The survey, which registered over 18,000 responses, reported that 87% of doctors believe that physician associates will sometimes or always pose a risk to patient wellbeing.
Additionally, 86% of respondents felt that patients did not know the difference between the roles of a PA and a doctor, showing the potential extent of confusion about the level of care they are receiving.
Despite the fact that 4,000 PAs are currently working in the NHS, a separate study by the BMA found that 57% of patients had never heard of a physician’s associate. Furthermore, many are worried about the Minister and Health Chief's plans to expand the PA workforce to 10,000, filling a widening gap in the NHS workforce.
The Department of Health and Social Care outlined that “Physician’s associates work alongside doctors in a multi-disciplinary team” after undertaking a 2-year postgraduate master's degree, a shorter term compared to the 6 years at university spent by most doctors. Moreover, physician’s associates do not have the qualifications or experience to perform operations or prescribe medications.
Although both positions are trained to perform medical examinations, analyse investigations, and take medical histories, physician’s associates must be supervised by doctors.
However, confusion between the roles of physician’s associates and doctors is having an effect on patient experience, as outlined by Professor Philip Banfield:honorary professor in the Cardiff University School of Medicine
“If well-defined, associate roles can play an important part in NHS teams, but the Government has refused to give associate roles that definition. Patients deserve to know who is treating them and the standard of care they are going to receive. By blurring the lines and allowing a situation where PAs can act beyond their competence without the public understanding what they are qualified to do, both professions are demeaned and risk losing crucial public trust.”
Concern about the expansion of the PA role peaked after the death of 30-year-old Emily Chesterton, who was misdiagnosed on two separate occasions by a physician’s associate. The associate prescribed propranolol, a medication for anxiety, after Chesterton presented symptoms of calf pain, a swollen leg, and shortness of breath.
She later collapsed from a blood clot and was rushed to hospital, where she later died of a pulmonary embolism. Coroners further concluded that had she been correctly diagnosed and sent to A&E, her life would have been saved.
Before her death, Chesterton messaged her mother, Marion, explaining she had sought medical treatment but was never told that the person who treated her was not a doctor. She has since spoken out about her daughter’s tragic passing.
Said Chesterton, “The sooner everyone finds out about these physician’s associates, the better. People need to know what's happening.”
Plans are in place to safely expand PA positions with the support of doctors and GPs, which could improve patient safety. On the 13th of December 2023, the government introduced legislation to allow GMC oversight of physician’s associates. This would ensure that all PAs across the country work under the same levels of regulatory oversight and accountability. The new regulations are set to be implemented by 2024.
Edited By Sydney Smith
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