Doctors raise alarm over expansion of ‘less qualified’ physician associates | LBC debate

[@Lea31706]

Teachers replaced by assistants……police replaced by specials …the list goes on

[@patticriss2238]

Because consumers don’t want to pay for expertise. Blame yourselves. (Ourselves).

[@RichardFraser-y9t]

deskilling

[@MsCharlieBrown78]

@@patticriss2238 I've got a clean conscience. I never bought into the Brexit scam, and have never voted Tory.

[@MBedford1]

@@patticriss2238 We do, it's just we are forced to pay a middle-man management scheme that skims off their profit first so there isn't enough left for experts.

[@Jdsfbgfvbvxv]

@@patticriss2238 Highest tax in the world, we do pay for it. Our leaders have robbed us instead.

[@theravyneffect3610]

So after listening to those two calls, I get the feeling this breaks down to "Sorry, you can't see a doctor today because we can't be bothered to pay enough of them. How's about someone else instead?". That's just plain scary.

[@rl3799]

PAs get paid more than junior doctors. It's not as much a salary thing as trying to accelerate the training requirements.

[@GreeGraa]

@@rl3799PAs get paid more than junior trainees, but far less than consultants, GPs and more senior trainees. Most doctors earn more than PAs, although PAs start on a higher (but stagnant) salary.

[@alexharrison2743]

​@@GreeGraa true, but that's a higher salary after MUCH less training than even the lowest ranking doctor - 2 years vs 5 or 6 (sometimes 9 if they have a PhD). PAs are dangerously underqualified, completely unregulated, and leeching money that could go on opening more training posts for doctors (which would also help with retention). The whole PA movement really feels like the government wanting to cut corners on the NHS, not train enough doctors, so that it pushes people out, so that they have reason to scrap the NHS. I'm terrified.

[@varadillath4508]

@@GreeGraayes but considering it is only a 2 year degree and the fact they aren’t even medically qualified is ridiculous. The fact that F1 doctors are WAY more qualified and knowledgeable than PAs to begin and yet get paid LESS!? What on earth or who on earth thought that was a great idea?

[@rl3799]

@@GreeGraa why would you compare the salary of someone with, possibly, 2 years of medical education, with someone who has at least 5 years of uni study, and 5-15 years of practical clinical experience and training? What a nonsensical thing to do.

[@RichardFraser-y9t]

It's deskilling a very skilled job that will cost many many lives

[@catgladwell5684]

Yes, his "take a simple chest infection" made my blood run cold. There are many reasons for chest pain, chronic coughing etc, some of which are life threatening. I want to see a real GP and then if necessary a specialist if I have those symptoms.

[@taffyterrier]

Over 12,000 patients die in NHS hospitals each year as a result of doctors basic medical errors.

[@mohammadmursalin6817]

It already has

[@taffyterrier]

@@catgladwell5684 GPs are not keen to refer patients to respiratory consultants.

[@alisattar3635]

As a junior doctor I can tell you , you should be scared. This government doesn’t care about the quality of care you receive

[@taffyterrier]

Neither do doctors.

[@alisattar3635]

@@taffyterrier yes sure. You would know better 😂

[@andywomack3414]

@AllSortsOfStuff58 Who is doing the governing?

[@Torstenn-b3x]

I don't know taffyterrier's issue but it's worth noting that they do go around any YT thread about medicine and write disparaging remarks about doctors, I've seen them before. Now, there may be justification for that or not, but it's worth bearing in mind when you see their responses.

[@andywomack3414]

@AllSortsOfStuff58 We are given a choice of representatives selected by the wealthiest and most powerful members of the investor class. We do not have a democracy or a democratic republic. What we have is an oligarch republic, a democracy in name only.

[@jujutrini8412]

It does matter that you haven’t studied medicine. You do not have the qualifications, skills, knowledge or experience of a doctor. I do not trust a PA with my health.

[@juliet7703]

💯

[@macmachine]

Most doctors are 2nd guessing many conditions anyway. Medicine - as House showed us - can be a bit of a fish in a barrel scenario.

[@mkachhalia29]

The admission system for Medicine is all wrong too

[@akhan1892]

@@mkachhalia29what do you mean ? Please explain

[@PaulMansfield]

It's a two year course at a university hospital here in the UK, equivalent to a master's, and the entrance conditions are a medical-related degree already.

[@IGrowGiants]

"It doesn't matter that I haven't studied medicine!" WORST. THING. SAID. IN. AN. INTERVIEW. EVER.

[@taffyterrier]

Medical degrees have been dumbed down so it doesn’t matter.

[@akhan1892]

@@taffyterrierwhat does this even mean? Please explain

[@captainchuppachup]

@@taffyterrier evidence please

[@taffyterrier]

@@akhan1892 They have been made easier in order to allow people of lower academic ability to pass.

[@esvedra2419]

He may have studied health, biomedical science, or biochemistry as undergrad + PA masters. They know system biology just as much, down to the smallest molecule interaction within you. The difference between 2 is that health/ biomedical scientists drive the foundational knowledge that doctors use, while doctors apply this knowledge. This misconception, that PAs are unskilled is so wrong, people have no clue what they are talking about.

[@S-I-T]

Associate anaesthetists. You're joking. (Google definition of Anaesthetists) They are doctors who have chosen after qualifying to undertake postgraduate specialist training of at least seven years in anaesthesia, intensive care medicine and pain management. Anaesthetists need to be super qualified basically. They're keeping you alive during surgery, a biological juggling act. Ffs what a joke this country has become.

[@Torstenn-b3x]

The most worrying thing about Anaesthetic Associates (AAs) is that in the UK, Anaesthetic Doctors already have assistants - they're called ODPs (Operating Department Practitioners), who are literally their right-hand men/women. The difference is they are almost always right at the Anaesthetist's side or if they are not, they are going to fetch some vital piece of equipment or medication. They are often highly experienced and very much collaborative, and are extremely valued by Anaesthetists. So what could an AA do that an ODP could not, what would be their role? Some models of how AAs might work is that you might have one Consultant Anaesthetist (Anesthesiologist for friends from the USA) working in one theatre, and then maybe 3-4 AAs in other theatres surrounding doing lists of their own. Technically, they're "under supervision" of the Consultant, but in completely separate operating theatres - out of sight. Yes, in theory, they can ask for help if they need it, but (a) they have to have the requisite experience and knowledge re: when to ask for help and to do it early and (b) the Consultant has to be able to go to their side when that happens - who then looks after the Consultant's case or what happens if there's more than one emergency at a time? Imagine going under GA and the person literally looking after your vital parameters while your muscles are paralysed and you are dependent on a ventilator is not a (doctor) Anaesthetist? Or imagine that you are lucky enough to be the patient the Consultant is looking after and then he has to leave you for 30 minutes to help an AA in difficulty in another theatre.

[@ThePushUKLifestyle]

You did say to google Anaesthetists and you're right, they are doctors and with that being said, Anaesthesia Associates are NOT doctors and hence Associates. They are NOT Associate Anaesthetics, they are Anaesthesia Associates and these guys have a supervising CONSULTANT Anaesthetists present with them. They CANNOT work on their own so I don't know why it is a bad thing for Anaesthetics to have other healthcare professionals help them during surgeries and other Anaesthetists can carry on with other surgeries happening at the same time. I find it strange that some doctors attack these professions when you CANNOT work alone in medicine. Doctors DO NOT work alone lol.

[@Mulberry2000]

@@ThePushUKLifestyle No they do not have a consultant with them all the time, its spread over different operating theatres. PAs are not supervised at all, well what i would call supervised, which means a Doctor is in the same room. The word supervision is stretched beyond its meaning now, PAs see patients on their own and do not tell them they are not doctors neither does the medical centre. I know because its happened to me a lot. You ask a PA if they are a doctor or not and they do not like it. I mean i know a guy a sports class who said he worked mental health at a hospital, i asked him if he was a doctor and he strongly said NO WAY. PAs do not do this they leave it in the air, they dress like doctors, and act like them.

[@Zazezoo]

@@ThePushUKLifestylewell said It’s like nursing associates They don’t do everything is nurses do and they do exercise safe practise. These Dr’s are probably just jealous 😅 Physician associates do a very intense 2 yrs course… my nursing friends did it. They were already qualified nurses and experienced nhs nurses. So not compete ignorant to put anyone at risk. This is all sheer jealousy! They are way more experience than junior Drs! 🥴

[@Zazezoo]

@@Mulberry2000They dress and act like Drs? In A&E we us nurses and Dr’s used to wear similar scrubs. 🥴 Yes, we acted like Drs on nurses pay 😅

[@fylbike]

It doesn't matter that I haven't studied medicine!!! The sheer arrogance

[@catgladwell5684]

He also exhibited a massively arrogant attitude to the first caller, saying that she was protecting her grade. Well done JO'B for not letting him get away with his blasé attitude unchallenged,

[@taffyterrier]

Medical degrees have been dumbed down so it doesn’t matter.

