Why Doctors HATE Physician Associates..?
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- Опубликовано: 1 июн 2024
- Timestamps:
00:00 Intro
01:47 What is a PA?
03:13 What are the benefits of working with PAs?
04:40 Reduced funding for Dodctors
07:55 Unclear guidance on working capacity
12:00 Patient safety
13:50 Low pay of doctors in comparison
16:05 What should doctors do about it?
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What's up guys! My name is Kenji and I am a doctor working in London. In this video, I talk you through the recent controversy between doctors and physician associates.
If you enjoyed the video, please give it a like and a comment so I know to make some more! Also please show support by sharing it with a friend who's also interested in Medicine :)
Thank you so much!
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6 years in medical school, IELTS, Plab 1 and 2, F1 and F2, first 3 years in specialty training, more responsibility and on call but still earn less than PA 😂
I understand the frustration, personally as someone who is applying to PA, I agree that doctors should get paid more, however people tend to forget that PA’s have studied for 5/6 years too
3 years undergraduate and then 2 years.
The government is messed up, NHS is failing. If they didn’t make the entry requirements so hard to get into medical school and so competitive there would be so much more potentials for people who wanna do med. It’s just all about grades and I think it’s unfair that they define people based on a GRADE.
@@saraasam6407 "PAs have studied for 5/6 years too" ? do you know how to read and count? read OP's comment again and count the number of years mentioned to become a doctor. hint: its not 6 years, in case you fail to do basic arithmetic again.
@@saraasam6407 yeaaa not 5/6 years. and no where near the same rigor as medical school. stay in your lane
@@ashsmart6895 why you so heated?
@@NO1xANIMExFAN they studied for 5/6 years
3 years undergraduate
2 years postgraduate
Then more if they wanna become senior! I know how to count thank you very much, people who talk like you won’t get no where in life! Relax your self
Doctors should be valued more.
If they did their own jobs and didn’t need someone else to do their work we wouldn’t end up like this.
I don't get it why physician associate are getting paid more than doctor? If so, joining med school is nonsense.
Physician Associates like nurses and other healthcare staff are on the agenda for change scale. Doctors have their own agreed pay scale. Band 7 roles most often require a Master's level degree or equivalent. As the Physician Associate degree is a 2 years master's they get placed in this bracket.
I don't think the question is why are the PAs getting paid so much. It should be why doctors are getting paid so little.
Hope this helps!
This must be a British thing because PAs don't do any of this in the US and damn sure don't make anywhere near the salary of an MD or DO. Probably not even as much as an NP to be honest
I agree
I do like the balanced approach to the topic - we're all working towards the same goal.
I know nothing about medicine. But I have read around this subject. I wonder why the government decided to start the PA’s on such a high salary, knowing how little doctors are paid. Some people have asked in the comments section that we should be asking why doctors are paid so low rather than questioning the higher wage of PA’s. But doctors came before PAs so the question really should be the other way round. As I said, why is the pay for PA’s so high when the responsible bodies know that doctors are paid a lot less? What does that say about the value placed in GPs versus the value being placed in GPs. And why are they making the PA role more desirable than the GP role based solely on pay?
You raise very interesting points!
@@DoctorKenjiyea
Easy way for the government to say they're increasing the numbers of healthcare staff. Should also point out that the role was taken from the physician assistant role in the US. It works very well there but it's very different. their training is much more thorough. They eventually changed the name to physician assistant here. the UK PA degree isn't recognised internationally so they can't use it work abroad like drs can.. There's a lot going on but I think it's safe to say if you change the name from "assistant" to "associate" it is blurring the lines in terms of who patients think they're being seen by. The gov are essentially filling the gaps with a workforce that can't leave when they want to. With the changing of the name as well, patients will think they're being seen by Dr.
Further more the funding is a big thing. NHS England have ringfenced funding for PAs. A consultant needed more regs on his ward but when he asked for me, he was told there's no money to create a Dr job but there is money to employe PAs. Some of the senior staff are enabling this as well because PAs don't rotate so consultants are more likely to invest in a someone who will be there for more than a few months.
