Re: Helen Salisbury: Physician associates have no role in general practice
Dear Editor
I am a GP of 30 years standing. I'd always mostly agreed with Helen Salisbury's opinions over the years but this article is way wide of the mark.
To start with "There is no role....." I seemed to spend the first 20 years of my working life wondering why I was seeing patients with self limiting illness -- now I see almost none largely because they now see PA or ANP.
I'd argue that the "unsupervised" care of patients by GP of highly complex conditions is arguably more risky than the supervised care of relatively minor conditions.
We have 2 outstanding practitioners as PA in our practice. They are conscientious, knowledgeable and popular with patients who understand they are not doctors and may need to discuss their care with a supervisor.
Currently they see and phone 50-60 patients in total a day. I am not sure how or if we would cope without them.
They both did a large part of their training at our practice before we employed them and thus have an understanding of the community and our patients. They have both developed special interests - dermatology, HRT, psychological support - and they add to the quality of our care.
The suggestion these people have no place in Primary care is rude and patronizing - do we need to go back to Doctors "doing everything"? What about the legions of nurses who do chronic disease management? Maybe we should start taking own bloods again and dipping our own urine tests? The NHS has come a long way thanks partially to Doctors being able to concentrate more on what we are trained for.
Finally the suggestion PAs should re-train as Doctors is crass. I discussed this move with both our excellent PAs about 3 years ago. It would take them 8-10 years to match their current salary (med student/ FY / GP Reg) and they would accumulate a further £ 50 000 debt - hardly an inviting prospect.
Rapid Response:
Re: Helen Salisbury: Physician associates have no role in general practice
Dear Editor
I am a GP of 30 years standing. I'd always mostly agreed with Helen Salisbury's opinions over the years but this article is way wide of the mark.
To start with "There is no role....." I seemed to spend the first 20 years of my working life wondering why I was seeing patients with self limiting illness -- now I see almost none largely because they now see PA or ANP.
I'd argue that the "unsupervised" care of patients by GP of highly complex conditions is arguably more risky than the supervised care of relatively minor conditions.
We have 2 outstanding practitioners as PA in our practice. They are conscientious, knowledgeable and popular with patients who understand they are not doctors and may need to discuss their care with a supervisor.
Currently they see and phone 50-60 patients in total a day. I am not sure how or if we would cope without them.
They both did a large part of their training at our practice before we employed them and thus have an understanding of the community and our patients. They have both developed special interests - dermatology, HRT, psychological support - and they add to the quality of our care.
The suggestion these people have no place in Primary care is rude and patronizing - do we need to go back to Doctors "doing everything"? What about the legions of nurses who do chronic disease management? Maybe we should start taking own bloods again and dipping our own urine tests? The NHS has come a long way thanks partially to Doctors being able to concentrate more on what we are trained for.
Finally the suggestion PAs should re-train as Doctors is crass. I discussed this move with both our excellent PAs about 3 years ago. It would take them 8-10 years to match their current salary (med student/ FY / GP Reg) and they would accumulate a further £ 50 000 debt - hardly an inviting prospect.
Sorry, Helen, you are way off on this one.
Dr Gawain Davies
Competing interests: No competing interests