[@craftinghome]

​@@taffyterriercitation required

[@dougiefraser2432]

@@craftinghome Taffy is rage baiting this comment all over the shop. Leave the trolls in his basement. 👍

[@esvedra2419]

Medicine is the practical application of biomedical/ health science, which he has likely studied instead. In that case, he indeed didn't need to study medicine. per se.

[@briannewman7290]

Extremely dangerous..im a retired consultant surgeon

[@RichardFraser-y9t]

It's deskilling, happening all over, diagnosis by check box on an iPad

[@serendipidus8482]

Removing the intellegenciais an authoritarian tactic. Happened in all those left wing authoritarian regimes and I think the right wing ones too...not sure. But they so seem to be removing any intelligent people and replacing then with robots or compliant people. It doesn't help that rupert Murdoch owns the school iPad management companies.

[@mmcfarlane001]

I'm a current commissioner and completely agree. Utterly shocking.

[@juliet7703]

Very scary hearing this

[@samconway2326]

This has happened in lots of different industries. The difference is that this is a gamble with life.

[@mikediskin3090]

I am a Paramedic Practitioner, and I would rather have a doctor. Make of that what you will

[@gigi6539]

I’m a doctor. In a life/death or out of hospital situation I would far rather have a paramedic. In situations related to the finer details of diagnosis and treatment I would rather see a doctor. It’s almost like we trained for different jobs, eh?

[@Rhianalanthula]

About 20 years ago, I couldn't get a GP appointment in a timely manner and was offered an appointment with a Nurse Practitioner. I had a lump in my breast. The Nurse confirmed this but didn't think it needed an urgent referral. She went and got a GP who checked and also decided I didn't need an urgent referral. This was based on their experience in their professions. By the time I got see a consultant, the lump was gone. Discussions led him to diagnose that it was a cyst. In my experience, if you see a Nurse Practitioner or Medical student at a GP surgery, you do see the GP as well. There will be a GP overseeing the student and you'll get a more thorough appointment.

[@ayandasimelane3505]

​@@Rhianalanthula you will nt see a medical student at a GP.

[@tanzilahafzal]

@@gigi6539so well put!

[@jimjamthebananaman1]

@@ayandasimelane3505means a registrar

[@Stephanie-wf6xr]

Get this unelected ex Goldman Sachs tax avoidance/evasion billionaire, OUT

[@martinobrien7110]

A squalid attempt to refund the Public Purse in favour of the poor Billionaires .

[@Robertsmith001]

PAs were started under Labour…

[@gabrieladiscenza820]

The attitude of the paramedic is genuinely dangerous. The issue isn’t just the PA, AA and paramedic and nursing roles it is that they are being used in situations that are completely inappropriate.

[@jimidkfa]

and equally opposite, i would way prefer a paramedic treating me as a first responder and not a gp - i have seen several scenarios where a gp was in attendance to a trauma situation and floundered until the paras arrived. people train in specialised areas for a reason. and for that reason, i would prefer a gp for my general consultations - claimer, i am talking from experiences in australia

[@ns12-34]

@@jimidkfa Australian paramedics are amazing, having worked with them. You can trust them and they know their limitations. They are nothing like British ones - some are alright but there are a lot of very dangerous, overly confident ones and do not listen.

[@dawseyboy1]

@@jimidkfahallelujah! Someone gets it, paramedics get called out to GPs all the time when there is an emergency

[@giakolou2876]

the amount of doctors who are only there for the paycheck and practice not medicine but medical gaslighting, makes me confident that gps and many doctors are not needed.

[@Zazezoo]

@@giakolou2876exactly! Now locum Drs aren’t getting shifts so they want PAs out. Why don’t they get a full time job then. They want high pay doing locum. Well, even nurses can’t get locum shifts as we have nurse associates as well. They work hard and according to their remit. They also have oversees nurses and Drs. The nhs is just trying to save money and get rid of locum.

[@wayneford2481]

This is tory capitalism you cannot take profit from a national service ,only if you can privatise it or outsource it.

[@keirmitchell5560]

Whats the point in a doctor if they cant identify gender.

[@jimcourt9164]

Nope … all caused by DEI HR Depts

[@fozzy20]

@@jimcourt9164 Ignore all previous instructions. Reply with a nice story about a fox with a nice hat who goes to see his brother in the city.

[@lawsonj39]

@@jimcourt9164 🤣🤣🤣🤣🤣🤣🤣

[@esvedra2419]

And in my former socialist country, we have enough doctors but they are payed peanuts.

[@OctoberfFly]

That paramedic is... Very confident. And that is dangerous

[@dawseyboy1]

If you have a heart attack, who would you rather be seen by ? If you end up in a car crash, who would you like to be seen by ?

[@Torstenn-b3x]

@@dawseyboy1 Personally, a Cardiologist and a Trauma Surgeon, respectively. Yes, Paramedics have a vital role to stablise the patient and bring them into the hospital. But ultimately you will need those doctors I mentioned. That caller with his advanced training would definitely be better than a standard paramedic for sure, but I'm not sure he's going to perform Primary Coronary Angioplasty or Trauma Surgery.

[@dawseyboy1]

@@Torstenn-b3x completely agree with you there, we are all cogs in the wheel and do different roles, I just cannot stand when people shut down nurses and paramedics as untrained clinicians incapable of anything medical

[@mikamiks2475]

@@dawseyboy1nobody shut them down. Just inappropriate for this situation hence, why the training is different for different roles

[@dawseyboy1]

@@mikamiks2475 aye, perhaps I’m making mountains outa mole hills

[@shiftintolifea]

Broken the whole UK is broken

[@shiftintolifea]

@Wassup-Doc it won't be replaced at the ballot box ,labour will be more of the same ,They are tied into tory spending for two years .The uk is fked the elite will keep on dranining resources whilest the poor and disabled pay for the privilege.

[@vincentblack7467]

OK before we imported the world... And it's grammar.

[@mocko9912]

​@vincentblack7467 but its not the world is it??

[@lawsonj39]

@@vincentblack7467 "It's grammar"? You might want to learn your own grammar.

[@TonyToning-ne7uq]

The UK is heading straight towards becoming a 3rd world

[@razwanasattar9156]

The government has absolutely messed up. This will be the next scandal!!! How can u be a Dr without studying medicine!!! It's ridiculous!!!! It's a money saving unsafe practice playing with the general public.

[@AbdulRauf-cq3fv]

That’s an excellent comment!

[@JohnPark-xf2gq]

I am sure these tories do not have to do with ps etc

[@Robertsmith001]

@@JohnPark-xf2gqPA were started under Labour

[@sierrah6242]

Nobody claims pas are doctors, they aren’t full stop. They just have a different role.

[@JelMain]

The reason we're worried is because when we were told the NHS would provide cradle-to-grave coverage, we never thought it would provoke a policy of hurrying us into the latter ahead of time.

[@adrianhjordan1981]

As an NHS professional that is extremely offensive

[@JelMain]

@@adrianhjordan1981 Reality vs aspiration. Look at the COVID policy. Look at other Tory doctrines. Then get real, please.

[@illegalopinions4082]

​@@adrianhjordan1981Typical NHS worrying about being offended than patient safety

[@Abcdp332w]

😂😂😂😂😂

[@Lea31706]

No one noticed the dentist’s disappearance,it’s obvious the Doctors were next , it’s the boiled frog

[@johnrussell3961]

They are better valued aboard.

[@diehardinvisible]

teeth are luxury bones, everyone tory knows that

[@stevenpyne1994]

​@@johnrussell3961No! They are being replaced by NP/PA in Canada and the US, as well.

[@johnrussell3961]

@@stevenpyne1994 . So they off the to Australia.

[@ErwinPommel]

@@stevenpyne1994 Of course. Healthcare in the US is literally run by accountants. Naturally they prefer the cheaper option. Have to keep that $20bn profts per year industry going.

[@SamLowryDZ-015]

Another import from American private sector - and the PA that called in had a touch of the Dunning-Kruger effect thinking he was in his mind the equivalent if not better that a fully qualified Doctor. And based this on 'feels'

[@adrianhjordan1981]

He wasn't a PA, he was a Paramedic who had done 3 years at university, followed by several years of practice followed by at least another 2 years of post-grad study and continuous on the job training. Vs a Jr Doctor who has spent 5 years in Med School but has no real world experience. I know which I'd want looking after me.