The thing is a complete mess.
Ex nurse and current patient who GP describes as a "complex case". I refuse to be seen by a PA instead of a GP. I have multiple conditions including a rare one, and there's no way a PA could safely diagnose me.
I did once have an appointment with a PA who i thought was a doctor training to be a GP. Luckily for me she did ask the GP for advice, but her lack of quite basic knowledge was concerning.
People who are thinking about DOING PLAB and going to UK, this vedio is for you.
No one should go to UK this pathway.
The amount of payment and this new issue will really mess you up if you are middle class aisan like BANGLADESH OR INDIA and come to UK.
As a doctor maybe you can answer this question.
A doctor and/ or nurse, etc job is to help people regardless of age, colour or gender, etc.
Some of these people specialise in an area. Why do some doctors/ nurses choose to work with children only?
When a their job is to help PEOPLE?
I can understand not wanting to work in a different area, but why would they refuse to work with adults in their area. How is a child with let's say diabetes any different to an adult? The care might be different but the initial problem is the same for both.
This video was very useful, currently doing biomed and potentially looking to do post-grad PA course
Hi I'm starting biomed this September could u give me some tips about it??? Are you doing it in UK? If you are how can I do well in it??
@@nadiarosa7630 So yeah, I'm studying the UK and I'm currently in 2nd year (but I'm in exam season - so I've finished 2nd yr in terms of lectures). So 1st yr tends to be like MCQs (multiple choice), 2nd yr essays with some mcqs depending on the modules and uni and 3rd yr is fully essay/dissertation based.
So my tips would be firstly - preread lectures before going into uni or watching the lecture - just to familiarise and get an idea. Then - try and make notes the same day as the lecture to avoid being behind (although this is inevitable) - e.g. I annotate PDF slides with things that are not on the slides that are mentioned by the lecturer. But this is only half the work. From these notes - you need to find a system of remembering this information (personally I use flashcards on RemNote) - preferably an active recall process - reading notes imo are highly ineffective without some sort of closed book assessment of the info you have learnt. In addition to staying on top of lectures, try attend seminars/workshops as much as you can as lecturers may give u some support in person on things you are stuck - but you can always email or meet the lecturer to ask anyway. Do not fall into the trap of pure memorising without understanding (unless you really need to). Also ensure your math skills are decent (e.g. the chem equations u would have had a levels) - there is quite a bit of maths too.
Biomed is heavy in memorisation and understanding so with that in mind - these are my tips for success.
Best of luck!
@@DoctorKenji I've been watching non stop your videos regarding biomed they have been soooo helpful thank you Soo much
@@nadiarosa7630 I study in the UK and I would say that my advice applies generically to any course but for biomed the more u can remember the better. So like make sure you try stay on top of lectures (it's hard - and everyone will be behind) - understand them and attend workshops/tutorials/seminars because they can be useful to test your knowledge and potentially allow you to talk to the lecturer and ask for help. I recommend finding an effective way to take notes (e.g. use a laptop) - what I do is annotate slides and use the slides and my annotations to make flashcards with condensed info. Taking notes should only be to supplement the slides - don't fall into the habit of copying slides because it won't work - unless it's a diagram/drawing and your a visual learner. For yr1, it tends to be multiple choice and doesn't count to first years but to do well generally - understand the content and when u do use an active recall method (not just reading notes) to help remember the info. In terms of coursework - prioritise it over lectures if you need to because they are important to maximise the scores you get - you will have time depending on the uni to go through lectures - hope that helps - good luck ;)
When i’ll start working as a doctor, i’m scared of that exact situation u described. a PA pressuring me to perform tasks they legally cannot, perhaps with the justification of “it’s what the consultant ordered”.
