UK medicine is facing a ‘perfect storm’ of rising expectations, an ageing population with more complex and chronic needs, and a growing number of interventions that we can offer. Delivery of comprehensive high-quality care in general practice is also threatened by the increasing shift in workload from secondary care to primary care and the age profile of the GP workforce, as many GPs contemplate retirement (or indeed have already retired), go part-time or leave the profession entirely. Recruitment is also stuttering with only one in 10 newly-qualified doctors choosing a career in general practice and GP registrar posts going unfilled.1 Family medicine is groaning under the strain: are physician associates (PAs) part of the solution?
DEFINITION AND BACKGROUND
The PA role is new to the UK but has been established for over 40 years in the US, where they are known as physician assistants.
PAs are dependent practitioners who work for, and with, doctors. They are trained in the medical model, often in medical schools, and using the same approach to the clinical task as doctors. Thus they study anatomy, physiology, clinical examination and procedures, communication skills, and pathology; the list will be familiar to all readers. Applicants must already have a first degree in life sciences or health, and the course itself is a 2-year, full-time, highly-intensive postgraduate diploma (although some universities offer a Masters option which involves submitting a thesis). Different universities take different approaches to training: some offer early clinical contact, some make more use of problem-based learning, some use simulation to a greater or lesser degree and so on, just as with medicine. However, all …