I recently spoke to a physician associate (PA) who was desperately distressed about fatigue and the threat to their career in general practice and livelihood. The PA had been happy in their work but now felt the cold chill of disapproval beginning to seep down the corridors of their provincial employer. This PA, in common with most colleagues, is under 30, in the vulnerable early stages of their career, with no senior professionals to look up to or support them. PAs are managed by a professional class (us) that purports to despise bureaucracy, but which has seen fit to debate and adopt a policy that spells out the contempt in which PAs have come to be held.
This discussion crystallised the qualms I’ve felt about the conduct of the PA debate within our specialty. I’ve trained and supported PAs in the last 5 years. I know the downsides. Those issues could have been managed positively and productively. PAs are raw and ill equipped at the end of their training, not entirely unlike someone I used to know 35 years ago. (I know the differences so don’t bother.) None of the anecdotal horrors that are doing the rounds are unique to PAs; I’ve seen worse from many a colleague GP.
I feel fury on their behalf, and shame at my profession to a degree that eclipses all my frustrations at the sophistry of the usual closed-shop garbage utterances of our senior leaders. Why has a crisis in general practice been translated into the persecution of a blameless cohort of junior clinicians, all young people, who need our help? How has our most senior leadership seen fit to erase them from our surgeries? We will, in good time, need to seek forgiveness for this act of professional cruelty. Shame on us. Before it is too late, let us please act in tune with our professional values and move this forward to the benefit of everyone and not just ourselves.
- © British Journal of General Practice 2024
