New Guidance for Physician Associates | Titles & Introductions
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- Опубліковано 15 жов 2023
- The Faculty of Physician Associates (FPA) within the Royal College of Physicians has released new guidance around how PAs should introduce and title themselves when working clinically
www.fparcp.co.uk/about-fpa/ne...
Published 5 Oct 2023
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Coming from a background were we have nursing associates working alongside nurses, I have definitely felt the benefit that associate practitioners can bring to the MDT and the profession.
Sad to see that PA’s haven’t been well received as they are very valuable members of the MDT and again help towards more access to healthcare for patients. It sounds very much like a hierarchy issue and comes across as no one should be able to practice medical knowledge other than doctors. Which is quite sad to see. I don’t see how changing the PA name at all equals more patient safety as their job description and title remain the same. So again all comes back to sounding like some doctors feeling undermined as MAP’s are being trained to be able to take on some medical duties which only doctors used to do (identity crisis).
Not valuale whatsoever. PAs dont need to exist.
I've got to go ahead and ask what specific value have you noted? I'm not suggesting it doesn't exist, we just need to clarify!
@@OllieBurtonMedI was the first president of the FPA and after nearly 13 years of being a PA I would love to have a conversation about the establishment of the PA in this country, establishing the FPA and our title as I actually lived through it. There seems to be a lack of knowledge of what we are about abs who we are.
You're very very welcome to come on for a chat if you'd like, or have a call at some point. let me know @@user-xg1rx1wz4e
will never trust or comly with anyone who has pretend doctor on their team
no consent
no comment
As someone who's gone from PA to medical student, I think this document is really helpful. The only thing that I know will cause friction with some patients is when introducing yourself and explictly saying "I am not a doctor", there will be plenty of patients who turn around and ask why they are seeing you then and "when will I see the doctor then?" etc. There's nothing you can do about it from a practitioner point of view, I think the NHS as a whole need to educate patients more with this. Posters in waiting rooms etc would be a great start so when you introduce yourself as a PA there is likely to be less resistance or friction.
Thanks Alex for your considered comments, and good luck with med school. You're right, and I think the clarification (which is necessary) may induce friction. The real challenge is that (in my opinion) proper stakeholder discussions haven't happened with patients more widely around this, and the public have not essentially been told that despite paying as much as they ever did into the NHS, they can't/won't continue to expect to see a doctor at first contact. The political will to maintain doctors as first contact doesn't exist, and the budget for it doesn't either - which is a political choice. This is why so many people are fearful of a two-tier system developing, where those that can pay will see a doctor and those that can't, won't.
Considering applying from practising PA to graduate entry medicine. Would love to hear about your experience like difficulty step up, experience on placements etc.
@@ArtixBlader It is a big step up especially the first year with a lot of heavy science to learn. I think the biggest thing for me is the breadth expected of me but for the most part its not been too bad. On placement I tend to not mention I used to be a PA, I want to be treated like everyone else and hopefully get a more full education in that regard rather than having people assume knowledge.
@@alexjenkinson8510 yes I wondered how you had navigated the background - especially given the role is in a bit of an existential crisis at the moment sadly. How did you find the interview? I imagine they must have asked you about why you wanted to study GEM over being a PA? I think being independent is the driving force for me but I don't want it to come across contrived when there'll probably be lots of other PAs applying as the years go on.
@@ArtixBlader It didn't really come up in the interview as I had a MMI setup so there were just set questions for me. There are lots of reasons to study medicine, independence, scope, progression. I think ultimately a fundamental reason for doing medicine regardless of your role is more important, then build on that answer with specifics for medicine.
I have a question
If my university does not obtain accreditation from WFME, can I work in the European Union as a doctor?
Can you make a video about CESR?
I find it so infuriating that people still hate on pas when all they want to do is their job and help save lives and people are moaning so much when they are just extra stuff. Uk always has something to moan about. They are well established in America this needs to happen here.
Staff***
!!!!!!!
I find it so infuriating that people think PAs are needed when they're a government pawn to a manufactures crises. I find it so infuriating that PAs are negatively affecting our future doctors and surgeons by robbing them off vital training. I find it so infuriating that PAs are overpaid while have 1% of the skill of a doctor
I think part of the reason the role is quite well received in the US is because they are very highly regulated over there. Hopefully attitudes towards UK PA’s will change soon following the recent news that the GMC is beginning the regulation process soon
i will never trust speak or comply with a pretend doctor
Whether we agree or not regarding PAs' (and other MAPs) usefulness and safely, I think we can all agree that the planning/implementation/oversight/communication of this has been horrible by successive Governments.
