UK's largest GP chain replaces some doctors with less qualified staff.

Baggs

growstuff

But this isn't about Nurse Practitioners.

I think it could be in part, if it's an attempt to use what man doctorpower the practices have more efficiently.

That's why I asked about the reason for the investigation.

Nurse Practitioners are trained to do specific roles. They run clinics for specific conditions and deal with minor ailments. They are trained to spot anything outside their own expertise and refer it to doctors.

The Physician Associate is a different role. They are generalists in the same way as GPs are and see all patients in the same way as a GP does, so they could be dealing with somebody with severe depression one minute and somebody else with cancer the next. They could also be dealing with the huge group of patients who don't know what's wrong with them. I think we all know that GPs are variable in diagnosing, but a good one can spot things patients don't even know they have.

Baggs

If something unlawful was happening the anonymous GP should have reported it.

To be fair, given the shortage of GPs, what is a practice to do if it's to help all its registered patients? Without lowering standards of care, something has to give.

But accepting this is lowering standards of care, while the government can tick the boxes and claim that GP practices are fully staffed.

growstuff

Baggs

If something unlawful was happening the anonymous GP should have reported it.

To be fair, given the shortage of GPs, what is a practice to do if it's to help all its registered patients? Without lowering standards of care, something has to give.

But accepting this is lowering standards of care, while the government can tick the boxes and claim that GP practices are fully staffed.

Who said anything about accepting what is wrong? I was merely putting forward a thought: What are GP practices to do given there are too few GPs?

Not having seen the BBC documentary, I don't know all the facts of the case in question. I do know that there aren't enough GPs.

So what are they to do?

Put pressure on the government to get more GPs trained.

Yes.

And, since that takes quite a long time, what to do in the meantime?

Just asking. Is the government counting the PAs in their figures, as filling the chronic shortage of GPs?

The Physician Associate is a different role. They are generalists in the same way as GPs are and see all patients in the same way as a GP does, so they could be dealing with somebody with severe depression one minute and somebody else with cancer the next. They could also be dealing with the huge group of patients who don't know what's wrong with them. I think we all know that GPs are variable in diagnosing, but a good one can spot things patients don't even know they have.

This is all very well, but could it in a fair number of cases ( could it?) be better than not being able to get an appointment at all?

In some cases maybe, if the patient has a fair idea what's wrong and just needs monitoring, a change of medication or there's a very clear pathway. However, GPs see many patients who don't know what's wrong with them until the GP spots some warning sign.

For the first time in years, I had a proper face-to-face appointment with a GP last week. I had actually booked a telephone appointment because I want to change my diabetic medication and thought it would be simple. The GP insisted I see her, which could be something to do with the fact that I'm still considering legal action against the practice for not referring me, when they should have done.

So I walked in and sat down, discussed medication and the GP noticed my hands and asked what was wrong. I said I didn't know, but she said that she thought I had poor circulation and possibly some auto-immune condition, which was causing the painful red patches I've had for years. She'd also noted that I limp slightly, so she examined my hip and feet. While she was examining my feet, she noted that I have the beginnings of toenail fungus, so prescribed some medication. She's ordered full blood tests, including some I've never had before and has told me to go back to see her about my hip after my forthcoming cancer op. Oh! And she changed my diabetes medication and has told me to go back for monitoring.

The appointment lasted about 40 minutes and for the first time in years I felt that I was getting proper care. I know that not all appointments can be like that, but I seriously doubt whether a Physician Associate would have been so thorough, even if they did have the time. I'd be highly miffed if I was fobbed off with a Physician Associate for something serious.

It was actually a GP who ignored my breast problems last year, but I suspect a Physician Associate wouldn't have listened to me either because I didn't tick all the right diagnostic boxes. As a result, I'm due to have a mastectomy, which could possibly have been avoided if my cancer had been picked up earlier.

No, I don't think an appointment is better, if it's not done properly. I went away last October telling myself not to worry because the doctor told me it was nothing. I'm concerned that will happen more frequently if people are fobbed off with people they think are GPs, but aren't.