectures. There is too much generalising going on here. Most PA’s work in hospitals alongside doctors, in such places as A@E so they are working with doctors not instead of doctors.
@@cynthiamorris1874 What do you mean by trainee doctors? Medical students or doctors? The knowledge the PAs acrue is by virtue of having worked on the same ward/in the same dept for a long time. That still doesnt compare to the generalist knowledge of a doctor ,whether or not the doctor specialises in something or not. Yes, the PAs work in A&E which I odnt understand cos how can they possibly have the same body of knowledge as a doctor to see undifferentiated patients? They havnt worked as a doctor prior to their job, so they will never be able to pick up on subtle features in the history the way that a doctor can.
@@psps2034 I have NEVER advocated that PA’s are on par with doctors. I have NEVER said they have the same medical knowledge as doctors. Of course PA’s can work in A&E, just as nurses work in A&E. It’s a shame that they earn a little more than junior doctors for a short time, it seems for many on this thread that that is what it’s all about.
@@cynthiamorris1874 Nurses dont do the job of a doctor. PAs are , however, doing the same role of a doctor where they are seeing patients and treating them. You have acknowledged that doctors havse more knowledge than a PA. Therefore, with this in mind, how can you with an honest heart advocate PAs to see patients hand in hand alongside doctors knowing the care a patient received by a doctor will be better due to the greater knowledgebase?
@@psps2034 I have no idea really what you are talking about, PA’s are qualified to do the job they are trained for and that is working under the supervision of a junior doctor or a GP. You are aware that you can be seen by a Nurse Practitioner in a surgery or health centre, the same rules apply, there. If it is deemed a doctor is needed then that will be the course of action taken.
I'm a doctor who left the NHS long time ago but still keep in touch with my colleagues who are in the NHS. Having seen the decline and now with PA"s replacing doctors I will dread getting treatment in the NHS now.
A "short term solution"? Iain Dale seems to be telling us that he doesn't know how governments work. Especially Tory governments.
The people up toward the top of the pile never have to worry about how things work...that's what minimum wagers are for
There is nothing as permanent as a temporary solution.
It is not commonly realised that the GMC has changed drastically in the last 20 years. It used to be run at the senior level by experienced doctors who had moved to medical administration. This has gradually but clearly changed to having senior highly paid managers in these positions. There are a couple of doctors with honorary titles but the overall management and direction of the GMC is not controlled any longer by qualified doctors. The GMC and the BMA are both now very "woke" organizations with a profound left wing bias in their output. (in my opinion). However the GMC is a very powerful organization in terms of licensing and control of the medical profession, as they can use legal powers which the BMA does not have. Managers know this very well and use what sometimes amounts to kangeroo courts to discipline doctors. This is very little reported by the mass media and I don't see this situation improving in the slightest. The GMC's governance restrictions are one major reason for doctors of all types retiring early, when they could have continued on a part-time basis for many years. This isn't really possible any longer for many. This is also why they are being forced to employ non-doctors to clinical roles which they are not well trained for. Once the GMC became a non-professional organization, this was likely to happen. The senior doctors in the GMC warned of this at the time that reforms were forced through.
They are too far left because they allow anyone in.
And too right wing because they are all for deregulation.
Just call itwhat it is. They are unfit.
The telegraph article today explains that courses like history, geography etc are being deemed as acceptable entry qualifications. Its terrifying.
Is Ian endorsing this? I didn't hear any condemnation
A law firm might be called 'named partners ... and associates' - when you get an appointment to see someone who is not a named partner, you assume you're still, at minimum, seeing a *lawyer* !
Imagine going to a restaurant, and being told that the Chef's Associate is cooking your meal.
But that person only has 40% of the training, and basically anyone was let into their course
So a demi chef...
@@maielego1354 just call them that.
Demi doctors.
But that's misleading. Theyre not doctors, they support the senior doctor.
@@maielego1354 Of course it is misleading.
The whole thing is misleading, just call it what they are:
"Cheaper than qualified people"
Poundland Healthcare.
@@HTOP1982 But they are qualified, as PAs, which is why they're called Physician Associates. What's your point?
