Sammy Chan, a physician associate, tells of her work performing some specific roles for respiratory patients in hospital (‘I’m not a doctor’: the role physician associates play within NHS, 18 January). Physician associates have been successfully performing a number of roles like this for well over a decade: specific tasks for specific types of patients, under direct supervision.
What I am far less comfortable with is the sudden appearance of physician associates in GP surgeries, performing the actual roles of GPs. By this I mean seeing, diagnosing, investigating and treating completely undifferentiated patients: those with a new and unknown diagnosis which could be anything. GPs train for a minimum of 10 years in order to do this safely. I am extremely troubled that this new cadre, however excellent they may be, are being left to perform the task with as little as two years’ training.
Dr Jack Pickard
London
• The BMA’s anxiety about extended roles in medicine is not justified (Physician associates aren’t doctors and shouldn’t be regulated as such, says BMA, 18 January). As a former health professions teacher, I can recall that the historic concerns over unregulated “role creep” across professional boundaries is what caused doctors and other professions allied to medicine to get together in the first place to establish the physician associate role, create occupational standards and pilot them.
The health professionals who take on these roles are already registered by statutory bodies.
For example, anaesthetic and surgical associates are mainly recruited from operating department practitioners and nurses, registered with the HCPC and the NMC respectively. Can registration be developed within these bodies with the creation of additional competencies or does it need to be the GMC?
As for patient awareness of who’s doing what, there is a standard requirement to state and explain roles, and anyone who makes patient interventions, be they new students or mature practitioners, has an obligation and a degree of professional pride in introducing themselves.
Jonathan Hauxwell
Crosshills, North Yorkshire
• A national survey by the Doctors’ Association UK revealed significant concerns about the role of physician associates. While they could play a valuable role to assist doctors, the integration of their services into the NHS must be carefully balanced with the training needs of junior doctors and the overall safety of patients.
Dr Matt Kneale
Co-chair, Doctors’ Association UK
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