Can a doctor work only as a general doctor?? If he / she chooses not to study further and specialize in any specific field??
A doctor can specialise in anything, but to do so is often highly competitive
@@OllieBurtonMed I mean if he/ she chooses not to specialise and study further, would they still be able to work as a general doctor ? Or must they study and specialise??
A general practitioner is considered a specialty and must complete the GP specialty training in the UK to become one. To become a GP, one must complete two years of foundation training ( every medical graduate must do this to gain the medical license) + 3 years of GP specialty training for a total of 5 years after medical school.
Suppose a person wishes not to pursue a specialty training of any kind. In that case, they can stop after foundation year 2, and can work in any hospital setting but will always have to be supervised by a senior doctor. @@EkramNofal30
@@EkramNofal30general dr is a gp they are generalist you need to complete your full training
As a PA student, the only way I can accurately describe what I do is that I'm learning to practise within the _field_ of medicine, as a clinical practitioner. I feel like we study the _field_ of medicine itself, but not _medicine_ in the way its understood in a medical school context.
Thanks for your thoughts! Really appreciate it
I would elaborate on this by saying we learn the medical model, which is simply one of the various approaches to the treatment of disease (nursing model, psychological model etc)
dont care i wont comply to pretend doctors
@@AML89 just dont speak to me if i am in hospital it will embarrass a pretend doctor
i will berate you
@zebedeerotten533 the only thing you can berate is your keyboard. Pipedown.
I don’t see why they should not have physician in their name ? There are physician assistant for 60 years in the states - with no issues .
Well the operative question is why, as they're not physicians. A legal associate in the UK is someone with a law degree. A PA does not have a medical degree.
Because we are a class-based society that likes to look down on others and keep them in their place.
dont care their name i wont trust them or comply
I disagree with the title “Doctor” only being used by Physicians in a clinical setting since medical associate professionals can earn an actual doctorate or PhD whether it’s academic or clinical. The title “Doctor” is not synonymous with physician, I can understand it being illegal if MAPs represent themselves as medical doctors but in a funny way if MAPs with a Ph.D cant introduce themselves as “Doctor” in a clinical setting than neither can Physicians represent themselves as “Doctor” in an academic setting since they only have a bachelors of medicine. However if both parties have a doctorate level degree they should respect each others academics. But I full on believe if a MAP does not have any sort of doctorate they should not use the title “Doctor” clinical or academic.
As for developmental pathways I’d love to see a bridge programme (PA to MBBS) as I seen in America they have a bridge programme (PA to DO)
I see your point but firstly, a Medical Doctor introducing themselves as a doctor in an academic setting is not really that consequential whereas doing so the other way around is massively consequential. Secondly, no one is going to think to clarify someone who introduces themselves as a Doctor in a hospital as to whether they're a medical doctor or someone with a PhD.
Uh Dr Ollie has a hot gamer setup!
Can a patient refuse to be seen by a PA?
I suppose, although it may mean a longer wait to see a doctor in return. This is probably the general direction of travel in the NHS, and the development of a truly two tier system.
My issue with PA's are a lot of them can have zero healthcare experience and come into senior roles. Advanced clinical practitioner's do the same or similar and have nursing or allied health backgrounds which is better suited
Hi, Physiotherapist to PA student here, i kinda agree with this statement the majority of PA students are typically biomed, this makes sense as the first few years of medicine are typically (varying on the uni) biomedical science focused but in regards to actual healthcare experience they are very limited. There is a steep learning curve and my experience of medical placements is incredibly varied for PA's compared to my undergrad. The role has a lot of responsibility beyond that of when I was as a band 6 PT on the NHS and I honestly believe no one would do the course if it was paid any less because the career progression is horizontal and its extremely challenging (+expensive). However this is a completely different job, no amount of experience be in it nursing, PT, SALT etc is going to give you much of an edge outside of communication skills and familiarity.