The GPs job is diagnosis. This demands a very high degree of competence and range of experience. And commitment. Once a diagnosis is made, the choice of medicine and treatment is secondary. In one practice I never saw a doctor, or had a call from one in 4 years. I was phoned by associates only - even during a critical stage. My condition worsened without my knowing why. Incidentally, no-one will be blamed. No professional body had any over-sight or prior responsibility. No chain of command exists. Doctors’. Unions should have been up in arms. They are sabre-rattling now - but what were they even doing during the Tory years ? The miners would have been campaigning at least. Harassing the government. They had paid officials, for that job, every other trade union.
THERE IS NO SHORTAGE OF GPs! Thousands are currently sat at home, struggling to find work.
Any evidence of this?
@@gareth6326 This is RUclips, so no evidence for any of these worthless opinions, naturally
@@jibjub2121please look at the competition ratios for GP training. There is a 2 for 1 competition ratio. So there is currently thousands of doctors who would love to be a GP but there is no training posts for that. Blame the government
@@jibjub2121Are you “part of the medical team”?
@@gareth6326 search competition ratio of GP and you will find thousands of Drs applied for this post but only a few will be appointed because it is cheaper to hire a PA!! To see a Dr in the future you will soon have to pay. The government is hiring cheap professionals to substitute Drs.
When I was consulted for the first time over 6 by one of the doctors,he totally dismissed my symptoms 4 months later I was given a diagnosis of full blown cancer with no cure. imagine it?
Luke is absolutely correct. There are many doctors in this country who are qualified in a different country and having much experience. They should get a chance to practice under consultant as the knowledge clinical training is much far better then of a PA
We also have to consider differences in health concerns between different regions/countries. Some doctors may have a lot of experience which is not relevant here.
@@bigbarry8343 That's why foreign doctors have to take the 2 step PLAB exam that tests theoretical and practical knowledge before they join the system. So, foreign doctors do learn medicine relevant to the current scenario in the UK on top of what they already know.
They have Nurse Associates now too…it’s just cheap labour because there aren’t enough nurses.
Physician Assistants is what we call them in the US. They’re fighting tooth and nail to change it to “Associate”. They also like to call themselves “medical providers” and like calling doctors the same making them seem the same. I did not go to “medical provider” school. I have a doctorates degree in medicine. Took me 10 years of training after undergrad school to be able to practice as an attending physician. I would have been scared for the patients had Id been thrown out there after my second year of training.
Hi, i'm a 41 year old nurse with a graduate diploma in clinical care nursing in Australia, i'm thinking about doing the PA program in Ireland but with what I'm hearing now, I'd say why not going back to physicians assistant like in the US, if American are making it work so do you! In Australia we do have a huge lack of GP's while we only have 5 or 10mnt with the gp and pay a full amount of time. We used to have 45mnts, now, you get to the GP office and they are just asking: what can I do for you today? That's just not it, and the pharmacist can do the same these days, I don't know if it's only in Australia but the system can't keep going like that on top of getting into medicine (universities) is incredibly hard, too expensive, and the medical association takes so few of them every year, so no wonder why we have long time waiting list and by the time you got in it's either you don't need a gp anymore or your situation has worsened. My husband has been on a waiting list for 20years to fix up his foot (cause of cuisidal attempt) now they talking about an umputation and we only saw overseas doctors mainly from india, and we can't see another one cause we have singed a contract years ago that he is on a list in the mean time they changed their mind and WE can't refuse. It's just not it, the public is suffering you have got to do something
Info: who is going to prison If the PA messes something up? Are they as liable AS doctors?
It's not just GPs . I was almost palmed off on an oncology PA years ago. Total lack of transparency as well. Only got suspicious when that person said something that didn't sit right. It's all about cost saving.
The longer it takes for the public to wake up and push back on this issue the better. This is a disaster in making and clear cut playing with patients’ lives
They’re like the teacher and class assistant relationship
See when you're entitled to a prescription and they tell you buy it. It's because they aren't qualified to give prescriptions. Found that out a few yrs ago. A blond lady was telling it all. Can't remember what platform I saw it on
Not quite, but it might be an indicator yes. Obviously there are loads of meds GPs can prescribe that are available over the counter, so it's no different in cost or time for the patient to just buy it themselves.
GROSS NEGLECT of patients' health to bring in this system of PA's.
It's the same with schools employing Instructors and in social work - social work assistants - they made the professional bodies that oversaw professions and safeguarded protected titles that proceeded to water them down due to money and cost.