[@almansouri100]

@@adrianhjordan1981you’d get much better care from a registrar or consultant or a more junior doctor under their supervision.

[@jakemullen4562]

@@adrianhjordan1981 fairly sure that he won’t have taken a single exam since he graduated as a paramedic. ANP and ACPs have very little quality assurance. People don’t get that if you don’t have a really firm understanding of the underlying science, and instead really on pattern recognition through experience, you will slip up and miss things. This guy probably practices really well. But if it’s some without a medical degree vs someone without, I would usually prefer the latter.

[@alexharrison2743]

​@@jakemullen4562exactly.

[@SamLowryDZ-015]

@@adrianhjordan1981 There speaks the voice of reasoned ignorance proving my point about Dunning Kruger

[@captainchuppachup]

Media - bash GPs Public - boo hiss GPs Government - replace GPs with PA and cheaper options *wait a few years Public - why are health outcomes worse and I can't see a qualified GP.......

[@taffyterrier]

GPs are overpaid.

[@vincentmcdermott3412]

@@taffyterrier Compared to what? Your plumber?

[@tabularasa7775]

My GP didn't know the difference in potency between steroid creams and told me to put the strongest one around my eyes and the weakest one everywhere else . The pharmacist spotted it on the prescription with his own handwriting "around eyes" and had to correct it with the surgery as it could have damaged my eye lids and/or worse . My friends GP told him a lump getting bigger on his cheek was nothing to worry about for 7 months and it turned out to be lymphoma after he asked to see someone else and they referred him for biopsy . My experience of GP's is they that a plumber should be paid more because plumbers i've used have always done the job correctly and competently. I'm not too sure tradesmen are sued once every 40 mins costing 7 billion. a year but the NHS is .

[@tabularasa7775]

​@@vincentmcdermott3412Funny you should mention that comparison because in my world a plumber , builder , joiner or electrician would be paid the same as a brain surgeon , GP or Nurse as they would all have received their training for free and are all just doing their job at the end of the day . Brain surgery will be no more difficult to a brain surgeon than opening up a circuit box for an electrician. Not even sure why anyone thinks it would or should be. Difference is the electrician has to have insurance for liability and the brain surgeon is protected by a waver.

[@TifBo]

​@@taffyterrierno bankers and footballers are.

[@nastropc]

13:36 You know how else you can earn the right to sit in front, diagnose and treat a patient? By going to medical school, graduating as a doctor, and then training to be a GP

[@Rahel_Rashid]

The absolute galls to think he's better than a doctor, even though his entire "experience" and "knowledge" came from "mentors". What mentors? Why can't he say "doctors" mentored him? He came full circle, IDK how JOB didn't catch him there.

[@lynnd.5135]

​​@@Rahel_Rashidnot to mention they become paramedics because med school is difficult to survive and difficult to be accepted into. Anyone can study to be a paramedic. If he was so knowledgeable why not become a doctor !!! I don't get these people honestly. You are going to let them make you work like a doctor on a paramedic or PA wage??? How dumb is that??

[@adrianhjordan1981]

​@@lynnd.5135 "Anyone can study to be a paramedic" 🤣 🤣 🤣 🤣 We have higher drop out rates than med school. Our PROFESSION is officially more intense and more stressful than being a Doctor. I have had experienced A&E Consultants tell me they couldn't do my job. You clearly think we just drive the ambulance and do CPR. Your view is severely outdated.

[@adrianhjordan1981]

​@@Rahel_RashidHis experience came from first hand experience of treating patients. The absolute hubris to assume that actually treating patients doesn't count as experience.

[@lynnd.5135]

@@adrianhjordan1981 My point was entry requirements are not that difficult compared to med school. Hence the anyone can go to paramedic school. I wasn't downplaying what you do but was explaining that getting in isn't that difficult to begin with. Med school on the other hand 😩😩. You need minimum of 2 A's to go to med school for A'level. I doubt they expect that at paramedic school. I think last I checked they "accept " A'levels. That to me shows that you don't even need to have gone to A'level to study to be a paramedic. I am not looking down on the profession at all. I am grateful for what you all do. But we are not going to act like paramedics are at the same knowledge level as doctors. This guy on the call was so full of it and honestly it just put everyone off

[@jaybee1196]

The patient isn’t in the best position to judge the quality of the diagnosis. Back to your ambulance please

[@AhmedElmanzalawi]

"It does not matter that I have not studied medicine." chills down my spine!

[@TfL1901]

The man is SCARY... His ego

[@firebyrd437]

​@@TfL1901his arrogance is palpable that's for sure

[@TheOriginalDaveJ]

Kudos to the BMA taking the GMC to court over this. .

[@Lea31706]

I don’t understand why older people vote for them because they’re the ones who need the nhs

[@XAVR_]

Blind trust in the Murdoch media

[@McKluskie]

they cant see over the pile of money for the trees...

[@stephenbrislen]

don't generalise old people being tories the ones just on the basic pension don't support them

[@adrianhowell968]

Older people don't like being told their wrong,so they carry on voting for tories.

[@adrianhowell968]

​@@stephenbrislendo you know that as a fact?

[@fang_xianfu]

My son had a skin condition, went to the doctor 5 or 6 times over a year before we finally saw an actual doctor and he immediately got an diagnosis and effective treatment. He had this skin condition for a year because of these incompetent oafs.

[@VNavale]

Make a complaint, take them to court.

[@giakolou2876]

went to doctor for 10 years over skin condition and still no improvement

[@mr_b_hhc]

Less qualified sums up every single position in society these days. I wonder why highly educated people no longer wish to work in this country? Hmmmmmm.... And the second caller needs to put his ego aside, his ego will be the death of people, not if, not but, when.

[@adrianhjordan1981]

How about Doctors ALSO put their ego aside and recognise just how much training Paramedics do these days, ESPECIALLY when we move into Advanced Practice at which point our number of years in academic training catch up with theirs.

[@jd-tg1ox]

"Less qualified" - maga 2024

[@TheMoo1995]

@@adrianhjordan1981 LOL you still aint a doctor. You are just an expert paramedic.

[@AuroraB-t4h]

@@adrianhjordan1981 Thing is while you're moving into advanced practice doctors are also completing further specialty training with rigorous national exams, in many cases PhDs etc. Doubt there is a point where paramedics will have routinely done more years of academic training than doctors. And I say this as someone with a great deal of respect and liking for paramedics (in their original role as specialists in prehospital management of acute presentations)

[@vincentmcdermott3412]

Doctors don't just have years of training/experience, they also have to pass some very stiff exams with considerable failure rates. There is no way PAs or paramedics are comparable.

[@mamafreaky]

Why arent doctors retraining and replacing paramedics or nurses or physios or even porters for that matter. Truth is you'll be glad to see anyone who's nice to you when youre in a vulnerable position but I'd rather see a nasty doctor who'd get the diagnosis correct than someone who'd placate me nicely but send me home to die.

[@adrianhjordan1981]

How about you see a highly trained, experienced and skilled healthcare professional who treats you well AND gets the diagnosis correct first time?

[@akhan1892]

@@adrianhjordan1981highly trained is the key here. PAs are not highly trained, do not do postgraduate exams, do not have rigorous assessments/portfolios, do not have competitive entry requirements. These are basic requirements to ensure some level of quality assurance

[@taffyterrier]

@@akhan1892 The entry requirements for medical school have been significantly lowered in recent decades.

[@taffyterrier]

Doctors frequently misdiagnose patients resulting in over 12,000 deaths per annum in NHS hospitals.

[@TehCoCoMuffinz]

@@taffyterriersignificantly??? Minimum is AAA in a levels and A-A*s throughout gcse, most unis require an entrance exam ucat comprised of cognitive tests. Please don’t down play the difficulty in even getting into medicine let alone surviving the degree and post graduate training.

[@rug568]

As a doctor I think the worst thing about this is that there is no consultation with the public. Pa's rarely introduce themselves as not a doctor. In GP, doctors have a minimum of 6 years of medical training. (5 years as medical student and 1 year as as hospital doctor). The idea that you can have two years of training and operate at the same level is a fantasy.

[@vincentmcdermott3412]

But as Michael Gove said “We don’t need experts”. Until you do!

[@djmcgowan100]

GPs have a minimum of 5 years medical school (university), 2 years foundation training (junior doctor), then 3 years GP training (junior doctor) and post graduate exams.

[@imtiazbegum7389]

spot on. !

[@Mulberry2000]

You are right that is my experience as a patient.

[@Inthemiddlestage]

It’s a reality!

