Claiming physician associates are trained in ‘medical model’ is ‘misleading’, says BMA 

Government claims that physician associates (PAs) are trained to the ‘medical model’ are designed to ‘mislead’, the BMA has argued.

Academic leaders at the union have put out a statement today examining the use of the term ‘medical model’, which they say is now an ‘outdated and inaccurate’ description of doctors’ training.

The Government and NHS England have repeatedly referred to physician associates as having been trained in the ‘medical model’ – a claim which was recently echoed by a High Court judge.

In a new statement, the BMA medical academic staff committee claimed that the phrase has ‘been used to widen the appeal of these occupational groups while inappropriately blurring the lines between them and those of uniquely qualified medical practitioners’.

The statement examines the history of the term ‘medical model’ since its use in the 1970s, arguing that it has been replaced by the widely-used ‘biopsychosocial model of training’ for doctors, which takes a more ‘patient-centred’ approach, considering the ‘whole person’ rather than focusing on a single disease.

BMA academic leaders said: ‘The term “medical model” is now considered an anachronism, reductive and verging on the offensive if used to describe medical education or the work of medical doctors.’

They argued that it is not a valid descriptor for doctors’ training nor physician associates’ training, which also appears to follow a biopsychosocial approach.

‘The well-established and universally recognised biopsychosocial model of training across the health and care professions by UK higher education institutions demonstrates that those who continue to use and rely on the outdated and inaccurate “medical model” description in relation to associates do so to mislead and promote their own particular narrative,’ the statement said.

It also pointed out that the ‘fundamental difference’ between doctors’ training and that of associates is ‘the sheer breadth and depth of the curricula’ and that the aim is to provide doctors ‘with the ability to assimilate new knowledge critically, to have strong intellectual skills, to grasp scientific principles, and to be capable of effectively managing uncertainty, ambiguity and complexity’.

Academic leaders also pointed to the upcoming review of PA safety by Professor Gillian Leng, which is considering the identity and naming of the roles, and is expected to be published next month.

They suggested that this could also cover use of the term ‘medical model’, since the review team has confirmed that it will cover ‘wider aspects of identity’ beyond the ‘titles set out in statute’.

In response, the Department of Health and Social Care (DHSC) highlighted that GMC regulation of PAs began in December to ‘ensure patient safety and professional accountability’.

A spokesperson continued: ‘The Secretary of State has launched an independent review into PAs and AAs to provide a reset from the regrettable situation that has developed over recent years.

‘We will act to finally address the legitimate concerns over transparency, scope of practice, and the substituting of doctors.’

The BMA recently lost its High Court case against the GMC for ‘blurring the lines’ between PAs and doctors, with the judge dismissing all three of the union’s claims which concerned the GMC’s use of the term ‘medical professionals’ in its standards document Good Medical Practice.

Earlier this month, the regulator also faced a High Court case from a group of doctors over its refusal to set an official scope of practice for physician associates. The hearing was adjourned until mid-June.