@@taylor1316 I've looked into PA but exactly your point in horizontal and although the role carries responsibility it isn't accountable not carries the career progression, gravitas as being a Doctor. I understand why the role is becoming more prominent in that allied professionals are becoming more autonomous and developing in other areas but from a Doctor's perspective the PA role is diluting the profession to an extent and is certainly a cost cutting role also. Personally I wouldn't do PA I'd rather have that full responsibility as a Doctor has with real career structure however I also know it's still has an element of snobbery within medicine and it can be difficult to get on the course.
If you are thinking about this transition, you also need to remember to separate the elitism, snobbery and lack of accessibility in medicine with the standard of care. Or I suppose, yes all of those problems are rampant within medicine. BUT that does not justify accepting a standard less than what a doctor would provide, because that doesn't solve either problem. The way that dilemma gets solved is that a PA should never, ever be used where a patient should be seeing a doctor. The challenge is in deciding what patients are suitable for PAs to see and review, and how good your process for deciding that is, as cases are simple only in retrospect.
They learn through uni and work and are supervised do some research
@@OllieBurtonMed I think you need to have more experience in talking to people who work with PAs. Then you could give an even more balanced opinion based on fact.
I would highly appreciate if Mr ollie Burton could reply to my small query through a video
Sir me and my friends have been sending hundreds of job applications for the last 6 mths but failed to attention even from a single a trust
Do let me know if there is a job scarcity of this massive level and how to make sure I get job in next one mth
I take issue with the fact that the role has been in place for 20+ years, but guidance on their titles have only just been released. Clinicians & patients have been flying grey for years about who these professionals are and what they can/can't do, and we only find ourselves talking about it now (despite years of encroachment) because of a vocal group of trainee doctors.
It is scandalous that none of these problems were anticipated when the unregulated and undefined role of a PA was first introduced.
None of that is true. PAs have constantly been updating their code of conduct with the RCS and the Big changes are coming in now, NOT because vocal Dr's, but because of the campaigning by the RCS and FPA for regulation. All of this is to adhere to the GMCs standards.
@@AML89 They don't belong on anything GMC related. It's all pantamine to make themselves feel like they're a doctor. Put on a stethoscope and go tell mommy I'm a doctor when really I'm a clinical assistant
I don’t think they should have physician in their title at all
PAs are 'associates' of Physicians, they work alongside them.
Physio to PA student here I agree, the word 'Physician' is the most confusing part of the title to patients, changing associate to assistant still would be confusing because most patients will still hear physician as the first thing coming out of my mouth. Assistant definitely down plays the actual level of responsibility of the role and associate sounds too close too nursing associate (which is what some members of the hospital thought I was) I think something along the lines of clinical/medical care practitioner would be better suited to make that distinction.
@@taylor1316 Medical assistant should suffice in my opinion. How anybody thought it wise to call them physician assistant is beyond me, especially in a country where a lot of people think “ junior doctor “ refers to someone who hasn’t qualified yet
@@taylor1316nah they are assistants
it should be ★ Medical Associate ★ Clinical Associate ★ Clinical Officer (CO).
They should colour-code all healthcare uniforms; white for doctors, pink for nurses, blue for physician associates, etc.
(I’m half joking.)
I think lab coats should come back. They have been disproven as an infection risk.
@@NoCokeOnlyIce True, good point.
@@NoCokeOnlyIceThey get in the way though
so ony trust white coats then everyone else no comment no consent
I'm sure PAs have their role in the NHS but my experience has not been great working with them in a severely understaffed hospital. They should be an addition to assist doctors not a replacement. Its not their fault but they would rotinely be used to plug junior doctor rota gaps and I felt that I was doubling my workload as I had to prescribe and request radiology for them when they saw a patient. In some instances it was unsafe as the junior docs were under pressure to take what the PA said at face value when they saw a patient because there just wasn't the time to see their patient again. PAs are not the same as doctors no matter what anyone says. They've done 2 years training versus 5+ years degree and 2 years doc foundation training and often don't do on calls so don't get as much experience. I often found that they couldnt handle emergencies because they just didn't have the experience having not done the long hours and on calls us doctors had done.
I found in the surgical specialities and medical specialties they were often used to assist the reg /cons procedures because they couldnt prescribe etc so couldnt be left on the ward. And this was to the detriment of junior doctor training.
I was taught how to do abdominal drains by a PA because she was taught by the registrar and they didnt have time to teach me because I was always stuck doing the prescribing etc. Its just insane.
I think the name should be changed to Assistant as it makes the role more clear.