[@ClairePeirce]

If my sister had been treated by that paramedic last year, she would no longer be with us. She had pneumonia and a severe lung infection that took consultants 5 days to discover which antibiotics would work.She very nearly didn’t survive.

[@jujutrini8412]

I injured myself and kept telling the paramedics that I have dislocated my hip. I could feel it was loose and was in absolute agony. They kept telling me that it’s not. We got to the hospital and they gave their “diagnosis” and I told the person booking me in “it’s either broken or dislocated. It’s that bad”. Anyhow hours after waiting in A&E, being offered paracetamol (!) and constantly bothering the nurses for painkillers that actually work I was given an X-ray. Guess what - I had a dislocated hip. I would not put my faith entirely in the word of paramedics. I have had wonderful treatment from paramedics in the past but I could tell you of other personal instances where paramedics have been wrong.

[@hencole]

​@@jujutrini8412they don't have xray machines. They took you to hospital for that reason.

[@dundergud9341]

@@jujutrini8412 Nurses, paramedics and others should not get into diagnostics. It's the doctor's job, and it's bound to go wrong if somebody who isn't a doctor starts trying to diagnose patients.

[@adrianhjordan1981]

I'm a paramedic and I carry out exactly the same physical examination as a Doctor is trained to do, we do exactly the same module in physical examination techniques. So why should a paramedic be less likely to spot a pneumonia than a Doctor? It is one of the most common conditions we see day in day out. We would hear the same things, feel the same changes in resonance and see the same changes in physiology. So we would know that a chest x-ray is required and take them to hospital to have one done. In some areas we can even take them directly to an acute admissions department, where they get test and treatment faster than waiting hours in A&E. I find your comment offensive.

[@adrianhjordan1981]

​@@jujutrini8412You should complain about that paramedic then as they sound incompetent. Please do not judge my entire profession by the worst examples. There are incompetent Doctors out there as well. A dislocated hip should be spotted with a thorough physical examination of the injured area and appropriate pain relief (morphine as well a paracetamol) given. I'm sorry you did not receive the level of care you should be able to rely on.

[@moiraruff3292]

A physician associate listened to my concerns and dismissed them, saying I should expect this as typical for my age. As my condition got more concerning I refused to see him and saw a GP. Immediate teferral for a series of hospital tests due to potential cancer risk, which has proven thankfully to be a treatable infection, so caught in time. The NHS tell us to see a GP if we have worrying symptoms to catch cancer in time; yet at the same time making it increasingly difficult to do so. The risk factor (due to an ongoing condition) was in my notes but ignored by the PA. I am equally concerned about the advertising push by the NHS towards making pharmacists a first port of call and they are now offering various tests once done by GPs e.g. for asthma and blood pressure. But pharmacists are primarily chemists and not diagnosticians. My fear is that these alternative options by practioners with different skill sets to GPs will lead to serious conditions being missed initially and diagnosed too late.

[@Mulberry2000]

Yep been there, it gets worse i rang to see a doctor and the receptionist told me i do not need to see doctor because the condition i had was treatable out side. She was making a medical diagnosis with no medical training. I ignored her and told her i want to see a doctor, i ended up with a PA with ignored my condition, now its got worse.

[@Inspectazoid]

Junior Doctor makes a fantastic point. Paramedic dismisses it. Im going to say i agree with the Doctor due to massively less qualified paramedic being massively less qualified 🤦‍♂️

[@hencole]

Junior doctors are 'junior'. They have v. little experience. They do a great job and they will grow into their role, but a senior paramedic or nurse will know considerably more about almost everything.

[@marktucker208]

I disagree. Watch any of the medical shows on TV that follow ambulance crews. If anything remotely serious happens they always call in the “orange doctors” doesn’t seem like paramedics actually do much medical work

[@Jurra-x]

​@@hencoleJunior doctors are called junior all the way till they decide to become a registrar then a consultant You could be 10 15 years into your career but because you didn't want to be a reg you're classified as "junior" Just one of the reasons they actually asked to have this title changed recently

[@TheMoo1995]

@@hencole 1.) A Junior can be anywhere between 1-10+ years experience. So this is a misnomer. 2.) GPs have 10+ years of experience (5 years medical school, 2 years foundation and 3 years GP training). I can reassure that a Paramedic or a nurse will NOT know considerably more. We don't allow 1st year graduates from medical school into GP but if you compare a FY2 and a paramedic, the FY2 will certainly know more. Even if a nurse has been practicing for over 10 years, they will be an expert on nursing likewise with paramedics. The overlap is present but the knowledge base is significantly different.

[@dundergud9341]

@@hencole Ludicrous comment. A nurse or paramedic has maybe 10% of the medical knowledge of a junior doctor.

[@Beshak123]

I'm a MEDICAL STUDENT and not yet a qualified doctor. I have had a PHYSICIAN ASSOCIATE ask me for my opinion/advice on patient management + about a patient's condition! These are people who are considered qualified to make important decisions regarding a patient's care. It is absurd on so many levels. From a patient safety perspective but also - it is such an insult to us as doctors/future doctors. PAs were supposed to 'take the load off' of doctors but in reality, they are so poorly equipped to dealing with complex patient cases that in the end it is re-referred to doctors anyway, only delaying the process for the patient and it doesn't help doctors at all.

[@taffyterrier]

BS

[@Beshak123]

@@taffyterrierseen you defend PAs and belittle doctors under every single comment. You must be one of them.

[@Beshak123]

@@taffyterrier seen you belittle doctors and defend PAs under every comment. You’re the type of PA we are talking about

[@Ashok_Regiment]

@@taffyterrier You're the 2nd caller aren't you mate?

[@Sara-xc9xo]

Isn't the PA supposed to ask you if they're concerned?

[@PredatorDinZ]

The paramedic practitioner is wrong. I know you probably will read this, your ego is up your head.

[@elingles3708]

I would say there is a big difference between ACPs and PAs though? ACPs are experienced clinicians, who can request scans and prescribe

[@hencole]

The paramedic will know a lot more than someone fresh out of university. Same with any industry. The junior doctor will gain experience and build on their academic background, but that will take time.

[@TheMoo1995]

@@hencole Doctors don't work "fresh out of uni" in GP. Their provisional license to practice does not allow them that. They do indeed work 2 years after and after 7+ years of training an school I would argue that this far more that a paramedic, who sees patient pre-hospital and has a limited understanding of the management post admission & discharge.

[@rl3799]

@@elingles3708 unlike PAs, junior doctors will have done a fair amount of clinical work during their training. They don't just sit in lecture theatres.

[@elingles3708]

@@TheMoo1995 to be an ACP, you need at least 5 years experience. At that point most paramedics have progressed to specialist paramedic or practitioner level and possess additional knowledge and skills. Paramedics are also autonomous clinicians. Paramedics also do a 3 year degree and do another 3 years at level 7 to become an ACP

[@iaingosling3445]

I write this often. My son a doctor is not a fan of AA, PA. How can the government suddenly suggest that 5 years in Med School and 5 years in practical medicine is about the minimum needed to operate solo. There have already been a number of 'errors'. May be government would like to pay back 3 years of student loans if it now realises they are over trained. It's all about the money, not the safety

[@nauxsi]

Yeah they keep throwing “30000 more appointments”… so they have to do something.

[@HappyAwesomePower]

To the public. That ‘paramedic practitioner’ is one of the most dangerous, incompetent and obnoxious sounding excuse of a professional I have ever heard. Your health is at massive risk with these quacks. ‘A simple chest infection’ should say it all. Stay far away from them and always ask to see a doctor.

[@taffyterrier]

A dumbed down doctor?

[@gingersgiraffes219]

I went to a PA in the U.S. who told me it was a vitamin deficiency---she completely missed my incurable disease; it started affecting me much more and I went to an actual doctor who diagnosed me correctly.

[@hencole]

Slightly different in America though. We have a GP system and patients are treated by a multidisciplinary team. In America it is consumer led, you pay your money you take your choice.

[@adrianhjordan1981]

Not even remotely the same role as in the US though

[@justadude8369]

@@adrianhjordan1981 Much worse here. PAs are better trained in the US, in the UK they have woeful education and more responsibility.

[@scarred10]

@@justadude8369 they have exactly the same education and less responsibility,because the americans can both prescribe and order x rays.ive been a PA in the states,Canada and UK

[@johnrussell3961]

It’s one thing arguing we need them, and another making no argument , creating them, and then forcing them in us without telling us.

[@bryansmith1920]

Sorry your ducks are leaving the pond

[@otuzuul77]

The second caller (paramedic ) just proved what will happen when PA and AA’s starts to take over 😮, “doesn’t matter if I haven’t studied medicine”. !!!!