@drakeybryter. Let’s face it. We are now a Third World country. And when did it start ? Who has been in charge all this time.? You all know perfectly well.
I understand that the acute shortages of GPs are due to very limited GP training spots available, while the funding for PAs is made available (even though PAs command higher salary than junior doctors in the first 4 years). In fact, only 1 in 3 of medical school graduates who applied to train as GP is accepted. The proliferation of PAs while underfunding GP training spots will result in even worse GP availability, with PAs supported by standarised AI run from India with high cost of living arbitrage opportunities, will become the norm in this country.
I think Adam was the most qualified person to speak in the programme having experienced being a PA and a medical student. I guess it’s hard for doctors and PAs to fully knowledge role and responsibility as most NHS trusts don’t have a scope of practice for PAs.
I feel equally bad for both PAs, who feel they work beyond their capacity with no development plan, as well as for Junior doctors who feel they do more work and get paid less.
Certainly more discussions are needed.
I think more time requires data entry of patients in Surgery center .
So help can be provided to gps for this help. It might decrease time spent on each patient. All assessments should be done by the GP.
However there are lots of GPS sitting home waiting to get an offer for a job.
There are unemployed GPs now as they are replaced by lesser qualified people like PAs as they are cheaper.
Bottom line, if I have anything more than a cold I want to be seen by A DOCTOR. Not a nurse, not an associate anything, the person who is actually qualified to make the assessment, not a pretendy doctor
DOCTOR! DOCTOR!
People in the comments thinking Drs are fighting for patient safety is honestly the funniest thing ever.
The ARROGANCE. 😮 😠 😡
….because your beloved Tory party have ruined our NHS, Ian.
Your beloved labour helped destroy the NHS in Scotland via dodgy PPI schemes yet starmer still takes to the media to attack the Scottish NHS. Dishonourable man, not to be trusted.
What nation are you loyal to and why?
@elliot mate why do you think anyone anti tory is pro Labour?
@@dl4731 I wouldn’t waste your time mate. He’s an utter vacuum of personality.
@@dl4731 cause he has shown elsewhere he will defend labour to the end of earth
@@dl4731 Do you stop buying cars because you can’t afford an Audi ? You need one , so you get the best available.
This presenter putting words in the caller's mouth. 'you don't think physician associates have any use at all?'. No physician associates are probably useful as physician associates and trained doctors are useful as doctors in the field they were trained in. It's not rocket science. Standardised practice exists for a reason. In large part to safeguard those in need of whatever services are required, but also to best maintain the standard and integrity of whatever practice is being used. People are trained for what they intend to do. Would you want a car mechanic performing spinal surgery on you or a spinal surgeon tinkering around with your car engine? No because they don't meet the standard specialist knowledge to perform that role as a professional. Maybe don't assume you know better than an established process that knows exactly what it has to do to deliver the best service to people and just trust that the people who know these institutions from the inside probably know more than you on how they operate. My word the hubris. I expect he has a journalism degree. I wonder if he likes it when 15 year old influencers claim they are his peers in the field of media commentators.
But no one has defined specifically what PAs should be doing to say they are 'useful as PAs'. The NHS has become a wild west where some PAs are just filling in forms and helping with administrative tasks on the wards and others are performing C-sections with no supervision. As with many things in the NHS, safety concerns are being swept under the rug and staff members careers are being threatened if they whistle blow.
@@justadude8369 again utter made up nonsense. Where is the evidence that PAs are performing unsupervised sections? Other than in your crazy little mind?
Unfortunately this logic doesn’t stack up, because physician associates don’t possess any skills that a doctor doesn’t have, yet lack most of the knowledge gained in a rigorous medical training programme
@@lewisplayssaxophone tell me what you know of the pa course?
@@jibjub2121 Its inferior to a medical degree in every way. And yet PAs are paid more than doctors. Every pound spent on PAs is a gross waste of taxpayer money which could be used to recruit more doctors, nurses, pharamacists, physios, paramedics, OTs, radiographers etc all of whom are established professionals who work synergistically with doctors. A doctor could not do the work of a nurse, physio,OT etc because they are different discliplines. PA is not a discipline and the role could be performed (at a higher level) by an actual doctor.
There's a very simple change the government could make to instantly improve this situation: allow GP Practices to use the money alloted for PA's to also be used to employ GP's. It's a no brainer. Why isn't the press all over this?
