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At the heart of general practice since 1960

Are you kidding me?

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Your mother is feeling very sick, but you manage to put her into bed and call your GP practice.

The receptionist says that there is no GP available in the surgery today, but there is a slot available with Mr White that afternoon if you can make it.

‘Gosh, who is he?’

‘He’s our new physician associate,’ says the receptionist proudly. ‘He is very good and, just between you and me, the older ladies adore him.’

‘OK, can I book an appointment with him?’

‘Of course. I’ll put you down for 3pm.’

You take the phone from your ear and your finger hovers over the ‘End call’ button. But something stops you.

‘Excuse me,’ you say. ‘Are you still there?’

‘Yes.’ The merest suggestion of a sigh at the end of the phone.

‘Is medically trained?’ you ask.

‘Who, Mr White?’ says the receptionist.

‘Yes, is he a doctor?’

‘Not exactly,’ says the receptionist, ‘But he has a 2:1 in Media Studies and he is very friendly.’

‘Ah, but is he a registered health professional?’

A pause. ‘Well, no, I don’t think he has to be registered, but he has two years’ training in many of the aspects of medical training, such as diagnosing illnesses and developing management plans. Plus, he has lovely warm hands.’

‘But he is regulated by somebody, surely?’

‘No, but he reports directly to the GPs in the practice. And you should see his reviews on NHS Choices.’

‘But where is Dr Brown today?’

‘Oh, well. Dr Brown is off today due to sickness. He has been off a while you see due to personal issues. Dr Green has moved to Australia with her family.’

‘What about that lovely locum I normally see? She is very good with my mum.’

‘I’m afraid she was booked up today. Bit of a shortage of locums at the moment since the seven-day hub opened up in town.’

‘So let me get this straight. You are recommending I take my sick mother to see an unregulated member of staff that has had a couple of years of training and no supervision, as opposed to a doctor with ten years medical training? Are you kidding me?’

‘Wait,’ says the receptionist. ‘We do have a slot with the practice pharmacist and they are very good.’


‘How about a Skype consultation with our community physician?’

You hang up.

Nigel Praities is editor of Pulse

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Readers' comments (30)

  • A taste of things to come in the not to distant future.

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  • Rural Africa has 'bare-foot doctors' - we are in danger of getting 'bare-arsed doctors'!

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  • How about you all grow up!? PAs will only see the crap that GPs should never see. It does not take much training to see if someone has a minor illness, is worried well or needs to see a GP.

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  • 'Anonymous | 16 July 2015 12:36pm
    How about you all grow up!? PAs will only see the crap that GPs should never see. It does not take much training to see if someone has a minor illness, is worried well or needs to see a GP.'

    How about you take a look around you. This is actually happening now and I have seen the consequences ...I often work in a practice where half the salaried Drs left and they can't replace them. The patients still need to be seen. They are making do with practice nurses and a pharmacist seeing patients's virtually impossible sometimes to decide in advance wether a patient is going to be 'someone who is a worried well' and 'should never see a GP' or wether their 'trivial head ache' is actually meningitis. When this practice can get a Locum to cover its often me and I get called in by the nurse to double check these 'simple cases that didn't need to see a GP' . It shocks me sometimes and I have nothing but the greatest of respect for the nurses asked to do this work, but it isn't fair on them, illness isn't simple and the more experience and training the better, in fact you can't have enough ...often theses aren't simple cases at all ...but they're seeing a nurse because there's no one else for them to see. Replicate this over the country large scale and you have a right bloody mess.

    Get real and wake up .

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  • Vinci Ho

    Well , the true meaning of seven days NHS.

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  • I'm guessing anon@12.36 has no medical training and no relevant experience

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  • Use Paramedics. They're regulated, registered and generally pretty good at spotting 'big sick'.

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  • As a PA I can honestly say I dont know any colleague with an undergraduate degree in Media Studies and not a science background! And we have been fighting for regulation for several years to avoid this fear of patients seeing some sort of unregistered maverick who can call themselves a PA without the credentials. Illness isnt simple which is why its important to have a supervising GP to have discussions with when a presentation doesnt quite "fit".

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  • Well this is a little embarrassing for Mr haven't done your homework have you? You can't train to be a physician associate if all you have is an undergraduate degree in media studies. You should have known that! Pulse has published articles that mention requirements for PA students several times in the past

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  • Fair criticism, it should have been a science-related degree. Although the whole thing is supposed to be slightly absurd.

  • Pulse seems to want to bash PAs,we need to work together with our colleagues and not against them ,we need all the help we can get.

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