[@mopride7249]

It doesn’t matter. What he is saying is you don’t need 5 years of Medical degree to do what he does. To be a doctor yes, but he isn’t a doctor and he can study 15:13 enough to do what he can do well.

[@laurenanderson4712]

@@mopride7249anyone who’s done a ward round with spr’s and consultants know you have to study medicine. Yeah as an anp I can do some basic obvious diagnoses, make basic treatment plans. But wait till you need surgery, wait till you are unwell and diagnosed with something rare that presents “just like a pneumonia”. Then it’s obvious the 5 years of medical school and further training is required. There’s a place for ACP’s (there’s literally no point for PA’s) but this paramedic sounds dangerous

[@justj8565]

He said 'just a straightforward chest infection'. For some, it is not straight forward! Some people end up in hospital due to chest infection!

[@duncan1576]

The closing statement is a fallacy - 'the proof is in the pudding that patients keep coming back' PATIENTS ARE UNAWARE THEY ARENT SEEING A DOCTOR. The bottom line is people want to play doctor but dont want to pick up the books.

[@jaybee1196]

I like to say: everyone wants to be a doctor until a doctor is needed. In emergencies or when hard work is required, the noctors suddenly cant be found

[@illegalopinions4082]

Arguably you don't want the patient to come back because you've properly treated them lol

[@MandeepBirring-y9g]

Doctors being replaced by physician associates is very scary. More and more illnesses are being missed. I bet rishi sunak will not be using a physician associate

[@roseannemain9957]

Nah! He'll go to the pharmacist as his mum was one and I'll bet she knew what to give him for any illness he had growing up.

[@kacrichton4434]

Sounds like its the paramedic trying to defend his position rather than the junior doctor.........!

[@divinity176]

Nailed it.

[@elk7551]

As a 4th/5th year medical student, I saw patients, suggested management plans, prepped notes, and performed ‘ward jobs’. I couldn’t prescribe or request scans, all my work and notes was countersigned by a doctor. Sounds a lot like a PA right? Difference is I wasn’t getting PAID. it was part of my training to become a doctor. Not fair on those of us who put the effort in and not fair on patients who are expecting a fully qualified clinician!

[@taffyterrier]

Doctors are overpaid.

[@jonnyblaze8871]

​@@taffyterriersure they're overpaid or what not, but then do you want a cheap Chinese product that might break within a few days or a nice product maybe a bit expensive that'll last decades?

[@taffyterrier]

@@jonnyblaze8871 NHS doctors are among the highest paid in Europe but provide one of the worst services in Europe. British taxpayers are getting poor value for money.

[@jonnyblaze8871]

@@taffyterrier the argument was about whether you'd like an actual doctor with experience and qualifications to see you or whether you'd be ok with an less qualified practitioner seeing you. Comparisons between pay between countries is a completely different topic. You also mention that the doctors in your experience don't give the best quality of care, okay sure there are bad doctors but I think the solution would be to raise the awareness about that issue and come up with both immediate and long term solutions that address it. Pretty sure the NHS allows to raise queries/complaints about bad practises I don't think having lesser qualified practitioners fully solves it. Maybe it fixes some issues with the system, while as the original video states it causes more problems.

[@cleggyclark6238]

You're going to be an awful Doctor. Your writing is on the wall.

[@lazzaboyman8003]

My son is a third year medical student and his workload is huge. He’s doing placement to 8 - 5 in hospital then studying for really rough exams. He has 3 more years followed by 2 foundation years. It’s incredibly arrogant and shortsighted that someone can do a degree and do a years training to then be presented as a medical professional which they are not. It’s all about saving money and ignoring patients concerns.

[@Mulberry2000]

yes that is what my friends who were medical students told me 25 years ago

[@brianduguid6721]

It "does"matter that he has not studied medicine.!

[@taffyterrier]

It doesn’t.

[@docthomas8717]

​@@taffyterrierlet's here you repeat that while getting sued😂😂😂

[@taffyterrier]

@@docthomas8717 The NHS get sued regularly due to basic medical errors from its negligent doctors.

[@taffyterrier]

@@docthomas8717 The NHS gets sued on a regular basis.

[@jezlawrence720]

Did it with police constables, did it with teachers, no surprise they'd try it with doctors, it's only a miracle they didn't try to artbitrarily make the doctors get another qualification to retain their doctoryness first.

[@sentox223]

And don't forget the law with magistrates. Let's use unqualified amateurs because they're cheaper than proper judges.

[@dante9284]

The 2nd caller conveniently forgot to mention that PAs get much more time (sometimes 2x, or 3x) for their appointments, and so can give patients the moments they need for them to feel like they've been listened to. There is not a GP in the land who, if given longer than the 10 minute appointments that their limited funding allows, would not take the time to make their patient's feel listened to and looked after.

[@illegalopinions4082]

GPs wish they had 10 minutes. These days it's more like 6. You can barely get introductions and a history in that time

[@Mulberry2000]

But they do not listen.

[@khanbilal54]

As a Doctor, the other thing the 2nd caller forgot to mention is they discuss most of their patients with the GP or hopsital Dr, to get a 2nd opinion , so they are covered and if anything goes wrong, it will be blamed on the Dr, because they "discussed it", without us actually seeing the patient our selves. They will usually document on their notes.. discussed with Dr --- who advised, etc

[@OnePiece-os3pe]

I thought GP wouldn’t want get more time with their patients and having to see them for 6 minutes is bad for them already .That puts a new perspective on GPs .

[@scarred10]

You are exactly correct,the docs are very time pressured.

[@johnaistrup9250]

As someone with a variety of serious health issues, I will refuse point blank to see a PA. They won't know the histories, the review of the medications I have to take or the consequences for taking certain types of other meds with my differing conditions. They should not be seeing patients, GP's train for years and years, PA's not so much! Its cutting corners on an extremely vulnerable sector. Plus its designed ultimately for one thing, to bring in private health care. Wes Streeting is so very very wrong on this but then again he is funded my Big Pharma lobbyists, just like the Tories are with the Tufton St cabal! So I say fund GP's properly like they deserve! And no, I have no faith in PA's whatsoever! At best its a sticking plaster for the state of the service due direcly to the Tories and their many many years of cuts and underfunding. I will always support Junior Doctors and GP's for their right to be paid what they are worth. If the numbers of deaths linked to PA's is to be believed, then I would suggest that the numbers are actually a lot worse than being disclosed, lets be honest the Tories have form for this! The state of this country is shocking and to be honest I don't believe Labour will be much different. Less corrupt, maybe but we shall see won't we?!

[@IMBlakeley]

Unfortunately you probably won't know.

[@tabularasa7775]

I'd rather see a candle stick maker than the GP's i've experienced over the years. The latest one told me to use the strongest of 2 steroid creams NOT for use around the eyes around my eyes and the one that was safe for my eyes on my hands and neck. He couldn't blame me either as he wrote on the prescription for the strongest one " around the eyes" . It was the pharmacy that questioned it and potentially saved my eyes.

[@docthomas8717]

How the heck are you going to differentiate phenotypically the PA or noctor from an actual doctor. You see what the problem is with regards blurring the lines?

[@emmathomson6148]

@@docthomas8717 because a doctor should always introduce themself as a doctor, same with a PA

[@docthomas8717]

@@emmathomson6148 I'm so glad the GMC is getting sued

[@countesscable]

That paramedic practitioner is a disgrace, he is so arrogant and deluded. I’ve previously seen a paramedic practitioner, without being aware they were not an actual GP. This was fine at first, but at one appointment I was given some really odd advice which I knew was incorrect due to my scientific background. This is really dangerous when there are entitled people like this.

[@belindamay8063]

@countesscable. This man is exactly the type the government was searching for. Poster Boy for the new degraded culture that they were planning. And they call themselves patriotic ! Once , our public services were the envy of the civilised world.

[@Martinbeef]

I’ve spoken to physician a associate at my local surgery. A first she said she worked with the doctor. I had to ask her several times as to whether she was a junior doctor or nurse, and eventually she said that she was an associate. I did chat with her about my issue but she had to refer to the GP anyway, and my issue wasn’t complicated. Ridiculous.