Dr bob gill explains it in detail
The BMA have always extremely protective of their turf, they were against nurse prescibers and really against nurse practitioners. We need a bump up in medical personnel, otherwise the NHS Will be understaffed for nearly a decade while new doctors are trained up.
Also there seems to be an assumption that doctors never make a mistake! That is clearly not true.
The £86 billion of outstanding claims for clinical negligence against the NHS would indicate that.
Sound to me that PAs can be replaced by AI eventually
Thankfully with the government changing, we there will be mlre jobs and funding for doctors. PAs are not the answer. There are plenty drs... just not the jobs
Now we go to Sarah in Harrow - Harrow Sarah.
I read this at the same time as he said it 😂😂😂😂
Nicely done
Literally I too
Why dont they get experienced Paramedics to work in the Gps. Thats makes alot more sense?
Not really
I mean, this actually goes to show how Ill informed the public are…. Paramedics have been working in general practice surgeries for several years. Some practices have more than others, and yes, it does make sense… do you know the curriculum of a paramedics training, what their remit and scope of practice is? Do some research and come back with a more informed argument, where you may or may not then agree with your sentiments. Certainly, more doctors would be great. But would you rather a GP or a paramedic turn up to your house when you are in a healthcare emergency? Who do you think GPs call? 😅
Robbing Peter to pay Paul
@@therona23823yeah the standard of debate on this is absolutely dreadful. Many of the public have no idea how the healthcare system actually works. They’ll moan about the state of the nhs, then vote Tory and complain about any attempts to remedy the situation. Maybe the British public will get the healthcare they deserve, and with their criticism and the current state of the nhs, maybe they’re getting what they’re deserve after all. My advice to doctors, PAs, ACPs? Leave this country as it’s only going to get worse. Go to a country that appreciates you.
@@therona23823My partner is a GP and says their remit and scope is to decide if the patient needs hospital treatment and if so stabilise the patient until they can get hospital treatment (by doctors), the latest being the only reason a GP would call paramedics. On the other hand, while on duty she's also had paramedics calling her from the field, asking for the best course of action to take as they were not able to decide what to do with their patient. Bit ironic that you wrote about how ill informed the public is.
Blame your government for undermining and underfunding the medical profession. PAs (having worked with them and had them shadowing) are terrible diagnosers but can be useful in checklist thinking. By definition GPs deal with UNDIFFERENTIATED illness, PAs cannot without training can’t do very much and get paid better than junior doctors.
Broad brush and anecdotal evidence. How can you brand thousands of people the same after working with half a dozen? I thought as a clinician you were meant to have a basic understanding of statistics and inferring from incomplete data? Bit of a concern actually
@@jibjub2121 i’ve worked with and trained over a hundred PAs and the ‘training course’ is not fit to have some come out the other end to diagnose without supervision. My data comes from the LMC feedback that I am a part of. As for anecdotal evidence i’ll wait for someone to do the published science. As for the salary you can see the evidence on nationally published pay scales.
Plenty of Doctors about. Infact a recent article in the BBC noted 4 in 5 GP locums are looking for work. About time they worked permanent contracts. Locum Drs have been getting paid over a thousand a day for years. I know one locum Dr that worked in the same practice for 10 years. A lot of them are hopeless and just come to collect their pay cheque. Most GPs refer onwards to specialists. I work in healthcare and I can tell you now. A lot of GPs are hopeless. The referral letters are incorrect, they refer to incorrect pathways and don't follow up results.
These associate doctors are a Tory idea. Next question! Devaluation of all values? Tory policy! Next question.
Fake news
Post Brexit Britain doesn't need "experts" thank you very much. 😂
There are some fantastic physician associates. But these are the ones who have prior medical knowledge…it’s right that people applying need to be vetted to have appropriate prior degrees and knowledge.
I’m an advanced nurse practitioner who did a 2 year masters. But prior to that I did a 4 year degree in nursing and worked as a nurse for 7 years before I did my advanced training. It means I’m completely knowledgeable and competent to consult in many area’s independently the same as a doctor, with doctor support if needed.