Does anyone have experience with handling that type of situation? I would solve this by calling the consultant to clarify and to state that i’m not comfortable signing stuff for patients i haven’t seen particularly bc of my lack of experience. But i’m worried that this could ruffle some feathers as in the PA being upset bc they think i don’t trust their judgement and my other colleagues thinking i’m miss self-important.
What I did in these circumstances was read through the notes of the patient to clarify. If I can’t find a documented plan from the consultant or a plan that makes sense to me medically, I simply say I’m not comfortable doing so for that reason and there’s never been an issue. This is the same case when I’ve had nurses ask me to prescribe things on behalf of a seniors plan. No documented plan (that I agree with), no prescription. You don’t necessarily have to have seen the patient, as long as there’s been good documentation. Also, people should never pressure you to do things, doctors or not. Always act within your competency and don’t allow anyone to rush you
The same type of problems exist here in the USA with the PA/NP dispute and the residents or training doctors pay/treatment/responsibilities. Leaving the NHS for the USA at least isn't better or the grass really is greener on the other side.
Aren’t doctors paid like 2-3 times the amount PAs are paid once they complete residency?
I agree I think there should be clearer guidance for supervision especially for newly qualified PA's - I have seen a GP practice who offered a preceptorships scheme which involved specific training for a newly qualified PA in GP. I think in primary care it is very dependent on the supervision - as you can imagine even for a F1 you would want to be supervised closely. There are some senior Dr's who are putting PA's in difficult positions. I have seen highly competent PA's working in a practice for years and have been promoted accordingly. It is dependent on the PA/ amount of supervision contact. I am hoping when regulation occurs - they will be stricter guidance for newly qualified PAs.
Regarding GMC - hardly any patients know what a GMC number is. I think regulation is a much needed step forward. I don't think its blurs any lines - a PA should always ensure they introduce themselves - in my experience this has been the case. The GMC have confirmed the choice of regulator will not be changed. This was agreed in around 2019 - however the debate has heightened in the last year.
Although very unfortunate, I disagree with individual cases - as Dr's make mistakes too. I don't think it is fair to generalise to the wider profession. There are many cases were Dr's were involved in never events.
Agreed working within the right capacity + supervision needs to be ensured!
Dr's 1000% need to be paid more but that is not the fault of PA's. Other allied roles - speech and language therapists/ nurses also earn more than newly qualified junior drs. PA's are paid fairly - junior dr's are paid incredibly unfairly fpr years. Definitely I agree all HCP's should be respected :)
I personally do not thin there is a plan to replace Dr's - there are approx 3000 PA's in the UK + over 300,000 Drs. I think there is a role for PA to positively contribute to patient care - as you mentioned longer waiting times, increasing ageing population etc. There is alot of work to be done - I think roles like ACPs/ PAs can help. The other issues will help ease tension - if Dr's were just treated alot better as they deserve!
I think you raise a lot of good points!
Completely agree, there needs to be more differentiation between an experienced PA and a newly qualified one. A standardised preceptorship would help massively for other professions to understand the differing levels of experience PAs can have.
I don't believe a GP would fail to suspect a DVT in a patient presenting with calf pain though. DVTs are common, not never events.
@@kurukulle5294 This was in 2015 - a DVT was missed by 2 GP's. My point was 1 incident cannot be generalised to a whole profession. All these cases are incredibly unfortunate.
"Mrs H went to the Practice in summer 2012 with pain and swelling in her left leg. The first GP warned her of the possibility of a DVT and prescribed painkillers. Mrs H was still in pain and returned to the Practice a few days later. She saw a second GP who thought she might have a cyst behind her knee, and prescribed more painkillers.
Mrs H remained unwell and was admitted to hospital nine days later. The following morning she had a pulmonary embolism and died."
