Re: Margaret McCartney: Are physician associates just “doctors on the cheap”?
Dear oh dear, what a deeply disappointing personal view from Margaret McCartney. But I entirely understand where she is coming from as this was also my initial reaction when approached some 15 years ago and asked if I would run a PA course. My response? ‘It took me almost ten years to train and I am still learning’; ‘How can it be possible to treat patients with only 2 years training’; AKA 'Hmph’! But, unlike Margaret, I learned, by listening to those who know about PAs. And after all, the workload isn’t going away; and I speak as a GP with almost 40 years’ experience (14 full-time and, since entering academia, 25 years part-time). There is plenty of evidence of the effectiveness of PAs in other countries, and indeed of the effectiveness of non-Drs assisting with the medical tasks (and how are such tasks defined anyway?) We cannot simply carry on doing what we have always done and hope the workload problem will somehow be sorted. There are approximately 15,000 biomedical scientists graduating a year in the UK and the PA profession mostly recruits from them, thus bringing new people into medicine, avoiding impacting other professions, and indeed reducing unemployment.
There is no ‘magic stuff’ that only Drs can do: but there are plenty of things less qualified workers can do to the same standard but under supervision. And Margaret’s comment: ‘Forgive me for my old fashioned view that GPs are best placed to see patients’. Actually, no; I don’t forgive you. Old-fashioned can indeed sometimes mean ‘It was better then’; it can also mean ‘I have already made up my mind and am not listening’. Oh, and by the way Margaret: ever heard of nurse practitioners, extended scope physiotherapists, practice nurses, paramedics? Do you really mean that only Drs can see patients?
No, we need PAs, they will make a huge difference; and the evidence we have (and are gathering) shows they really will help us at the sharp end.
Competing interests:
I am the Chair of the UK and Ireland Board for PA Education, the Director of the PA programme at University of Birmingham, have published on PAs and am one of the PIs on an NIHR funded study (14/19/26 - Investigating the contribution of physician associates (PAs) to secondary care in England: a mixed methods study).
27 November 2017
James Parle
Professor of Primary Care
University of Birmingham
College of Medical and Dentall Sciences, University of Birmingham
Rapid Response:
Re: Margaret McCartney: Are physician associates just “doctors on the cheap”?
Dear oh dear, what a deeply disappointing personal view from Margaret McCartney. But I entirely understand where she is coming from as this was also my initial reaction when approached some 15 years ago and asked if I would run a PA course. My response? ‘It took me almost ten years to train and I am still learning’; ‘How can it be possible to treat patients with only 2 years training’; AKA 'Hmph’! But, unlike Margaret, I learned, by listening to those who know about PAs. And after all, the workload isn’t going away; and I speak as a GP with almost 40 years’ experience (14 full-time and, since entering academia, 25 years part-time). There is plenty of evidence of the effectiveness of PAs in other countries, and indeed of the effectiveness of non-Drs assisting with the medical tasks (and how are such tasks defined anyway?) We cannot simply carry on doing what we have always done and hope the workload problem will somehow be sorted. There are approximately 15,000 biomedical scientists graduating a year in the UK and the PA profession mostly recruits from them, thus bringing new people into medicine, avoiding impacting other professions, and indeed reducing unemployment.
There is no ‘magic stuff’ that only Drs can do: but there are plenty of things less qualified workers can do to the same standard but under supervision. And Margaret’s comment: ‘Forgive me for my old fashioned view that GPs are best placed to see patients’. Actually, no; I don’t forgive you. Old-fashioned can indeed sometimes mean ‘It was better then’; it can also mean ‘I have already made up my mind and am not listening’. Oh, and by the way Margaret: ever heard of nurse practitioners, extended scope physiotherapists, practice nurses, paramedics? Do you really mean that only Drs can see patients?
No, we need PAs, they will make a huge difference; and the evidence we have (and are gathering) shows they really will help us at the sharp end.
Competing interests: I am the Chair of the UK and Ireland Board for PA Education, the Director of the PA programme at University of Birmingham, have published on PAs and am one of the PIs on an NIHR funded study (14/19/26 - Investigating the contribution of physician associates (PAs) to secondary care in England: a mixed methods study).