I think the PA pathway just needs to be tightened and ensure previous clinical knowledge and experience
@ageeordieboy. No need for all that malarkey ! Let’s just get back to what we had 20 years ago. And let’s face it : today’s “masters” aren’t worth a carrot. Same as in the US.
what absolute nonsense. Don’t compare yourself to a doctor who has done an actual medical degree just because you did a “Masters” 😂
@@ilikeeverybody7581
I have many skills and competencies absolutely equal to a doctor.
4 year degree, 7 years post qualification experience and an intensive 2 year advanced practical medical qualification. You then go on to be mentored and supervised.
I can hold my own against many a doctor.
I’ve solved cases that doctor colleagues haven’t.
Unless you yourself work in this field….you know jack about it.
@@ilikeeverybody7581 my knowledge, training, experience and skills are comparable to a doctor.
I prove it every day of my working life.
End of story.
Unless you work in this area, you are the one talking nonsense.
@@ilikeeverybody7581 We are following the US in this. Here, having an MA, really meant something once. But the crafty government have been handing them out like sweets - cutting the cost of intensive study. They aren’t maintaining the value of the qualification. They are undermining it. Shame on them.
BMA institutional bullying. And now one has committed suicide - blood on their hands BMA
Nasty vindictive organisation.
PAs bully other doctors though
@@Robertsmith001 proof? Nonsensical slander
@@jibjub2121Loads of proof, you just ignore it
@@jibjub2121You won't get it. Because it doesn't exist. But you'll see plenty of PAs spiraling close to the edge.
If the U K was investing in the population, by way of reducing poverty, this whole emotional conversation might get somewhere. Preventative measures to reduce poverty would reduce the need for Associates and give G.P.s more time to get to know their patients, as well as reduce the level of inpatient hospitalisation. The ROOT cause of all of this is the creation of Poverty by previous governments. Managing energy in creates bonuses and savings within years and all around. You have to look at the whole picture to solve anything. That should be taught to all school children. Arguments in isolation are useless. The media tends to prefer soundbites. Grow up U K !! Pathetic.
utter madness
Lack of GPs…. GPS can’t get work!
14 years of Tory Austerity
You can go into a health centre and just see a nurse practitioner, instead of a GP.
Not just. Three years basic training, five years clinical experience and most have additional, specialist qualifications. Even then, they don't diagnose and treat.
@@PaulK-ve1pu I don’t trust any of these made-up qualifications. Invented yesterday as a cover up.
You go to the doctors and they can’t tell you anything, it’s as though they don’t know what they’re doing… it’s scary, or they ask YOU what do YOU think is wrong .. like ☠️ it’s really weird. I don’t trust them.
@misstgirl. The GP is irreplaceable. His specialism is diagnosis - the basis of absolutely everything. He has vast experience, and he can see connections that even the patient isn’t aware of - in quite a short time. No PA or nurse can give that guarantee. Lose the GP and you will drag things out - and endanger the patient. Checking on a smart phone is criminal by comparison.
I had a suspected heart attack, after 8 hours in A and E the Cardiologist asked me what I thought was wrong!
At that point I walked out…
@@belindamay8063 The new breed of GPs are dangerous.
It is part of medical training. When training to take a medical history part of that is to ask about the patient's ideas, concerns and expectations. Often reassurance can be given that the terrifying diagnosis the patient found on google is not accurate.
The BMA is fighting for their profession, but attacking and denigrating PAs is so low.
Pretty disgraceful, going after and leading attacks on a profession they know doesn’t have a union and can’t fight back. They wouldn’t dare do this to nurses. It’s disgusting. Many people became PAs to help, and they’re just getting slandered and insulted. What happened to clap for carers?
@@jibjub2121PAs undermine and bully Doctors (whilst pretending they are Doctors to Patients)
@@jibjub2121Junior Doctors can’t fight back against PAs bullying them
@@Robertsmith001 the doctors unions are bullying them!! Are you mad
@@Robertsmith001 not to mention the doctors unions are bullying PAs because they know they don't have a union and can't fight back, that's the definition of bullying. Also, stop liking your own comments its cringe
Cut out anything but the negative side, tailor the discussion to generate relevance and anger, brilliant journalism LBC, absolute joke 😂
Most of the GP’s I’ve seen recently just look on google or the NHS website and just read it off. It’s all fake doctors now. Completely pointless going.
