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Physician associates

Rob Oldfield said:
Not wanting to widen the thread into a general 'state of the NHS' one but think important to remember that in 2010 the level of satisfaction with the NHS peaked (at least in recent years). And then the Tories took over. Their plan was always to move to a private model with more money to be made.

www.statista.com

Public satisfaction with the NHS 2000-2023 | Statista

Individuals interviewed in 2010 were the most satisfied with how the NHS is run, with 70 percent saying they are 'very or quite satisfied', this share dropped to 24 percent in 2023, th lowest in the provided time interval.
www.statista.com www.statista.com
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I'm not convinced by public opinion when there is no comparitor other than what was there before. Compared to health services in EU the NHS has missed the boat on educating it's staff. So the devil is in the detail. If your comparitor is say, UK vs. US drug prices we should all be very satisfied with our lot (https://www.linkedin.com/feed/?trk=guest_homepage-basic_nav-header-signin)
 

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I think the issue is more subtle than doctors vs physician associates.
My Type 1 diagnosis was misdiagnosed by qualified GP as a UTI whereas I have had excellent experience from physician associates who lack any arrogance and very willing to look things up rather than rely on (unreliable) memory.
 
helli said:
I think the issue is more subtle than doctors vs physician associates.
My Type 1 diagnosis was misdiagnosed by qualified GP as a UTI whereas I have had excellent experience from physician associates who lack any arrogance and very willing to look things up rather than rely on (unreliable) memory.
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Yes: plenty of fatal errors by GPs over the years. It would be interesting to see numbers of (fatal) errors as a percentage of total consultations by GPs and by Physican Associates.

We can't extrapolate from individual cases, however tragic. After all, the Harold Shipman case didn't lead to people assuming that all GPs are potential murderers and demanding to just have Physician Associates instead.
 
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CliffH said:
Yes: plenty of fatal errors by GPs over the years. It would be interesting to see numbers of (fatal) errors as a percentage of total consultations by GPs and by Physican Associates.

We can't extrapolate from individual cases, however tragic. After all, the Harold Shipman case didn't lead to people assuming that all GPs are potential murderers and demanding to just have Physician Associates instead.
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My daughter was told she had sinusitis by a GP in the days when people actually got house calls and was given antibiotics, but needed a second emergency call, the doctor diagnosed meningitis and called an ambulance.
I do think the policy of people only being able to discuss one issue per appointment means things do get missed or misdiagnosed. But also people sometimes don't mention all the salient facts when they see the GP.
 
Leadinglights said:
My daughter was told she had sinusitis by a GP in the days when people actually got house calls and was given antibiotics, but needed a second emergency call, the doctor diagnosed meningitis and called an ambulance.
I do think the policy of people only being able to discuss one issue per appointment means things do get missed or misdiagnosed. But also people sometimes don't mention all the salient facts when they see the GP.
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I'm a Clinical Psychologist and I want to know as much as possible about the person in order to be able to carry out a comprehensive assessment.

Even if the individual thinks they know the reason(s) for their psychological distress, it's my job to consider other possibilities too. It would be ridiculous for me to say, "We can only talk about your depressed feelings today: your anxious thoughts will have to wait for another session"!
 
CliffH said:
I'm a Clinical Psychologist and I want to know as much as possible about the person in order to be able to carry out a comprehensive assessment.

Even if the individual thinks they know the reason(s) for their psychological distress, it's my job to consider other possibilities too. It would be ridiculous for me to say, "We can only talk about your depressed feelings today: your anxious thoughts will have to wait for another session"!
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Sadly that is the case with some GPs, there is a notice up in our surgery saying 'one appointment, one condition'.
 
Leadinglights said:
Sadly that is the case with some GPs, there is a notice up in our surgery saying 'one appointment, one condition'.
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Unfortunately I've seen signs like that in GP surgeries for many years: it's the medical model taking Cartesian dualism to its logical extreme :(.

I think that the GP system needs a shake-up: perhaps Physician Associates can be part of a new approach to 'first line' NHS healthcare.
 
CliffH said:
Unfortunately I've seen signs like that in GP surgeries for many years: it's the medical model taking Cartesian dualism to its logical extreme :(.

I think that the GP system needs a shake-up: perhaps Physician Associates can be part of a new approach to 'first line' NHS healthcare.
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I always find it hard to be too critical of the NHS as both my daughters and son- in- law work on the front line in the NHS and I know how hard they have worked to get where they are and are always overly busy not just with their day or night hours but continuous professional development.
 
Leadinglights said:
I always find it hard to be too critical of the NHS as both my daughters and son- in- law work on the front line in the NHS and I know how hard they have worked to get where they are and are always overly busy not just with their day or night hours but continuous professional development.
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I agree: I worked in the NHS for decades and always worked hard (I like to think!). However, the NHS needs to be as effective and efficient as possible - which means people working smarter rather than harder.

Any organisation needs to focus on continuous improvement - and the NHS is no exception. From my time in the NHS, I think the biggest issue was the amount of clinicians' time that was wasted through not having efficient or effective support systems in place. I think often the NHS forgets that clinicians' time is its most important asset.

Now that I'm in private practice I can't afford to waste my time, as I only get paid for 'face to face' time with my patients. So, for example, I don't mess about with a printer for too long if it isn't working properly, whereas in the NHS I would often have to spend significant time (as a Consultant Psychologist) filling in paperwork to get a new printer cartridge. Unfortunately, if clinicians waste time in the NHS it's the patients who lose out - and the NHS system just shrugs its shoulders at the lengthening waiting lists.
 
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