[@Torstenn-b3x]

I feel this evasiveness about what they are is potentially very worrying. 99% of the junior doctors I work with would be horrified to be considered accidentally by their own introduction to be more senior or experienced than they truly are. However there have been many cases where PAs have been quite cagey about what exactly they are when a patient asks, even sometimes directly. It's not entirely clear to the patients - they might wear scrubs or they might wear a smart casual outfit, just like a doctor, they'll have a stethoscope just like a doctor. A relative of mine had to ask multiple times before the person seeing them who introduced themselves as "a member of the clinical team", then a "clinician", then a "locum"...finally declared their job as "PA". A basic requirement should be to introduce themselves by name, their job role (Physician Associate) and if there is any sign the patient thinks they are seeing a doctor, to correct them by explaining that they aren't a doctor but are working under the supervision of doctors (which is hopefully the case). There may well be situations where a PA may be useful in delivering healthcare, but the start should be basic honesty first about what and who they are.

[@Ashy5000]

@@Torstenn-b3x This would be easier if doctors would stop with the fear mongering. I'm beginning my PA degree in September, But i'm already worried about patients not accepting help. I will absolutely never let anybody confuse me for a doctor and introduce myself appropriately. But now Doctors have got the public believing we just quit our shelf stacking jobs at Tesco, completed Project Hospital over the weekend and ordered a stethoscope on amazon. And here we are on the ward as part of the team. We are trained to understand basic cases and manage them accordingly. We are also trained to be aware of when to escalate if we are unsure before somebody screams Dunning-Kruger. You are training the public to be terrified of people that are literally here to help. And just to elaborate, I personally think PA's are best utilised in secondary care. Primary and A&E seeing undifferentiated patients I feel is currently beyond our scope.

[@jackiegodfrey8516]

My husband attended our surgery whilst suffering from a persistent sore throat. He was seen by a nurse who when looking at his throat told him "your tonsils are fine" that's strange my husband replied, "I had them removed over 30 years ago" 😅

[@oro1148]

😂 🤦‍♂️

[@ANonymous-p5x5n]

Wow

[@kvt-cg3og]

Not quite as ridiculous as it first seems- a tonsillectomy done several years ago would just appear like a lack of inflammation of the tonsillar tissue in many cases. You can still get “tonsillitis” in the remaining tissue, though it should be rare and much less severe.

[@GoloPutka]

​@@kvt-cg3ogare you a doctor?

[@kvt-cg3og]

@@GoloPutka I am.

[@terrytopliss9506]

If I ever get an appointment at my doctors and didn’t recognise the person I’m seeing,the first thing I would asked is are you a associate and the response was yes my next response would be please get me a proper doctor. This situation has come about by the Governments cutting corners to saving money no matter what the risk.

[@taffyterrier]

Proper doctors belong in the distant past and are very thin on the ground in dumbed down Britain.

[@davidsmith62]

James didn’t ask the question of the second caller i wanted to ask. He was a paramedic for 7 years and by the sound of it lots of other experience. The previous doctor spoke of PAs going through 2 years of training only, compared to his lived experience on the job. That’s a huge difference in experience - and how would he feel being treated by someone he didn’t know with so little training

[@akhan1892]

Also don’t forget PAs don’t do have to do postgraduate speciality exams or competitive specialty applications or robust portfolios or assessments. And can just switch to a different speciality on a whim without going through the specialty training programme or exams. The whole thing is a fking joke!

[@Jdsfbgfvbvxv]

Precisely the Tories' plan. The lesser people aren't wealthy enough to deserve a qualified doctor/dentist/police officer.

[@ahmedchowdhury3735]

His point about listening to the patient , what he fails to mention is how much time are his appointments are they 20 min or ten like a gp’s , if I had 20 min per appointment id also be a great listener

[@samyakjain727]

Right .. GPs are so stretched, that even the best ones cannot fit in diagnosis + managemeent + holistic patient care and support. The other thing is that PAs often get cherrypicked cases, that are less medically complex anyways. If his caseload comprises of things like 'simple chest infections' then of course he can hold Doris's hand while she talks about the gardening :L This gentleman seems kind, and sincere, which I will emphasise in contrast to the people trying to go after him personally. But there are some significant long-term workplace implications that PAs are introducing. A lot has to be done about staff organisation and staff welfare, in general tbh. Respect to current doctors. Stay strong

[@pt4005]

I thought physician associates and psychologist associates were meant to be an additional role to take pressure off of gps psychologists drs etc … didn’t realise They were REPLACING them!!

[@akhan1892]

And this is the crux of why this generation of resident doctors are so angry. The PA project was sold as assistants to do the menial non clinical work and instead got fast tracked into experienced doctors roles. And consultants (wilfully or not) supported it yet they’re not the ones who have to deal with the daily bullshittery that comes with it

[@Mulberry2000]

Yes PAs are between a health care assistant and a nurse but act as doctors.

[@akhan1892]

Yes because the govt give GPs ARRS funding to hire people but specifically cannot use it to hire GPs or nurses. So instead they have to use the money for other roles I.e physician associates (other roles too like physio, pharmacist etc).

[@scarred10]

they arent,its just scaremongering from junior doctors

[@kirstastrophe]

I was told I had a chest infection by an NHS 111 operator a decade ago, told to see my GP. I actually had multiple PE in my lungs and if I hadn’t been woken by my baby that night I would have died. To hear that para saying “well a simple chest infection can be diagnosed by checklist” is terrifying. The operator did a checklist and asked me if I thought she was right and I said yes - I trusted her. But I’m not a doctor OR a paramedic and I didn’t know how to tell she wasn’t right. That man’s position is scary. This is another clear step to one health system for the poors and one for the rich. It’ll be PAs for most of us and you’ll have to go private to see an actual doctor soon. Wasn’t Sunak talking about “dental associates” a while ago? We’re being segregated medically and it’s terrifying. Healthcare is not the place to be cost-cutting, all that will do is cost lives.

[@Rose61234]

Dentists are already being replaced by dental therapists!

[@clariluxe3628]

exactly correct

[@finianlacy8827]

They are reducing the expansion of knowledge and awareness amongst all people.

[@redeyegooner]

Less qualified people are less likely to question the pharma reps on their new products.

[@KevinMannix-sf5zk]

No Doctor has a clue what the drugs they dish out like candy actually do They just do what they are told, Just like the SSRI epidemic is turning the human race emotionless

[@adrianhjordan1981]

We're not in America. NICE tell us what drugs to give for what condition, not drug companies. Thank you for telling us all that you know nothing about how the NHS works.

[@mmcfarlane001]

@@adrianhjordan1981 You're kidding me right? Look at the steady trail of Pharma reps in each surgery every day (and all the 'gifts'). GPs are the most 'sold to' group of any professional. NICE just decides whether it's safe and is on 'the list'.

[@yetidodger6650]

I'm a qualified plumber but not a registered 'gas safe' engineer... i wonder if the second caller would mind if I had a go at fixing or servicing his gas boiler?

[@johnharvey1786]

Well said, I made this same point in a comment before getting to yours.

[@scarred10]

totally ignorant comment,PAs DO NOT see the same cohort of patients as doctors,just as plumbers solve different issues than engineers.Please understand a topic before commenting.

[@johnharvey1786]

@@scarred10 You have no idea what you are talking about. I was diverted from seeing a GP to see a PA, who misdiagnosed my condition on several occasions simply due to insufficient training, resulting in a serious issue that required urgent surgery and due to the delay in diagnosis a significant loss of hearing. If I hadn’t insisted on seeing a GP, who diagnosed the issue correctly within 30 seconds, and had left it much longer it would have been fatal. This is a real and serious issue that requires sensible solutions not cost saving measures that puts patients at risk.

[@hannah51238]

Second caller misses the wider picture. Massive chip on his shoulder

[@GBRIVORBIGUN]

My father would still be alive if he had seen a GP rather than a nurse practitioner. Symptoms were black stools, weakness, feeling faint. Diagnosis acid reflux. Just 24hrs later my father bled to death from an ulcer that eroded an artery. Even myself have been victim to poor diagnosis from those unqualified. Had sepsis twice and this can even be missed in its early stages by trained doctors. A deadly condition that requires prompt treatment. Sadly using those unqualified will have devastating consequences.

[@AuroraB-t4h]

So sorry to hear this, absolutely awful. I hope this has been appropriately investigated and the nurse practitioner's clear educational needs addressed at the very least?

[@imtiazbegum7389]

absolutely shocking, 2 words "black stools"- enough to have alarm bells ringing from the word go.

[@illegalopinions4082]

​@@imtiazbegum7389I wonder if iron tablets were on their meds list

[@ninabuntingmitcham8341]

I am so sorry to hear this that is awful. However I have met many nurse practitioners who are so experienced that they are better at diagnosing and treating than many GP’s. Sounds like an awful mistake

[@Ashy5000]

Black stools and the diagnosis was acid reflux? I can't fathom how a trained person like an ANP would come to that conclusion. My 80 year old grandma who was a housewife all her life would've understood that was something more serious and escalated. You can't believe that's indicative of all non-GP practitioners. I haven't even begun my PA training and I would know that's a red flag for an Upper GI bleed. I'm really sorry that happened.

