Should we know the qualifications of the person who is treating us?

I wouldn't accept an appointment with a PA unless it was after a confirmed diagnosis, to monitor the condition or discuss a change of treatment. No way would I trust them to diagnose my symptoms.
I don't think my surgery has them, but they have lots of nurse practioners who by & large don't involve themselves with diagnosing a new condition, but with managing an ongoing condition that may have changed & the ones I've seen have been very competent.

ferry23

I've never heard of a Physician Associate so I just googled it.

According to the NHS website, Physician Associates support Doctors.

I've never made a "physician's appointment" nor gone to the surgery "to see a physician" or even told anyone what the "physician" said. I have however made a Doctor's appointment, seen a Doctor and told people what the Doctor said.

Bit of an out of the box idea here on my part - but how about calling them "Doctor's Assistants"?

I think they use the term Physician rather than Doctor because it is more specific.

You can have doctorate in many different disciplines.

You do have a valid point though as you would hardly be turning up a doctors' surgery expecting to see a Doctor of Divinity let alone an Associate Doctor of Divinity.

Our surgery was always absolutely clear that one of their staff was a Nurse-Practioner. That I can accept - she is a nurse with extra training.

PAs are neither fish, flesh nor good red herring. I cannot see how they can be any better than a nurse practioner. At least a nurses practioners basic training is solidly hospital and medically based. They will have experience of having seen patients with all kinds of different diseases, and their treatment and responses to treatment.

According to the government webste to become a PA you need a first undergraduate degree in a health or life sciences subject, such as:
biochemistry
medical science
healthcare science
nursing

I have just checked out sample syllabuses for these degrees. Now where do they learn anything about diseases, how they present in humans, how they are treated, how they are diagnosed. They then do a 2 year course where they learn, again according to another government document

taking medical histories from patients
performing physical examinations
diagnosing illnesses
seeing patients with long-term chronic conditions
performing diagnostic and therapeutic procedures
analysing test results
developing management plans
provide health promotion and disease prevention advice for patients.

How on earth can they do this if they do not have any practical experience of patients and illnesses and diseases that form the basic of any medical and nursing degree?

They are less well trained than nurse practioners and according to the stats earn considerably less, which in itself shows what their place in the pecking order is.

I think they should ditch PA and concetrate on training more nurse practioners.

It never occurred to me that a PA would only have undergone 2 years training. I believe that the first degree RGN course in Nursing takes 3 years so I assume it must take even longer to qualify as a Nurse Practitioner.

You don’t get a choice if who you see valdavi, you are grateful fir an appointment, go into a room and there sits someone you hope might be a qualified medical doctor but unless they tell you outright or you ask them, you will be none the wiser.

Nurse practitioners are usually highly skilled.

silverlining48

Nurse practitioners are usually highly skilled.

I think you’re right, but the problem is, we don’t know.
The last NP I saw certainly gave that impression, but I can’t say the one previous to that made me feel she was highly skilled. She looked about the same age as one DGD (can’t say that, it’s ageist) and she answered any questions I asked by consulting her computer.

Information about physician associates on BBC news tonight. I’ll wait to see what it says.

No we don't need to know the qualifications of the person who is treating us but we do need to know their status. Physician Associates cannot and should not make a diagnosis. The Patient needs to see a Doctor first and the PA should be supervised by the Doctor. Unfortunately PA's have been used to plug the gap where there have been insufficient GP's. This is totally unacceptable and should be stopped immediately.

Confession here - I am totally against Physicians Associates (or whatever they are now going to be called). The whole idea needs scrapping. It was never going to work and was just a cost saving exercise in a climate where our newly trained doctors are struggling to find jobs. It is a disgrace.

I was once phoned back by one of these persons, who did not declare who they were and it was only after they suggested something that I knew to be totally wrong that I asked her if she was a doctor. Someone with a less knowledgeable background would have taken the prescribed meds........ or would they? Presumably a medic has to check on what's been suggested - in which case they might as well have done the job themselves in the first place.

I find it utterly beyond belief that non-qualified people are making diagnoses.

An official report has just been published on PAs. The full report is quite lengthy, but the summary and recommendations are worth reading.

www.gov.uk/government/publications/independent-review-of-the-physician-associate-and-anaesthesia-associate-roles-final-report/the-leng-review-an-independent-review-into-physician-associate-and-anaesthesia-associate-professions#executive-summary-and-recommendations

Judy54
The need to know if you are being seen by a qualified doctor, means exactly that.
Hiding the fact that they are not in actually a qualified doctor by using a misleading title it’s another reason why you need to know what their qualification is.

Luckygirl I agree with you about PAs making a diagnosis. It seems that they are more of a problem in primary care than secondary care. My guess is that hospitals have better systems in place for training and can be more flexible about PAs are employed. GP surgeries usually only have a few staff and the temptation seems greater to plug the gap when there are vacancies.

Having said that, I'm not against non-doctors being in charge of my care. My diabetes nurse is excellent. She has a Masters in diabetes care and has written a number of peer-reviewed research articles. She knows more about all aspects of diabetes (and associated conditions) than any medic I have ever come across. She is able to refer to secondary care and prescribe a limited range of medications.