I often witnessed PAs being addressed as doctor by nurse colleagues and patients and they wouldnt correct them which was worrying.
Side note: I have the same massive monitor as you but I love big screens hence why i'm a radiology trainee 🌚
Am applying for rads training myself in a few weeks so wish me luck! Power to the big monitors
@@OllieBurtonMed oh interesting. From the looks of your profile I thought you were going into neurosurgery. Don't blame you though. Neurosurgery is super super tough. If you want a life radiology is the way to go but can be very challenging in a good way if you like to be challenged! I've sent you a connect on linked in if you need to chat but suspect you probably have things in hand. 😀
2024 they will be regulated and will be able to prescribe getting rid of this issue hopefully
What will be interesting to see is what prescribing mechanism is used to train PAs - whether it's a V300 or some other supervised course, unsure what we'll see happen@@NataliaGlebocka
I'm thinking about becoming a PA and work part-time as a researcher. My first degree was adult nursing. Final placement was A&E. I've worked as a lab assistant in a haemotology lab at hospital for a few years. Currently finishing my PhD in epidemiology from the school of medicine and computing to development mathematical modelling software (and a web tool) to represent populations and model screening strategies for familial hypercholesterolaemia. I want to keep coding and stay in and researching in the field of medicine and love the clinical environment...
The role of the PA creates confusion to patients and the public. It can and has resulted in patients death.
No this is not true. You need some education and perhaps should listen to the video.
@@user-xg1rx1wz4e The evidence is clear. Whether you like it or not there is evidence available in the public domaine. The role of PAs / AAs creates confusion. It is simple - Just ask for a DOCTOR.
@@arangeofevs973 you think patients can only be seen by doctors? Are you for real?
@@user-xg1rx1wz4e When PAs are on a consultant rota - that is creating serious risk. That is why patients need to ensure that they know who they are being seen by.
This role should not exist. Assistants are a danger to the public, and we have not invested in the NHS for decades for this. While our politicians see high-quality private doctors, we in the public are forced to see these unqualified fake noctors. This isn't what we paid taxes for, and it is an outrage.
How do you think emergency medical technicians work? We start as ambulance care assistants also known as ACA's then we upskill with experience and become Emergency care assistants known as ECA's then with more experience we upskill to full technicians and then we upskill to associate ambulance practitioners. Then we apprentice to paramedics. We Don't have to go to university but those options exist in an emergency any technician is better than nothing its our job to keep you alive long enough until someone woth more experience can treat you. We are an emergency service provider not long term carers.
If you want a competent clinician a proper tech is more likely to keep you immediately alive than a paramedic. Most consultants prefer a decent technician because the technician can help maintain lifespans long enough under paramedics.
@@sabrinamurray This is complete nonsense. A medical doctor has gone to medical school and followed an incredibly intense and competitive pathway to become a doctor. A PA who has failed their entire academic life cannot do this. There is no progression from PA > doctor without going to >>MEDICAL SCHOOL.
I don't care about other healthcare roles; they are indeed easier to progress into and therefore may have a progression pathway - irrelevant and incomparable to my comment or this video.
Being a doctor is so far beyond your understanding, and it shows. For example, "Don't have to go to university" - doctors do. You have to obtain an MBBS in Medicine and Surgery before anything, and a PA has not studied or completed any of the requirements of an MBBS - they couldn't even get onto the course and hence are doing PA studies...
"any technician is better than nothing". Objectively incorrect. There have been multiple instances of PAs causing the death of patient because they were acting outside of their competence.
I don't understand why you responded to me with a bunch of stuff about techs and paramedics; you don't even seem to be UK-based?
PS. A paramedic is significantly more competent than whatever the hell a tech is. Please stay in your lane if you're an assistant practitioner because otherwise, you're a danger to patients, and it's not fair. When we come into our health system, we deserve to be seen by a Doctor, not an assistant with an 18-month health diploma.
Everyone wants to be a doctor, but no one wants to lift them heavy-ass books.
Furthermore universities carry out IQ tests to filter out the number of applicants applying to medicine. There’s a number of people that could have become doctors but didn’t because they failed work out a missing shape despite being straight A students
It’s not dangerous they study very hard and they follow a matrix to diagnose certain things
@@NataliaGlebocka It's dangerous and people have already died because of it. PAs who couldn't pass an A-level are in positions treating patients in place of doctors who have a degree in Medicine and Surgery.