@@kurukulle5294
"In the early hours of 20 December 2017, S awoke complaining of pain in her right calf, chest pain, shortness of breath, and heart palpitations and asked her husband, M, to call an ambulance. To save time, their neighbour, a taxi driver, took them to A&E at Kingston Hospital. She was triaged before being seen by a junior doctor, who noted the history of DVT but performed no examination of her calves nor an assessment of her vital signs. She diagnosed S with an ear infection, despite there being no evidence of any abnormalities in her ear or throat. She was discharged with a course of antibiotics and to attend for an ECG test.
Over the next 2 months, S attended her GP as her symptoms continued.' The pt suffered an extensive PE.
Doctors in the US are paid way better. I make more than this running an applebees. Thats crazy
🥲🥲🥲🥲🥲
A Junior doctor in the UK is basically a residency doctor in the US, and although they are paid more than the UK junior doctors, you don’t start earning good money until you become an Attending Physician, and the US also have PA, but the medical associations have learnt to blur a line between the two professions, I believe that the US health system is by far better than the UK, so how about the UK let go of pride and learn from a country that has had the PA profession for over 100 years.
I would also add because I have an MBBS I am essentially barred from going onto the PA 2 year course, this occurs in no other field (you can always retrain), Or even convert to being a PA considering, we have completed all their modules and then some at university, that pathway should at least be open for a FY1 doctor to earn 42k and work 9-5. It shows it is about REPLACING doctors IMO
What do you think?
I think it will blur the lines between the 2 professions - I think it is best to have separate roles - interchanging will be complicated!
@@Sonia-ig9fj You haven't understood my comment.
I mean for a newly qualified doctor to work in the CAPACITY of a PA. Either after doing the masters or by the virtue of the fact that we have done EVERY single module a PA does during the 2 years and more. In fact this is the reason they give for not allowing MBBS graduates to go on a PA course.
If you didn't misunderstand me, I'm sure you also wouldn't want to blur the lines and bar nurses/post graduates from completing a medical degree ?
Can I ask why you would want to? Aside from the pay, surely doing an intense MBBS means you would want to work as a doctor not a PA, as while they work within medicine they are two different roles
@@ashs298 My brother just graduated, London born and bred and went to uni in London also. He got northern Ireland as his job for fy1, he would much rather be a PA at least for 1 year and reapply.
I disagree they are different roles, in the way say a nurse and a doctor are.
You are essentially just there to help the doctors as a PA, you can't prescribe and you are not regulated, pretty much the same job but way easier than a FY1 work 9-5 and have autonomy on where you live and work, don't think you can put pay aside also in reality.
@@ashs298 Also I found my medical degree to be pretty easy, loved it aside for occasional time wasting and being ignored on occasion during placement
1) Why the name change from assistant --> associate in the first place ? Only acts to artificially inflate trust in the role by blurring lines, an associate physician is a highly experienced DOCTOR
2) If you put multiple barriers in front of incredibly hard working and academic individuals who care about what they do, but don't put these barriers in front of less qualified people, what do you expect?
1. It was strongly suggested from within the DHSC that the term 'assistant' would hold the profession back from becoming regulated, as it was perceived at that time that 'assistants' did not need to be regulated.
2. I'm not exactly sure what barriers you mean but, the ceiling for progression for PAs is much lower than for doctors. However there definitely needs to be an agreed scope of practice for PAs to not take on opportunities and work outside their limit of practice.
@@yedann5457 the are assistants they are subjugated to doctors and are there to assist
Surgical physician assistants and surgical nurse practitioners are allowed to be in the operating room by themselves as long as there is a circulating surgeon work on the case. For example if you take a bathroom break the first assist fully takes over case and the 2nd assist becomes the first assist. It’s very uncommon for a back up surgeon to be a physician at least in the US. The cases where cases where a surgeon will assist another surgeon can be if a spine surgeon needs the anatomy he or she is operating on. It’s very common for urology to get involved in s general surgery because the ureters are always getting punctured. The issue with a majority of PAs is that medicine is just their “9-5”, they don’t have clinical and academic obligations like a doctor and there a-lot less conscious of maintaining standards of care in this every evolving industry. The fact that they make how much they make without the fear of losing their license and hospital duties is that are placed on a physician. Ultimately mid levels will only grow because they provide cheaper labor. The medical degree is going to become s leadership degree in future, in my opinion. While the non physician practitioners will be the first person you see at the hospital.
