Snapshot of _I thought I was seeing a GP – but I was misdiagnosed by a physician associate_ :
An archived version can be found [here](https://archive.is/?run=1&url=https://inews.co.uk/inews-lifestyle/seeing-gp-misdiagnosed-physician-associate-3137741) or [here.](https://archive.ph/?run=1&url=https://inews.co.uk/inews-lifestyle/seeing-gp-misdiagnosed-physician-associate-3137741)
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ukpolitics) if you have any questions or concerns.*
PAs should be nowhere near undifferentiated patients ie ones with a new presenting problem. Assessing such is one of the hardest jobs in medicine especially given the shortage of appointment time. Yes 95 PCT might have a cold but it's the skill to spot that 5pct may have something far more serious.
Went in to see my doctor after being sent to the CMHT and got one of them instead, they wrote in my notes that I had no history of self harm, they never even asked
I was wearing a T-shirt and it’s clearly visible, not to mention it was **part of the reason for the referral**
This is like mental health nursing 101. If you’re not asking or noticing (the art of noticing is hammered into all nurses) then you’re not fit to be on the register. Clowns.
My experience has been similar. Missing out key information of medical reports, not knowing why you’ve booked an appointment. I’ve even had one google medical answers right in front of me.
Don’t get me wrong PA can be good support when used appropriately but as it stands they do not inspire confident in the NHS.
1. Medicines Act 1983 makes an offence of impersonating a medical doctor. If a PA introduced themselves as Dr X in a GP setting I would be very upset.
2. There’s a decent pot of money for GP Practices to recruit more staff called ARRS. It explicitly forbids Practices from using the money to hire new GPs, getting a PA is the closest option. Wes Streeting has [promised to review ARRS](https://www.gponline.com/labour-will-review-arrs-end-absurd-gp-unemployment-crisis-says-streeting/article/1878744), which may help.
Turns out when you don't really want to pay for services but still expect said services to run, corners will be cut across the board.
The entire PA and other letter warble shit will, eventually, result in a multitude of reports that will change fuck all because the entire system will be heavily reliant on them by that time. Entire depts are trying to paper over the cracks by trying to get more "upskilled nurses" or whatever inane letter warble they want to use instead of hiring doctors because you can get three of them for the cost of one doctor. My favourite anecdote has been an endo consultant retiring, the dept hiring two diabetic nurses instead of a new consultant and the remaining consultants suddenly finding their workload massively increasing due to scope of practice AND needing to supervise said diabetic nurses.
It's basically going to be a rerun of the maternity scandals which have come about after midwives got pushed just a bit too much, and people suddenly realised that natural births are and were a lot more complicated and dangerous prior to modern medicine.
This is a very poor argument for using less well trained people.
If something is so difficult that people with decades of training still make mistakes, then I don't see how letting people with a 2 year diploma have a shot won't end in disaster
They're right to bring it up though. This individual case is making the press due to the fact it's currently a hot topic, but individual cases aren't the issue.
It's not really an argument for or against. Just making a point to add context.
We'd need to compare average rates of misdiagnosis by GP's and PA's to really make any conclusions
I would love it if the NHS was collecting that data. They aren't though. (I wonder why).
And that's not how medical science works anyway. You can't just unleash a new, untested treatment on patients and say "well, we don't have any evidence that it's worse than the gold standard, maybe we should start looking for that". If the NHS wants to introduce a new role they should conduct a pilot studies and trials to actually get that data. They need to do that before experimenting on the UK public.
The fact it’s existed for decades as a mad max be a doctor without Medical school secret passage into medicine, *and* we lack any of this self same data is yet more damning?
Can't really do that, it's a sitting duck for Simpsons Paradox.
GPs should be seeing the more complex cases as the triage should point the simple stuff towards the PAs.
Just because I get more runs facing Jimmy from the Dog and Duck than David Warner gets facing Stuart Broad, doesn't make me a better batsman.
American here, but this isn’t the first anti-PA post I’ve seen on this sub and I’m somewhat confused. Apparently there’s a big controversy over PAs in Britain and the profession isn’t legally well-defined or something to that effect? I don’t understand where a lot of this opposition to PAs is coming from, because here in America PAs are a very well-established field and they regularly handle many of the standard appointments that would otherwise be handled by a physician without controversy. I’ve seen anesthesiologists get up in arms over the existence of nurse anesthetists far more than I’ve seen any sort of opposition to PAs.
Because they're not well established here. They're used to plug doctor shaped holes due to government failure.
They also steal training opportunities from doctors but that's a different discussion.
My understanding is that the course requirements and standards are very different in the US vs the UK.
In the UK, nurse practitioners are generally well trained with lots of experience. Unlike in the US where you have NP degree mills and very low standards. Whereas in the UK it's PAs who have low entry standards, poor levels of experience prior to that and poor standards at PA school.
US PAs are more like UK NPs and US NPs are more like UK PAs
But PA proponents here point to the totally different American model and use it to justify the very different way things are done here
Because the US has lower taxes, and a culture of private health insurance instead, meaning you lot can access an actual Doctor if you'd really like.
Meanwhile we pay higher taxes under the old promise that we don't need to pay for private healthcare and we could see a Doctor through the NHS. But now we can't. We don't have that option, despite paying for it.
It's about choice and expectation.
Government spending on health care per capita is higher in the us than the UK. Overall the taxes might be lower, but Americans pay more in tax for healthcare than we do in the UK.
