The PA+PER’s Post

Physician Associates - The Royal College of General Practitioners speaks…. 🗣️In a hotly contested debate across the medicolegal world, the RCGP, a prestigious society, has given its verdict. 🚨What are the headlines? ‼️Physician Associates must always have a supervisor who adjudicates their scope and competency at the start of their employment ⬇️The RCGP has also established what the ‘scope’ of the PAs is: ❌Physician Associates may NOT be the sole provider on-call 🩻They must not interpret diagnostic investigations, such as ECGs.  👶They must not attend paediatric patients or perform 6-8 week baby checks  🤰They must not see pregnant or post-natal patients, or those with complex gynaecological conditions  🚑They must NOT attend to patients with potentially life-threatening presentations, such as headaches or abdominal pain  ❌They should not attend to patients with complex multi-morbidities or to patients with suspected mental health conditions. And, in my opinion, the most breaking of news:  ❌❌They must NOT attend to patients who have not been triaged by the GP already.  🤝I wholeheartedly welcome this clear and thorough action plan by the RCGP, which places clear red lines on a topic which has been, frankly, blurred beyond comprehension. 🧑💻In this post, I’ve summarised the RCGP guidelines, but emphatically encourage all of you to check the article out, with special mention to the table at the bottom, where every possible scenario has been detailed.  https://lnkd.in/ehZZ2p6q https://lnkd.in/e8utgEiM. What are your thoughts on the recommendations? #RCGP #primarycare #PhysicianAssociates

Updated: Fast track for overseas-trained specialists ⏩ GPs are among the priority for a Medical Board scheme to begin in October, but The Royal Australian College of General Practitioners (RACGP) says this is just reinventing the wheel. https://lnkd.in/gV5_v2kh #generalpractice #primarycare #familymedicine

Unfortunately I feel that logic left this debate months ago. This document lacks key stakeholder engagement and an empirical evidence base. In June 2024, the RCGP called for an immediate halt in recruitment for Physician Associates (PAs) within primary care. This was due to a survey conducted within its membership. Of the 54000 members, only 5112 responded which represents a less than 10% response rate. Of that 5112, 44% have never worked alongside a PA. This leaves 2249 members who have. This is not a representative sample. There is also a lack of empirical evidence to state that PAs present a risk to patients within primary care. Evidence has instead outlined the opposite. The CCQ has stated that "Studies on PAs in primary care in England and PAs working in primary care and other NHS services in Scotland show PAs to be safe, effective and liked by patients." On the other hand, the supposed evidence against Physician Associates seems to be purely anecdotal and hearsay. Fortunately, the Academy of Medical Royal Colleges has called for an urgent review of PAs amid the "whirlwind of claims" about competency and impact. Let us hope that this can put the debate to bed at last so that we can work together for our patients.

This is great news article by Emma Goldberg in The New York Times. This article features a letter from the U.S. Department of Health and Human Services (HHS) to the nation's teaching hospitals and medical schools informing them "that hospitals must obtain written informed consent from patients they undergo sensitive examinations — like pelvis and prostate exams — especially if the patients will be under anesthesia." Part of the letter to the nation's teaching hospitals and medical schools stated that "It is critically important that hospitals set clear guidelines to ensure providers and trainees performing these examinations first obtain and document informed consent from patients before performing sensitive examinations in all circumstances. Informed consent includes the right to refuse consent for sensitive examinations conducted for teaching purposes and the right to refuse to consent to any previously unagreed examinations to treatment while under anesthesia" I applaud this move and thanks to PBS NewsHour, for highlighting this issue 1 year ago featuring Alexandra Fontaine at the time a medical student and Phoebe Friesen a Bioethicist, at McGill University. ✨Unauthorized pelvic and rectal examinations were a routine part of my training as a medical student and a resident in obstetrics and gynecology. ✨I was told and believed that when a patient was under anesthesia it was an opportunity to improve your digital pelvic examination especially when there were abnormal findings. ✨As a chief resident I participated in this practice educating students and residents along the way ✨I am relieved to see that that "hospitals must obtain written informed consent from patients before they undergo sensitive examinations" #reproductivehealth #reproductivejustice #sexualhealth #womenshealth #gynecology #medicalstudent #patientadvocacy #obgyn

After three years, fully 3% of Texas #physicians earn exemptions from #PriorAuthorizations, #AKA #GoldCards. #CMS, in the interest of patient equality, used to not allow selective #physicain gold carding in #MedicareAdvantage #healthplans. Apparently they have changed their stance. The ultimate cure for prior authorization friction angst is for health systems & physician groups to take on full-risk capitation. Fully integrated systems require no prior authorizations of their physicians. See #KaiserPermanente & other fully vertically integrated systems.