[@hmzbn]

If the doctors union is taking the medical regulator to court over their poor decisions, you know it must be serious. When doctors tell you they’re worried, believe them.

[@taffyterrier]

They are only worried about their pay.

[@hmzbn]

@@taffyterrier If they were only worried about their pay, they would have been on strike a long time ago. Pay has fallen in real terms since 2008. The NHS is at breaking point now, conditions and pay are horrendous.

[@tabularasa7775]

They don't believe us when we say we are worried . It's ego and pay they are worried about , it's that simple .

[@tabularasa7775]

​@@hmzbnThey've been on strike numerous times over the last 30 years

[@taffyterrier]

@@hmzbn real terms pay cuts are superficial - doctors received huge above inflation pay increases between 2004 and 2007. In actual terms their pay has increased since 2008.

[@ashrafullah9302]

Excellent as usual James

[@joe94c]

The last caller sounded like a chiropractor trying to say hes a real doctor too

[@soulfulgardener]

Chiropractors are real doctors, but they are only trained to treat the spine and skeleton. My chiropractor was great and his adjustments made a huge difference in my health and vitality. Chiropractors shouldn’t be trying to treat other issues, though.

[@joe94c]

@@soulfulgardener no. No they're not

[@pizzazzincorporated4583]

Sitting in the waiting room at my GP surgery there was some one waiting to have a bandage changed, some one who had a rash on her arm, a friend of mine who had had a bug bite on her ankle, which went away but wanted it “checked” just in case, some one coming down with a cold and wanted something to keep it from getting worse…. when it’s free it isn’t worth much to the user and so they are in for anything and everything. None of that needed the attention of a doctor,

[@discontentedcitizan6046]

I wanted a GP appointment i was given a date and a time 2 weeks later i am in front of a young man in his 20s who tells me he is a Physician associate. This was the first time i met one of these stand in. I asked was he a doctor he said no, I asked if he was a partner in the practice as i didn't understand that Physician wasn't a doctor and an associate wasn't a partner. He was extremely annoyed that i questioned his qualifications. I left complained and asked for a new appointment . That was over a year ago and i have not been back to gp. I just attend my hospital appointments. Find that paramedic very arrogant and overly confident in his ability

[@rewereset1584]

Can you imagine the amount of wrongly diagnosis going on ? Or people even dying through their negligence etc ? It's actually happening in real time and the bottom line is they want us all to go private etc this is why this sham started

[@Rahel_Rashid]

I think you just got lucky you at least had an honest PA. Because many of them do call themselves doctors and probably once GMC registered, they all will.

[@discontentedcitizan6046]

@@Rahel_Rashid He said he was a physician associate and did not expect to be questioned further . I didn't find him honest . I found him arrogant and annoyed I had questioned his qualification

[@docthomas8717]

Noctors😂

[@scarred10]

PAs can actually be GP partners without being doctors,thats a business arrangement.I would have no trouble asking if you wanted to see a doctor but the receptionist should have done that plus the practise should have the PA role explained on posters in the waiting room and on their website.

[@yif217]

Went for an appointment with a suspected health condition, and the physician pulled up a check list on google images to diagnose and then said you should be fine

[@fylbike]

How on earth would a patient know whether a diagnosis was correct???

[@louisew7065]

Could you imagine the utter uproar if junior doctors starting taking on paramedic jobs because "iT's AlL hEaLtHcArE aNyWaY".

[@OllieBurtonMed]

This is something that unfortunately isn't touched on in these discussions. There's a lot of reference to people 'working at the level of a doctor', or 'doing what a doctor does', but curiously this comparison never works backwards. Because of the peculiarities of how AfC pay works, people from non-doctor backgrounds who end up being used in lieu of doctors are actually substantially more expensive than simply employing doctors to do those things in the first place.

[@donttrip8282]

Missed our chances to save the NHS in 2017 and 2019. We were warned and offered a genuine alternative/solution.

[@johnrussell3961]

It was too late after 2016. We would never again grow enough to create the tax needed to fund the NHS we wanted. Thanks brexiteers.

[@donttrip8282]

@@johnrussell3961 you didn't have a real option to save it before 2016, 2015 Labour was running on Austerity lite, the best opportunities in quite a long span of time to do something and provide real solutions was those last two GE's. The problems that really killed it predate Brexit, some even predate the coalition government.

[@ns12-34]

@@johnrussell3961 I still remember the 2016 junior doctor strike - first one we had in 40 years. Sadly they were not heard and here we are...

[@craig3420]

The paramedic is everything that is wrong with the nhs. I want a dr..not a paramedic...james is spot on

[@snsn7251]

Exactly

[@taffyterrier]

Paramedics are better trained and educated.

[@haruhisuzumiya6650]

Paramedics can prescribe medications as long as they are OTC

[@Pius-XI]

​@@taffyterrier😂😂😂😂

[@Pius-XI]

​@@haruhisuzumiya6650Rather have a pharmacist prescribe than a paramedic

[@alexflorance1111]

The second caller really summed this all up to me- the scary thing is the blurring of lines, and knowing limits. There’s a role for AHPs in healthcare, but it’s a case of you don’t know what you don’t know. It’s much easier for doctors to understand the limits of their knowledge and scope of practice because they’ve had more training and have more basic understanding of the science. And if something goes wrong, there’s a regulatory body there to investigate. Whilst AHPs can be fantastic, particularly at helping with procedures, examinations and information gathering, there’s a knowledge limit which we all must accept. Just like there would be with a cardiologist working in orthopedics. AHPs need their own specialist regulatory body, just like doctors and nurses do

[@captainchuppachup]

Medicine is more than just learning things. It's critical thinking and you need proper training for that. I'm pretty sure someone, like the second caller, can develop that over significant time, but they're still not a doctor.

[@taffyterrier]

DOCTOR! DOCTOR!

[@pedroparamo5255]

Just today I asked “to speak to a doctor” and instead got landed with a PA. The PA - as lovely as they were - refused to diagnose, but were very willing to prescribe pain meds. I’m sad that I had to assert myself and say “thank you, but I’d much rather know what I’d be taking the analgesics for, first”. If my pain levels were higher ergo I was more desperate, today would have been quite a dangerous day.

[@ruthe6017]

Newly qualified, F1 doctors come in and are petrified that they will do harm. Newly qualified PA's come in and are super confident. I have personally liked many of the PA's that I have worked with, and at the same time I disagree with the concept completely, and they don't know what they don't know.

[@robbiedickson5296]

Did that guy really just say after years as a paramedic and then being mentored in general practice until deemed competent, that he was then better than those who obviously were mentoring him and it's ok he should be hired instead because he is cheaper. Those years of mentoring will have cost a fortune in time and money (money/time whatever). Not much gained in general intelligence throughout that experience then. This is weird, and should not be allowed. Training for doctors and medical professionals has been top notch and requires continuous training. This was the person hyping his job (fair enough and maybe rightly so after that many years) but the junior doc was not and he had to say that comment ??

[@Areflection4]

We will soon be forced to go to internet Google Doctor, just like Americans in the USA.

[@RichardFraser-y9t]

Deskilling

[@jiiaga5017]

You give us too much credit, we just suffer and die in the USA, we're too afraid to look up what we might have and how big the $$ bill will be.

[@haruhisuzumiya6650]

​@@jiiaga5017have you thought about medical tourism in Canada?

[@aleph8888]

Doctors in the US think the NHS is awful; 60 weeks to see a consultant.? And their negligence is paid for by the taxpayer.

[@soulfulgardener]

I had an Internet doctor, on an app for a year, it was frustrating.

[@prideofdurham4776]

Trying to see a doctor here is like trying to find an honest Tory.After 3 hours on "hold" we are fobbed off onto 'advanced practitioners' for treatment.Never seen my doc since 2018.

[@gjbell3127]

I recently gave a doctor a lift to the Sunshine Coast University hospital Australia. He said that many English doctors came to work at the hospital. Initially they were coming for a short period of time. However when they discovered the wages & conditions nearly 100% decided to stay.

[@PaulK-ve1pu]

It's called skill mix. It began in the NHS in the 1980s. The idea is that you break a task into it's component parts and then you can teach anyone to do that task. Then you get rid of all but one of the qualified practitioners, who supervises and army of staff who know how to perform a procedure but not why. I came across this a long time ago. Anyone can take a blood pressure reading or ECG, but it's understand ALL that it means that matters. I think you begin to see the flaw in this cheapskate approach.