Snapshot of _I thought I was seeing a GP – but I was misdiagnosed by a physician associate_ : An archived version can be found [here](https://archive.is/?run=1&url=https://inews.co.uk/inews-lifestyle/seeing-gp-misdiagnosed-physician-associate-3137741) or [here.](https://archive.ph/?run=1&url=https://inews.co.uk/inews-lifestyle/seeing-gp-misdiagnosed-physician-associate-3137741) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ukpolitics) if you have any questions or concerns.*
PAs should be nowhere near undifferentiated patients ie ones with a new presenting problem. Assessing such is one of the hardest jobs in medicine especially given the shortage of appointment time. Yes 95 PCT might have a cold but it's the skill to spot that 5pct may have something far more serious.
Pity then that the specialty that needs to deal with said patients is shat on by the population, government, and the media all the time eh.
Went in to see my doctor after being sent to the CMHT and got one of them instead, they wrote in my notes that I had no history of self harm, they never even asked I was wearing a T-shirt and it’s clearly visible, not to mention it was **part of the reason for the referral**
This is like mental health nursing 101. If you’re not asking or noticing (the art of noticing is hammered into all nurses) then you’re not fit to be on the register. Clowns.
My experience has been similar. Missing out key information of medical reports, not knowing why you’ve booked an appointment. I’ve even had one google medical answers right in front of me. Don’t get me wrong PA can be good support when used appropriately but as it stands they do not inspire confident in the NHS.
1. Medicines Act 1983 makes an offence of impersonating a medical doctor. If a PA introduced themselves as Dr X in a GP setting I would be very upset. 2. There’s a decent pot of money for GP Practices to recruit more staff called ARRS. It explicitly forbids Practices from using the money to hire new GPs, getting a PA is the closest option. Wes Streeting has [promised to review ARRS](https://www.gponline.com/labour-will-review-arrs-end-absurd-gp-unemployment-crisis-says-streeting/article/1878744), which may help.
Turns out when you don't really want to pay for services but still expect said services to run, corners will be cut across the board. The entire PA and other letter warble shit will, eventually, result in a multitude of reports that will change fuck all because the entire system will be heavily reliant on them by that time. Entire depts are trying to paper over the cracks by trying to get more "upskilled nurses" or whatever inane letter warble they want to use instead of hiring doctors because you can get three of them for the cost of one doctor. My favourite anecdote has been an endo consultant retiring, the dept hiring two diabetic nurses instead of a new consultant and the remaining consultants suddenly finding their workload massively increasing due to scope of practice AND needing to supervise said diabetic nurses. It's basically going to be a rerun of the maternity scandals which have come about after midwives got pushed just a bit too much, and people suddenly realised that natural births are and were a lot more complicated and dangerous prior to modern medicine.
In fairness I've been, and I know plenty who have been as well, misdiagnosed by an actual GP.
This is a very poor argument for using less well trained people. If something is so difficult that people with decades of training still make mistakes, then I don't see how letting people with a 2 year diploma have a shot won't end in disaster
They're right to bring it up though. This individual case is making the press due to the fact it's currently a hot topic, but individual cases aren't the issue.
It's not really an argument for or against. Just making a point to add context. We'd need to compare average rates of misdiagnosis by GP's and PA's to really make any conclusions
I would love it if the NHS was collecting that data. They aren't though. (I wonder why). And that's not how medical science works anyway. You can't just unleash a new, untested treatment on patients and say "well, we don't have any evidence that it's worse than the gold standard, maybe we should start looking for that". If the NHS wants to introduce a new role they should conduct a pilot studies and trials to actually get that data. They need to do that before experimenting on the UK public.
But it's not a new role.... It's existed for decades.
The fact it’s existed for decades as a mad max be a doctor without Medical school secret passage into medicine, *and* we lack any of this self same data is yet more damning?
Can't really do that, it's a sitting duck for Simpsons Paradox. GPs should be seeing the more complex cases as the triage should point the simple stuff towards the PAs. Just because I get more runs facing Jimmy from the Dog and Duck than David Warner gets facing Stuart Broad, doesn't make me a better batsman.
Fair point
American here, but this isn’t the first anti-PA post I’ve seen on this sub and I’m somewhat confused. Apparently there’s a big controversy over PAs in Britain and the profession isn’t legally well-defined or something to that effect? I don’t understand where a lot of this opposition to PAs is coming from, because here in America PAs are a very well-established field and they regularly handle many of the standard appointments that would otherwise be handled by a physician without controversy. I’ve seen anesthesiologists get up in arms over the existence of nurse anesthetists far more than I’ve seen any sort of opposition to PAs.
Because they're not well established here. They're used to plug doctor shaped holes due to government failure. They also steal training opportunities from doctors but that's a different discussion.
My understanding is that the course requirements and standards are very different in the US vs the UK. In the UK, nurse practitioners are generally well trained with lots of experience. Unlike in the US where you have NP degree mills and very low standards. Whereas in the UK it's PAs who have low entry standards, poor levels of experience prior to that and poor standards at PA school. US PAs are more like UK NPs and US NPs are more like UK PAs But PA proponents here point to the totally different American model and use it to justify the very different way things are done here
Because the US has lower taxes, and a culture of private health insurance instead, meaning you lot can access an actual Doctor if you'd really like. Meanwhile we pay higher taxes under the old promise that we don't need to pay for private healthcare and we could see a Doctor through the NHS. But now we can't. We don't have that option, despite paying for it. It's about choice and expectation.
Government spending on health care per capita is higher in the us than the UK. Overall the taxes might be lower, but Americans pay more in tax for healthcare than we do in the UK.