I listen to various podcasts while driving and yesterday's The News Agents had an interesting section towards the end about Physician's Associates (previously Assistants).
What they said was that that many people were seeing these PAs and assuming they were GPs. But although they have a degree, (as I understood it) they are not medical graduates. They are graduates (I'm not sure of what) with two years extra training and stand somewhere between nurses and GPs.
But the point is you may not realise or appreciate it isn't a GP you see. And if GPs with all their training don't know masses about PMR (or GCA) then you certainly wouldn't want to trust a PA!
So I thought some of you might find it an interesting listen.
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DogAgilityObsessed
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I don’t care who I see as long as they know the limits of their knowledge, are intelligent, think critically, are keen to find out information and know where to find it. It would be good if they aren’t just good at regurgitating facts. They will be both compassionate and understand psycho/spiritual aspects of care and also understand scientific method. If they can listen I will be overjoyed. If they are not driven by ego, are only academic and have unresolved trauma and in it for the wrong reasons I’ll be ecstatic. My life’s course has been changed several times by numpties calling themselves doctors or advanced practitioners or whatever. I have been nearly killed a few times because the person was operating with a limited skill-set, poor emotional intelligence and great prejudice. Try being female, especially middle-aged! If I get a dud one or even a good one, but they are sleep deprived, their department is underfunded, their kid is ill and a parent who lives 500 miles away keeps falling, I’m already at a disadvantage. No matter how good their training, there’s a problem.
Having trained with a mostly job based learning I think the problem is that you can end up only as good as those who you shadowed unless you are an independent thinker. Also, I’ve been on here long enough to know that a specialist at the top of their game can be worse than useless because of their personality and lack of knowledge updating. I have also seen people who have been upgraded in terms of practice level after some courses, who then think they know it all. It’s a tricky one and sometimes I think a computer based diagnostic tool used by someone with all of the good things above would be preferable.
I saw a PA recently. She in fact had more common sense than my GP.
It was recently when a young woman was diagnosed by a PA with a sprain when she actually had a blood clot. At a second appointment, she was given anxiety medication after reporting further symptoms of a swollen leg and shortness of breath.
She collapsed later that day and died in hospital in November, three weeks after she first sought medical advice.
OTOH - can happen at the ED. A colleague of my husband was kicked during a football game and later the leg swelled and was hot so he went to the ED. Because he was in his 30s, he was sent home, told it was bruising. It was a clot and he died during the night. For the sake of a simple blood test ...
My GP has just diagnosed cancer as a hernia! My previous doctor diagnosed flu and it was meningitis and the person died. He was known as Dr Death on the other hand.
I think the fuss was made in the medical press about the PA was that doctors would never let that happen!
That could explain the idiot that I spoke to, calling himself a rheumatologist, and scaring the living crap out of me right after initial GP diagnosis. That was a different one to Mr Dodgy Crystal Balls. So far, my experience with rheumatologists has not been good.
On the other hand, the musculoskeletal specialist that I saw, and seemed more like a glorified physiotherapist, was full of common sense and gave me a very through physical examination. I have an idea that he might have been one of these PAs. Actually, I have a lot of respect for him, he listened to what I had to say and was very thorough. Out of all the HCPs that I have seen about my PMR, he was also the first to send me for x-rays to eliminate anything structurally wrong.
The MSK "specialist" I saw was a physiotherapist who informed me there was nothing wrong with my back as I could touch my toes and he couldn't!!! Even I can see the scoliosis on x-rays! But then, a so-called orthopod (about 90 and had come back to help out) told me much the same.
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