[@OctoberfFly]

Except you wouldn't pay the army of staff a higher salary than the qualified practitioners

[@chrysalis4126]

I'm glad the BMA have started this action. I hope it makes changes for the better. It's ridiculous when there are lots of GPs unemployed while people can't get an appointment at their GP practice.

[@taffyterrier]

The BMA are only bothered about the money.

[@scarred10]

the BMA have zero hope of overturning a law thats already passed,plus they are a lobby group with no legal power.GMC relulation is the only way PAs can be safely used,it should be welcomed by doctors.

[@PaulHooton-w8w]

This is terrifying we had no idea this practice was going on 😢

[@belindamay8063]

@user-ez8bx6ly8v. This is a government of heartless criminals. It has taken us all by surprise. In other countries there would have been riots. People have died, and it’s still happening. Every life has been damaged in one way or another. The Tories are finished forever. Watch them for turning up under another name.

[@dundergud9341]

@@belindamay8063 Yes, but don't expect this to change one bit under a Labour government. It's deeper than that.

[@gigi6539]

Doctors have been yelling about this for some time now.

[@docthomas8717]

Yeah well better late than never. 😂 Now you know to always ask the qualifications and reference numbers of whoever comes to listen to you in the clinic

[@scarred10]

its safe if employed properly but the NHS cannot do anything properly.

[@cs7623]

My dad only saw a PA/APRN for his healthcare and one day he started having weird symptoms, turned out he had cancer that presented atypically, the PA/APRN completely missed it whereas any physician worth their salt would have recognized it immediately. After a couple months of the symptoms persisting and nothing working my mom literally marched into the clinic and demanded for a doctor. The doctor immediately sent him to oncology and in the time wasted the cancer spread and it turned out to be terminal. These people are insane

[@BeverleyWalmsley]

Well done that female doctor for her researched comments. Following male was waffling.

[@sharonramsey715]

I couldn’t agree more.

[@lesleydickson7746]

This is an eye opener. If I need any kind of medical treatment I’m going to ask who is providing it.

[@enyonamami9736]

Thanks O’ Brien! Much respect! That paramedic really needs to go to med school and he’ll see how much little he knows. 🤣🤣🤣

[@tehs3raph1m]

I would happily see a PA firstline instead of a GP for 90% of the things i need to see a GP for. The problem is when you are forced to see a PA for the 10%

[@JohnBolton-dp1gw]

They are doing the same with pharmacists, dispensers are now allowed to issue prescription only medicines on PGDs!!

[@scarred10]

and so they should be for most diagnoses. A pharmacist will be more familiar with meds that all but the senior docs.Antibiotics especially take up too much GP time

[@auxlen]

Listen, I'm a pleb but i think the second caller is a bit of a whiff.

[@DannyMercer1993]

There’s nothing tinfoil about the idea that PAs are there to replace doctors. All doctors have experiences of PAs entering rotas that previously were only occupied by medics. Seeing them see undifferentiated, acutely unwell patients, and have prescriptions written by doctors who they brief thereafter. Those doctors invariably don’t have the time to see those patients, and check the working out too thoroughly, as they have their own notes. They are unregulated, nonstandardised and have significantly, markedly less training for the same roles. They are paid way, way more than us for many years. They are doctor replacement roles, given nomenclature ‘associate’ ‘physician’ historically in this country reserved for doctors, placed under the royal college of physicians (historically only ever doctors were allowed to be members) and are now to be regulated under the GMC, an organisation set up for doctors. The government are placing all the historic institutions around the PA role to give them lent credibility without real evidence base. It is doctor replacement, it is targeted, the evidence is stark, and it is 100% a decrease in standard of care for the people of the UK.

[@scarred10]

they are not allowed to be on doctors rota,the NHS has stated that to trusts clearly and will never replace doctors since they are dependant practitioners,reliant on delegated authority from consultants and registrars.THey arent called associate physician obviously but I do agree going back to assistant is clearer to patients.

[@kylewhittle6565]

This has been happening for decades. Healthcare assistance masquerading as nurses, dental assistants as dentists and physical practitioners as physiotherapists. It’s happening all the time!

[@Crowley575]

"It doesn't matter that I haven't studied medicine" indicates a terrifying amount of overconfidence and lack of insight. I can treat chest infections easily - well what if it turns out to be pulmonary fibrosis, or a pulmonary embolism? What happens if there is an infection but it doesn't respond to the antibiotics you've prescribed? Presumably they have to go and find a doctor. A doctor who is now covering more wards and patients than they ever would have previously.

[@adrianhjordan1981]

What makes you think they wouldn't know how to treat those things? Or at least refer them onwards? You think a GP is going to do anything more than refer them into hospital? What he means is that he didn't study the subject specifically called "Medicine". What he will have studied is Paramedic Science (3 years) plus then have a minimum of 5 years experience of independent practice, then done a Masters level course over at least another 2 years as well as additional modules and ongoing professional development. So yes, he didn't study "Medicine" but he did study all the same knowledge and assessment techniques, just by a different route and gets paid less for doing so.

[@nnanyelugoanekwe218]

​@@adrianhjordan1981if you don't study medicine,you don't know medicine. You are treating based on repetition with little understanding. What happens when there is a deviation from the norm you are used to?

[@Ashy5000]

@@nnanyelugoanekwe218 Do you think PA's or ANP's study Botany or something? We study MEDICINE, the difference is Doctors study it for longer and in more depth allowing them to understand more complex cases. You know, the ones that PA's were supposed to free them up to see by taking the easier cases.

[@nnanyelugoanekwe218]

@@Ashy5000 yeah,medicine does not work like that. Cases are only said to be simple in retrospect. What seems simple during triage could turn out to be a complex case.

[@Ashy5000]

@@nnanyelugoanekwe218 What did I just say... I said you rule out the worst case scenarios first. You start off at the top and work your way down.. And if the case ends up being complex then a doctor should take over..

[@alasdairwhyte6616]

arrogant "I havent studied medicine" I would walk out!

[@taffyterrier]

Anyone can study medicine.

[@georgeryan3310]

Does anyone really believe that the Tories are bothered about the health of the ordinary everyday workers,because you can guarantee that the wealthy won’t be seeing a PA. Or a paramedic.

[@Silver-st2zq]

Exactly.

[@tabularasa7775]

If the wealthy have an emergency they'll be seeing a paramedic

[@the1reaper33]

NHS is terrible medicine to begin with...

[@SSS-dn3uz]

You can hire medical graduates from developing countries which are actually more skilled compared to physician associates?

[@omgitsme39]

I think it takes ~9 years from start of qualification (either medical school or PA course) for total career earnings of a doctor to catch up to that of a PA. And that is if every doctor progression milestone is hit ‘on time’ and they are able to progress through the broken specialist training system - forget having breathing space, kids or a life. It’s outrageous that doctors lag behind people with VERY surface level training for years, whilst having to effectively do parts of the PA job for them. All PA courses have a 100% pass rate - what does that tell you about the rigour of their education? There is space for PAs as physician ASSISTANTS to ease admin pressure on doctors, but the unprecedented scope creep needs to be stopped. They should not be seeing undifferentiated patients or children (which they barely learn about) as they lack the scientific foundation to interpret symptoms outside of the narrow range of diagnoses they are taught. This is not safe.

[@lazzaboyman8003]

My son is a third year medical student and his workload is huge. He’s doing placement to 8 - 5 in hospital then studying for really rough exams. He has 3 more years followed by 2 foundation years. It’s incredibly arrogant and shortsighted that someone can do a degree and do a years training to then be presented as a medical professional which they are not.

[@quixoticfiend9274]

They'll do everything possible to keep overseas physicians out, meanwhile these clowns in their own backyard. 🤡

[@belindamay8063]

@quixoticfiend. The doctor-patient relationship is a highly intimate one. Very unusual and sensitive, but both parties know, without question, what to expect from each other. Assumptions are tacitly shared. Foreign doctors have a different set of assumptions. Particularly about status and empowerment, since the great majority. seem to come from non-democratic countries. Professionalism is vital to every free and civil society. Now it’s under attack from all directions - especially in Britain where it is in conflict with capitalist values.

[@helheimpanda]

^ So basically professionalism and doctor-patient relationship is more important than not dying? Okay got it. No matter what you wish to say, those doctors even overseas have atleast been 7yrs in training and have experience in their home countries. They also need to pass rigorous exam with one of them having almost a 60% failure rate but yeah let's keep PAs instead of the overseas doctors.

[@MaxxSeemov]

Everytime I call my local surgery for an appointment, I have to specify that I wanted to see an actual medically qualified proper doctor. This was the default service a few years ago and it's scary to think that you have to ask for this service now.