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A faulty production line

'Physician associates remain an unknown quantity'

Dr Tony Grewal 

The position for general practice is absolutely dire. There are practices that cannot recruit or are grotesquely understaffed, and demand is soaring.

Physician associates remain an unknown quantity and only six physician associates from the USA have actually been recruited for an NHS pilot, so any evaluation will be at best inaccurate and at worst misleading.

If scarce resources are to be invested in a UK-trained PA workforce, we must be sure they can deliver.

It would be an error to think GPs are replaceable; even in a 10-minute consultation they perform minor miracles that would be hard to replicate without the skills, continuity and trust that UK GPs have.

If a PA can earn up to £50k a year and a GP partner is on £100k – though few of those are left in London – they have to deliver at least half of what a GP partner does, or do it in less than twice the time or the money is wasted.

But if PAs are a short- or medium-term solution, are you going to be diverting funds, expertise and impetus from that absolute need to increase the GP workforce? We can’t just re-plaster a damp wall.

My concern is that PAs can only do so much – the dwindling GP workforce will still have to do most of the work.

Dr Tony Grewal is medical secretary of Londonwide LMCs

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Readers' comments (5)

  • I like the tone of your article because the situation is indeed both dire and grotesque.
    We plough through 10 mins consultations at breakneck speed and a huge amount of skill is required to do this, built on, in my case, 20+ years experience.
    We simply can't expect to replicate a fraction of that from someone half baked who has done a few courses in anatomy and first aid.

    Sorry, it's stupid.

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  • Quantity is known - only 6. Its the quality that is the issue

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  • I genuinely mean no offence to you Dr Grewal, this is just an observation.
    Has anyone ever told you that you look like Victorian Dad from Viz?

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  • As you stated, retention and recruitment in GP practices nationwide is a problem. So why would you write an article ridiculing a member of the nhs workforce that sets out to help overcome this.
    And they are not 'half baked' or 'done a few anatomy courses' as the ignorant anonymous comment mentions above. They've spent at least 5 years at uni!! It's a postgraduate course delivered to individuals that have already worked in healthcare or studied scientific degrees - intelligent people that want to work hard to help the NHS, patients and staff, get through these difficult times.

    And do you not think that for those training in the UK, it is daunting enough knowing that when they graduate they are going to have to prove to everyone that they do have extensive medical knowledge (granted not as much as a doctor, nobody is saying that) and will be continuously ridiculed in the meantime by individuals making ill-educated comments.

    And the £50,000 salary for US trained PA's is not the norm salary it was an incentive to attract those with much experience - with not much success because a) they are highly valued professionally and financially in the U.S. so £50k wouldn't cover the cost of moving and b) why would they move across the world to this reception from medics?

    I personally know many doctors that think Physician Associates can be a fantastic asset to the multidisciplinay team and those hospitals and GP practices that aren't living in an old fashioned box will benefit greatly.

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  • Both the PAs I am training are fully trained medical doctors from outside the EU .Both very knowledgeable.

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