Dr Shaun Meehan calls on doctors to defend physician associates and other ARRS colleagues after they receive an onslaught of abuse on social media
Dear BMA and the medical profession,
I welcome the Doctors’ Association and RCGP statements, and hope we can now move towards a more mature and positive debate about how physician associates (PAs) can be best used and best supported. Recent comments by my profession towards PAs have been hurtful and potentially very harmful.
I write as a just-retired GP helping to train and mentor PAs in primary and secondary care. I remember my first day as a doctor in 1986 being handed a bleep and told I was working a one in two (meaning I was working a day/night/day/sleep rota). My jobs included all care, bloods and IV treatments for two consultant surgeons’ inpatients, as well as first management of every other day’s emergency admissions.
Things have changed a lot since then with our fellow professionals increasing their skills and their enhanced roles in patient care, taking over many of these jobs. I have had a busy and often challenging career, but not once in 38 years did I blame nurses, consultants, receptionists, GP assistants, ANPs, PAs or patients for my woes. Instead, I often criticised the real reason: the deliberate defunding of the NHS by successive Conservative governments intent on destroying our most precious public service.
I write to ask that you now consider the appalling social-media scapegoating of PAs nationally that my profession has direct responsibility for encouraging. The BMA needs to reconsider its blind support of doctors who want to destroy those who keep our NHS breathing. These doctors who post venom towards our colleagues should understand that their words cause intense distress and damage our patients as directly as they damage our colleagues. I fear greatly for the mental health of our PAs especially.
As a doctor, I want to apologise to all our professional colleagues who feel abused. I would speak for those doctors and patients who want to thank PAs and our other colleagues for their amazing dedicated care. We could not manage without you. I encourage all doctors to show them support now.
I read with increasing frustration about clinical scenarios that are deemed clear cut, but in my experience they rarely are. I read that PAs have taken jobs from doctors when I know that there are hundreds of vacant doctor posts left unfilled, usually in deprived areas of our country with PAs and ANPs often working in these areas instead, supporting overwhelmed practices who would collapse without them.
I think it’s time for all doctors who criticise PAs to stop, including the BMA. Your anger should be directed towards the reason, which is 14 years of intentional NHS defunding, especially primary care funding. Stop scapegoating hard-working colleagues – whether PAs, ANPs, paramedics, social prescribers, GP assistants or reception staff. They are essential in a future for our NHS where all contribute their talents.
We are part of the same team, and the BMA should be working harder to encourage that spirit so our patients benefit. Doctor numbers have never been higher, but they now work fewer hours than before, and rightly so. That and an ageing population with newer treatments previously unavailable needs to be managed, but there is no magic doctor tree. This must mean patients seeing whoever is the best person available to do the job.
I, for one, want a PA to see me if I need it, because I know I will be treated professionally and kindly. Let’s treat our PA colleagues professionally and kindly, too.
Dr Shaun Meehan
Dr Shaun Meehan is a retired GP in Merseyside who mentors and tutors PAs and medical students