Ps kenji, I’m sorry for missing the payment on the writing course.
Most PA courses require a science degree, you can get on without a science degree but you usually have to have significant healthcare experience and the course is so intense that without that I would imagine a student without that background would not do well.
Yes there should be more training places for doctors and they should be paid more, but maybe that should be separate to the discussion of the PA role. PAs have been practicing in the NHS for 20 years and maybe if more had been done to regulate them earlier and define their role this wouldn't be an issue.
I think there should also be a caveat that the role of a PA in a GP surgery vs a hospital in terms of working independently is different. And there is also a difference between a newly qualified PA and one who has been working for 5-10 years.
The solution to what you're expressing doesn't seem an easy one but the hate towards PAs is intense and like you say they are also trying to do their best for patients and also have specific training but it seems like they are being targeted as the focus of hate regarding issues facing Dr's that should be resolved on a higher level.
Good points there!
It’s simple. The healthcare landscape has already begun to shift in the last 10 years towards use of APPs and less use of physicians. This happened as private equity begun to take over hospitals, urgent care clinics and ERs. The good old days are over.
Why hire an expensive physician
When i can hire a cheap PA
Patients safety? PFFFFT BOHAHAHAHAH AS IF I CARE
Private equity
I can already see a future where 1 physicain leads 5 PA instead of residents
Uk is technically saying doctors take too long to train …
It does take to long to train unless you start immediately after highschool to go to 4 years of college and 4 years med school and thennn 3-7 years of residency by that time if you make it through you’ll be 28-35 years old and then you don’t even see money until you finished the residency your which is the 3-7 years hahaha
UK PAs are vastly different than US PAs. Way different scope of practice and training. PA training programs in the US are very robust and prepare the PA for high level acuity practice. As a PA in the US I can practice in any specialty.
Further, we have NCCPA and AAPA governing bodies and board certifications in place. It sounds like the UK has a lot of growing to do if they want the PA career to grow.
“Practice in any specialty” is very misleading. Just like the creator said, PAs assist physicians. This includes the US. Also the pay scale is more justified to the amount of training for each medical profession
@@DFOlover1 how is it misleading? We literally can practice in any specialty. PAs in the US have great autonomy and in some states don’t need a collaborating physician.
@@DFOlover1It isn’t misleading at all. PA’s within the US can practice in w/e speciality piques their interest & can move to another if they want a change. They also have a lot of autonomy in many cases. The physician is not hovering over their backs. They can even open up their own clinics & hire MD’s & other medical staff to work for them. I very much rather to see my PA than my doctor personally. She’s amazing.
@@the1reaper33 you can “assist” in any specialty yes but your autonomy and decision making doesn’t even exceed that of an NP.
@@dtae7855 what you’re implying as “hovering” is a safety net against patient misdiagnosis and harm. Also it wouldn’t make sense for a doc to work for a PA since CEOs don’t typically make less than their staff.
I’m sorry your experience with a physician was less than stellar, but your situation does not reflect the populations’.
We have PAs and NPs here and now nurses can get a DNP, doctor of nursing practice. What bothers me are chiropractors calling themselves chiropractic physicians
I think what this fails to encapsulate is the fact that admissions into PA programmes require a degree in health or life sciences degree, so that’s biomedical science, nursing, physio. Saying only 2 years experience feels short of the many years of experience some had had prior, a PA who’s newly qualified but has over 20 years of experience as a nurse is still a VERY experienced and knowledgable practitioner
I see your point, but in the last few years in the NHS I haven’t met many PAs at all who had a long nursing background. Experienced nurses tend to go for ANP roles, not PAs. In the case of ANPs with long nursing background I partially agree with you, although that is a whole other nuanced topic. I’d be interested to see what others have seen in their experience
Also, PAs know they are not Doctors, they are healthcare professionals in their own right separate from doctors. They do need to be regulated but maybe the BMA could focus on educating the public on what a PA is, instead of trying to get rid of a profession that is not going anywhere, and that is going to be regulated by the GMC, there is no going back on that one so maybe the BMA should be trying to work with PAs instead of fighting against them. We all know Dr's are experts in their field so they should be the ones helping to shape healthcare and being at the forefront of positively supporting healthcare professionals. I'm sure there isn't a PA out there who isn't supportive of Dr's being paid more and of more training places for them becoming available!
