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

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.

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.

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.

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.

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.

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

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.

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.

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

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.

Nurse practitioners are usually highly skilled.

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.

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.

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.

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.

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.

Physicians Associates are not trained nurses, they are post grads who do a post graduate year or maybe two of medical training.

Hmmm, Physician Associates? Sounds too much like a glorified game of 'Doctors & Nurses', and we only get one stab at life so no thanks.

Old-fashioned fully qualified medics if you please.

Yes, we should be told about who the person actually is, and yes, for certain procedures, happy to go with a nurse or other qualified practitioner.

I would be appalled if I thought that I had seen a Qualified Doctor when in fact the individual was a nurse with extra training.
No offence to the Practice Nurses who are skilled and kind and invaluable but they are there to take blood samples and I think that I've had specially trained nurses do ovarian cancer "scrapes" and even gall bladder ultrasounds. The two latter send results to be reviewed by experts who I presume are doctors.
If I have an undiagnosed medical problem worrying me I want to see a trained doctor.

I was expecting to see a doctor too, and mostly people assume who they see are doctors, but maybe we shoukd ask. This mornings she told me at the start she is a PA.

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 have just returned from a doctors appointment where I saw a young woman who introduced herself as a physician assistant.
She was thorough and helpful and I have a blood test and on a wait list for an appointment with the nursing staff at the practice.
I heard on the radio today programme this morning that PA s should not see patients who have yet to be diagnosed, ie me I suppose but that hasn’t yet been implemented.

I think we really have to be in the ball now. My mother was a nurse and I have been brought up to think doctors are gods and you do not question them.

I now know that is very much not the case and they should be questioned. Politely of course as I dont want to be removed from the practice.
The same applies to hospital staff. I was a few months back diagnosed with a particular bowel condition. ON THE PHONE!! Weeks before the endoscopy was actually performed. The letter I received after the telephone call was so ambiguous it made my GP think the procedure had been performed and this was the resulting diagnosis. He almost didnt believe me that nothing had actually been done.....I almost didnt believe it myself.

I had to really stick to my guns.

GrannyGravy13

I often see the nurse practitioner who has been at our GP practice for many years and knows the patients over and above a new Physician Associate, if I cannot get in with my own GP

If the nurse is unsure she will ring my GP during the appointment.

I too often see a nurse practitioner just for blood tests, results and sometimes to get referred e.g. for an x-Ray.
During one lot of blood tests I asked her what she had had to do to be an NP.
Her answer, which I don’t totally recall, left me quite happy to see her for those purposes.