It seems to me that there's muddled thinking about the roles of nurse practitioners, paramedics and PAs (and trainee doctors in hospitals). I'm sure they all have a place and are qualified in certain fields. However, none of them have the holistic training of GPs, who should be experts in diagnosis.

I think there need to be much clearer guidelines about responsibilities. GP practices, in particular, need to be discouraged from using cheaper staff to cover for qualified GPs.

Magenta8

It never occurred to me that a PA would only have undergone 2 years training. I believe that the first degree RGN course in Nursing takes 3 years so I assume it must take even longer to qualify as a Nurse Practitioner.

Yes, Nurse practioners first qualify as nurses then meed to get 2-3 years work experience and then do a Masters degree in Advanced clinical practice.

I assumed from the descriptions given of what Physicians Assistance did that they were senior and better qualified than NPs. But, on the cntrary they are a lot less well trained.

It seems to me the sensible thting to do would be to ditch the whole PA system and concentrate on training more nurse practioners.

Monica I agree with you. The majority of nurse practitioners and specialist nurses (or whatever their job title) have been excellent. They include my practice's diabetic nurse (as already written about) and the specialist nurses who cared for me after my breast surgery, skin cancer and heart attack. They all really knew about their specialism and haven't hesitated to refer me to a doctor if they're concerned.

I'm not really sure what an Associate Physician is supposed to do.

I have a choice who I see in my surgery. When I ring fir a appointment they tell me who I am going to see or who will telephone me. I ask is the person I am going to see a PA if yes I decline the appointment. I then get a Doctors appointment maybe a week or so later.
My partner was given a PA appointment and said "No I want to see a Doctor", only to be asked why? as the PA was very good. Partner declined and was given a Doctors appointment.
I don't agree with PA's I think it's to save money, they are not as well trained, and their prescriptions have to be signed off by a Dr.

It is very clear on our doctors website who all their staff are and their title. My husband d and I have both seen Senior Nurse practitioners and Physician Associates and have had exemplery care. They made clear before the consultation began who they were and confirmed we were happy to be examined by them. They seemed to have more time to explain things clearly.

Redrobin51
That doesn’t happen at every surgery. Certainly there’s a board with all the titles on, but not really clarifying what their qualifications are.
I have seen from my appointment, which initials the person I’m seeing has, but I’ve never been told anything by them, before being treated or asked if I was happy to be treated by them.
One very good experience with a PN and one where her over- reliance on a computer left me feeling unsure about the treatment offered.
One bad experience with a PA which resulted in unsuccessful treatment and a three month wait for an appointment with an actual doctor to organise the correct treatment.

It's not even true that all PAs have a life science degree. The exam is multiple choice and there is a 100% pass rate.
They are much more used in secondary care than GP surgeries.
There isn't a shortage of doctors, there are unemployed doctors. In August there are 30000 doctors who finish their 2 year foundation and most have no jobs. They will end up going to Australia or leaving medicine after all that training and we are left with PAs.

Confession here - I am totally against Physicians Associates (or whatever they are now going to be called). The whole idea needs scrapping. It was never going to work and was just a cost saving exercise in a climate where our newly trained doctors are struggling to find jobs. It is a disgrace.

I agree. The role should be abolished.

Nurse Practitioners are usually very good and professional at what they do, but they are not doctors and should never try to give the impression that they are. One I saw for a first appointment for a joint replacement gave the impression she was a registrar and the Consultant's next-in-line but she failed completely and I suffered extra years of pain because of her.

Redrobin51

It is very clear on our doctors website who all their staff are and their title. My husband d and I have both seen Senior Nurse practitioners and Physician Associates and have had exemplery care. They made clear before the consultation began who they were and confirmed we were happy to be examined by them. They seemed to have more time to explain things clearly.

But if you phone up to make an appointment to see a GP is it right that you are not told who told until you see the person that they are in fact a nurse?

You can't always guarantee good treatment from an actual doctor. My daughter has a doctor friend who had been to her own GP several times about her swollen stomach. She was continually reassured that there was nothing wrong. In the end she referred herself to a hospital consultant and had an operation to remove a grapefruit sized cyst.

There are estimated to be 3000 physicians assistants in total, so they are not the reason why any more than the equivalent number of doctors would be without jobs. One of the main reasons is that there are a lot more doctors chasing the attractive specialties than there are posts, while other areas still struggle to recruit. Many work as locums until successful in getting posts in their chosen areas.

Allira

Redrobin51

It is very clear on our doctors website who all their staff are and their title. My husband d and I have both seen Senior Nurse practitioners and Physician Associates and have had exemplery care. They made clear before the consultation began who they were and confirmed we were happy to be examined by them. They seemed to have more time to explain things clearly.

But if you phone up to make an appointment to see a GP is it right that you are not told who told until you see the person that they are in fact a nurse?

I can't phone up to make an appointment with a GP. I complete an econsult form and am then contacted, further discussion takes place and I've always been given an appointment with a named person. It's always been with a named GP or nurse, depending what action is to be taken. My practice doesn't have any PAs and I've always felt the appointments I've been given have been appropriate. Maybe I've been lucky.

I thought all surgeries had a list of GPs with their qualifications up on a board prominently displayed. My surgery's website also says in its 'Meet the Team' section, who is a GP and who is a PA