I was really interested to read Barbara Morrison’s recent article on PAs. I was unaware of their existence until two years ago when a relative, Mary, graduated from medical school (6 years’ training) and as an FY1 junior doctor worked with a PA. The PA repeatedly asked her to sign off prescriptions, which as an FY1 she was not authorised to do (the PA knew this) and she refused. My understanding is that PAs currently hold no indemnity insurance and that any mistakes they make would be covered by the indemnity insurance of the supervising doctor.
PAs are not permitted to undertake certain paperwork such as death certificates. Consequently Mary found that doctors in that department spent much of their time doing paperwork whilst PAs received training performing procedures. This was exacerbated because PAs have a permanent role in the department whilst FY1,2 & 3 doctors are on rotation and only in the department for a few months. It could be seen as more beneficial to offer hands-on training opportunities such as procedures and attendance in theatre to permanent PAs rather than to transient junior doctors.
Mary is currently a junior doctor. She cannot get a mortgage as she is on a one year contract. She has applied for specialty training (which takes 8 years) but there are not enough places. Approx 2.5 junior doctors apply for each place. Those who don’t get a specialty training place are left competing for further one year contracts. Mary drives a thirteen year old car. The PA she worked with drove a new high-end vehicle and was buying a house.
Thank you for helping to bring this issue to the public’s attention. I will always ask for a doctor.
Editor’s note: It is our intention in publishing this letter to draw attention to the broader issue and not to cause offence to physician associates as individuals or as a profession.
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