If a doctor hates a PA… there is something wrong with the doctor. The person doing the hate is always in the wrong. Its a healthcare team now not a dr only team. Doctors that have this thinking are horrible to work with or upset they did a bunch of schooling and people are not kissing their feet like the old days. There is a reason a Pa education is popular and why the 2024 match had a bunch of open spots left lol.
I see many other videos like this and even though author says, im not biased, some statements blur the line as such..
Here in the US..
Both PAs (physician assistant/associate student) and Medical students have the same prerequisites to entire their program. Both can have a art degree or a science degree as long as they meet science prerequisites. Both are very competitive to get into.. (PA schools require prior health care experience, Medical schools may require research or community service etc.)
Medical school is 3 to 4 yrs (3 yrs for accelerated tracts in GP/IM, OBGYN, Pediatrics and psychiatry which are growing in numbers)..
PA schools take approx 2 to 3yrs the work force as a general practioner with the ability to specialize in any area..
Notably: PA schools are accelerated with only 1-2 wks break in between semesters.. thats what makes it 2 to 3yrs long..
The same for 3yr accelerated Medical school programs vs the traditional 4yr medical school programs which have considerable more breaks especially in the 4th year which can be used for research or subinternships and interviews for residences
At the end of both programs, both PAs and medical students are GPs.. YOUR TRAINING DOESN'T BEGIN UNTIL RESIDENCY..
Residency training ranging from 3yrs for Family medicine or IM or EM to 8yrs for Neurosurgery..
PAs don't have residences and entire the workforce with limted knowledge with the expectation to grow that clinical knowledge and expertise overtime within their specialities..
Both newly minted PA snd residents are and should be supervised. As both gain more clinical knowledge, the more autonomy is given..
I don't believe a PA thats has been working the same specialty for the past 5 to 10yrs (except for the surgical specialities) should be supervised or micromanaged just as much as a resident who trains for 3 yrs is no longer managed after their 3yrs..
Doctors don't make mistakes?
Physican Assistant...
First of all, the title is part of the problem. First it was physician assistant. Now they are trying to change it to physician associate, already blurring the lines and confusing patients. Next they will want to be called physician. No thanks. I’ll just call them midlevels if they gonna be like that.
It’s not physicians associates it’s physicians assistants
Loud and wrong
@@normanilyrics1311 Feelings hurt? PAs will never be equal to a doctor. Not even close.
@@thomaskoning7395 no shit😂their scope doesn’t reach a doctors. But they are valuable to health care especially in rural areas
@@normanilyrics1311 Of course. They cost less. That's great for providers.
why are don't doctor always demanding pay rises? There are so many other staff in the NHS who work just as hard or if not harder than doctors. I think nurses, PAs, HCA and Physios should be paid as much as doctors if not more.
I think we all deserve a pay rise!
Nonsense
Doctors train longer and are more demand and doctors are the most important resource in medical treatment
@@citizen1l that’s not necessarily true there are many important workers in the healthcare industry , which without the NHS would fall apart.
@@jigglypuff5918 No other person in a hospital can do what a surgeon does without going to jail
Because they are a cheap!... This is not rocket science...
Tory logic of course
PA's are just fine for treating minor everyday ailments. Once you cross over into a chronic disease state like diabetes, forget about it! I find it to be extremely dangerous!