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The primary care witch project

The primary care witch project

The idea of noctors being able to take on GP roles is a load of hocus pocus, argues Copperfield

Now, if I’ve heard the mood music correctly, physician associates should be burnt at the stake. Which I think is harsh, because obviously they should be screened with the ducking-stool test first.

That said, the current obsession with all-things-associate shows no signs of fizzling out. For example, the number of nursing associates in GP practices is up 55% in one year. I have to be honest, I had to check what nursing associates actually are/do. Apparently, they are designed to ‘bridge the gap’ between healthcare and registered nurses.

Bridge the gap, of course, means blur the boundaries. And this is a view shared by the RCN, which sees nursing associates as a cheap alternative with poorly defined scope who devalue the profession.

This sounds oddly familiar. If we’re honest, though, the current associate witch-hunt is just the tip of the iceberg. The chief concern around the underqualified dealing with the undifferentiated isn’t restricted to those desperately trying to hide their ‘associate’ badge. Nurse practitioners and pharmacists in primary care can work at a higher level, but may stray well beyond the top of their licence by being non GPs stepping into a GP role. And that step is vertiginous.

The profession has been corralled into this position by the Government’s failure to conjure up proper GPs and by its only crumb of financial comfort being the ARRS scheme. Whether by accident or design, frontline primary care is increasingly staffed by the well-meaning but bewildered who are trying to pilot a plane with a cycling proficiency badge.

It’s the Government’s responsibility to fess up to this and acknowledge to the public that primary care is now officially second rate. They’ve tried the ‘bridge the gap’ with noctor-filla and the result is that Illness will be missed and wellness medicalised, and it’s their fault.

The only alternative is to generate the ultimate associate: the Patient Associate, a punter unschooled in the torture of GPs who attends with one problem, gives a text-book history and never says ‘While I’m here’. Physician associates could probably cope with them. In the meantime, if they feel like the responsibility, the stress and the uncertainty is drowning them, at least they know they are innocent.

Dr Tony Copperfield is a GP in Essex 



Please note, only GPs are permitted to add comments to articles

Not on your Nelly 22 March, 2024 4:36 pm

the Patient Associate – Can’t stop laughing….if only….

So the bird flew away 22 March, 2024 6:32 pm

Useful things PAs. I once got Derek to retrieve bogeys out of John Wayne’s nostrils…

John Graham Munro 22 March, 2024 6:51 pm

I’ve been signing myself off as a Locum G.P. for the last 100yrs.——–then, suddenly, overnight, courtesy of the PCT I became a G.P. Associate

So the bird flew away 22 March, 2024 7:34 pm

I once pretended I was a cricket ball, but then I got caught out…

David Marshall 22 March, 2024 10:49 pm

Hey “Dr” Munro… you promised us a revelation… I for one can’t wait. At least it will brighten the gloom.

John Graham Munro 23 March, 2024 11:16 am

C.V. Update.
I once described the local prison psychiatric services as nothing more than a bunch of silly, soppy schoolgirls wandering around with psychology diplomas, interviewing ”hardened criminals and con men” This was immediately seized upon by our editor who temporarily suspended me———-on the grounds that I was mysoginistic and sexist.
I pleaded that I knew what I was talking about———-because not only had I formerly been a ”Prison Medical Officer” but, on a separate occasion ”an inmate”

David Marshall 24 March, 2024 5:28 pm

John, thank you. But this leaves more questions unanswered! One in particular. Your audience awaits… 😉

John Graham Munro 25 March, 2024 8:05 pm

David——-Don’t want to hijack Copperfield’s platform, but specific questions gladly answered

Ian Ward 26 March, 2024 6:27 pm

“frontline primary care is increasingly staffed by the well-meaning but bewildered”
That sums it up nicely.

Truth Finder 27 March, 2024 4:13 pm

The statistics will show the number of consultations done by PAs safely omitting the fact that the GP has seen, examined, fill up on more history and made the management plan only for the PA to write it up. hang on, my secretary can do that at a cheaper price.