It’s encouraging to finally see an article that thoughtfully addresses the issues we, as Physician Associates, have been advocating for. The message is both respectful and constructive, reflecting the values we hold dear in our profession. Collaboration is at the heart of our work, and it’s through teamwork that we can expand access to care and serve more patients, especially those in underserved communities. By working together, Physician Associates and Physicians, as well as other healthcare professionals can improve patient outcomes and create a more effective and responsive healthcare system. Here’s to building a healthcare model rooted in partnership, where every professional’s contributions are valued and where patients benefit from a collaborative, compassionate approach to their care.

Rightly said. Basic medical literacy is an absolute necessity where one should be aware of the medications being prescribed and consumed. Being medical professionals, let's strive to make it a reality. Basic medical literacy, a right, indeed! #basicmedicalliteracy #health #righttohealth

I am now a pro advisor for having an MBBS graduate in a family As a doctor, I've often advised against pursuing a career in medicine, citing the field's saturation. However, two recent incidents in my own house have profoundly reshaped my perspective. First, my mother has a history of anaphylaxis to pantoprazole. She once went into cardiorespiratory arrest after just one shot of the drug.We were fortunate to have the event in a secondary care setting which aided in swift management of the attack. I also made sure she informed physicians of her allergy during any visits. Despite this, a physician recently prescribed pantoprazole to her again. Luckily, she always checks her prescriptions with me first before taking, and I was able to catch this potentially fatal error just in time. Secondly, just yesterday, my father experienced acute urinary retention. I received a call in the middle of the night, and based on his symptoms, I made a provisional diagnosis. I reassured my parents and advised them to visit a local hospital, where he received the necessary urinary catheterization. He is now awaiting a consultation with a urologist. My medical knowledge and network of contacts in various specialties were invaluable in managing this situation swiftly and effectively. These experiences made me realise the critical importance of having a person with medical knowledge within a family. What if I were just an ordinary citizen without such knowledge or connections? The anxiety and potential for misdiagnosis could have led to serious complications. How often do we misjudge a myocardial infarction as mere gastritis? Given the increasing diversification within the medical profession, my initial stance on the saturation of the field seems less tenable. Having a #doctor in the family—or at least someone with a fundamental understanding of medical concepts—remains invaluable. Completing an #MBBS not only opens numerous opportunities for an advanced career in the healthcare sector but also equips one with essential knowledge that can save lives within the family or in a close circle in case of dire emergencies. In essence, everyone should strive for basic medical literacy, which can then be supported by healthcare professionals. The value of this knowledge cannot be overstated, as it can make the difference between life and death in critical situations. #mbbs #medical #family #careeradvice #lifeevents #basicmedicalliteracy

⚕️ Public Health, Population Health and Community Health... The success of these three is deeply intertwined with our ability as leaders to bring awareness around those 'long-standing and well-documented' inequities that DEI efforts seek to address. 🌎 A 'global' understanding of diversity includes Language Access as a critical component in any program looking to increase equity in patient care and outcomes. For those of us who have seen first hand the impact of not having an interpreter on a healthcare setting, JEDI efforts have a multiplier effect when trying to explain the importance of communicating with patients in a language that they can understand. 📣 Today, as organizations across the country announced their support for DEI initiatives, let's remember that both DEI and Language Access are everyone's responsibility. ❓What role do you play in helping to move the equity needle forward? https://lnkd.in/enge8YDN

Primary care internal medicine is dying... The state of primary care is a critical issue facing our healthcare system. This THE JOLT - The Journal of Olympia, Lacey & Tumwater and Medscape article by Dr. Debra Glasser offers a powerful firsthand account of the challenges and changes in primary care internal medicine. It's a must-read for anyone interested in the future of not just primary care but healthcare overall. https://lnkd.in/gfg5gGWm? #primarycare #healthcare #medicine #healthcareindustry #healthcareproviders #health #doctor #physician #patientcare #medical #medicalfield #medicalindustry #medicalprofessionals #healthcareworkers #healthandwellness #healthinsurance #healthsystem #healthcaredelivery #healthcareaccess #healthpolicy #healthcaremanagement #healthinnovation #healthtechnology #healthpromotion #healthawareness #healthliteracy #healthadvocacy #healthadvocate