You don’t understand, they are double checking the dose/ frequency of the treatment (not googling it)
drug formularies and guidelines are found online, it would be dangerous to try and remember all of these things
@@Robertsmith001 That’s the rose-coloured view.
The BMA aka the daily mail
Uh oh! Here comes the latest round of Tory slagging off! Next up.. it’s doctors!
Trainee ! 🫨🫨🫨
The United States have had PA’s since the 1960’s.
Exactly why we shouldn’t have them.
@@ZoeSummers1701A I think the quality of healthcare in the States is high, if you can afford it. If PA’s had the correct education they would be an asset. Many of them do have the correct qualifications.
@@cynthiamorris1874You don’t know what you are talking about, American doctors/PA are completely different
In USA they are called Physician Assistants NOT Associates which is very deceitful
@@cynthiamorris1874 American doctoring is a racket. Just talk to ordinary Americans. Your contracts force you to pay for tests and things you don’t need.
perjury about Ravi Jayaram Fakedoctor LiesAbout Lucy letsby
FAKE
Doctorvisit
JayaramRan
Look into the workers in care homes looking after granny. Straight off the boat.
That's the sort of government you have that doesn't care in the least about that
Why don't you look after your own granny?
You said Brits would wipe their bums after Brexit. Not so. Hence the boat people.
Be grateful. Such long hours and hard work at £5-6 an hour. Is your GP, dentist, optician, pharmacist etc white, or people of colour?
@@andrewcarson5850 Probably because they have to work to bring up a family.
PA position is problematic. They act like doctors, dress like doctors, 2 years of training/studying on a crash course masters, they earn more than junior doctors (even though they have several years experience). I do think the government wanted to cut corners to make up for the lack of doctors and nurses… but i feel like this position will cause issues in the future. Nurses are even more trained than PA’s but PA’s carry themselves as “junior doctors” which is misleading.
GP,s... =Overpaid Prima Donna's!..Triage nurses in effect.
Hospital doctors= great,and worthwhile.
To become a GP you'll need to complete: a degree recognised by the General Medical Council which takes 5 years. a foundation course of general training which takes 2 years. general practice specialist training which takes 3 years.
True..but the way my GP(,s) have treated me(e.g.not referred me to specialists /consultants)the past 3 years...I cannot excuse sadly.=they never got to the bottom of my problem.They did here in Spain,albeit via private treatment,which isn't cheap,but didn't need a GP "blocking' my path.
Obviously the NHS is in deep trouble....everyone knows that,here in Spain they know that as 3 doctors alone say they used to work for the NHS,and know the decline in service and customer diligence.
@@chrissofpv3017so because YOUR experience with YOUR GP wasn't great all GPs are the same. Give over
@@chrissofpv3017Sound like a problem between you and your GP.
@@johnharding7318 DEFINITELY John!.. hopefully things will sort themselves out this year.🙏
I seen an African doctor and he gave me the wrong medication
It's a class problem.. not an ability issue.. the doctors wont allow people from working class backgrounds to get up the ladder. Why not have a conversion course to make up the alleged difference?.. of course that has been blocked by the Dr's, but happens all over the world, even as close as Scotland have the sense to offer a GP top up. Complete Class prejudice.
This is total nonsense.
So much 'nonsense' that it triggered your reply😂, If it wasn't true the medical schools wouldnt all have quotas for accepting people from poor backgrounds. Thats not my nonsense opinion, its fact@@gareth6326
@@gareth6326 4 doctors opinions no doubt 🤣
@@bregan7450 Fool
@bregan. I don’t quite understand your point. Fifty years ago we had a brilliant and wise family doctor. He came from a working class family in the poorest part of Glasgow. He was a cultured man - and courteous. So perhaps that’s what we are really talking about. Lack of the sensitivity and social intelligence that were very much the standard of those far-off days. Standards have dropped across the board.
this is long overdue, the medical profession has been holding the taxpayer hostage for entry into the profession for far to long
acting like a guild of old, which is all they are basically
I look forward to your next visit to A&E
So called Dr. Sebi, if alive, should be allowed to give medical advice and treat medical cases?
@@BradleyPitts666 The point is that if we had enough doctors in this country and paid them so they wouldn't go abroad, we wouldn't need this stop gap, second rate stuff.
@@PaulK-ve1pu
Exactly. Well said👍
Apparently overseas ‘doctors’ with three years training, are now working in the UK.