Patients who ask for doctors are being seen by physician associates instead – what’s the difference?

Almost a quarter of people do not know the difference between a physician associate and a doctor, a new poll has shown.

While 52% of people can differentiate between the two roles, some 23% said they did not know the difference, according to a survey conducted for Healthwatch England.

The patient champion has called for more clarity around the role of physician associates (PAs).

Writing in the GP magazine Pulse, Louise Ansari, chief executive of Healthwatch England, said: “The need for clarity on the role of PAs came across strongly in reports from local Healthwatch.

“Some local Healthwatch (organisations) explained that while patients might have heard of PAs and understood that they were not doctors, people’s understanding what they can and can’t do is more limited.

“In many cases, patients needed to be made aware of the local presence of PAs, and often only found out about the role when given an appointment with a PA.

“In some instances, patients had specially asked to see a doctor but were assigned to see a PA instead.

“Where people knew they had received care from a PA, their experiences tended to be positive. People particularly valued that a PA could provide care when they needed it.”

But what are the main differences between physician associates and doctors that we should know?

What is a physician associate?

If your care needs are not complex or if you need to see someone quickly, your GP practice might offer an appointment with a physician associate.

“Physician associates are healthcare professionals who work under the supervision of a senior doctor, such as a hospital consultant or a GP,” explains William Pett, head of policy and research at Healthwatch England. “They are trained to perform various clinical duties, such as taking medical histories, conducting physical examinations and helping with treatment plans.

“Physician associates usually complete a three-year undergraduate degree in a health, biomedical science, or life-sciences subject, followed by a two-year postgraduate qualification.

“The postgraduate training for physician associates covers some of the same topics as a medical degree, but is less in-depth.”

Jacob Lant, chief executive of National Voices, a coalition of health and social care charities in England, adds: “Physician associates are trained professionals and can provide patients with the high-quality care they need under the right circumstances and with the right supervision.”

How are they different to doctors?

Despite having physician in their title, physician associates are not doctors.

“Physician associates have around two years of training compared to the ten years of an average fully qualified GP,” explains Pett. “They must also be supervised by a senior doctor, and there are some activities they are not allowed to do.

“For example, they might suggest a prescription, but a doctor would be responsible for ensuring it was appropriate and for signing it.

“It is important for physician associates to follow guidelines that aim to ensure they explain their role to all patients they see so they can address any confusion.”

Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, wants to make sure that physician associates are supporting, not substituting, doctors.

“We need to see urgent action from the government and NHS leaders to grow the GP workforce and ensure that physician associates are not used as a substitute for GPs , and to support general practice and implement safe ways of working for physician associates in general practice,” says Hawthorne.

“This includes a robust system of professional regulation and significantly increased resourcing for GPs to support the supervision of physician associates.”

Why is it important for healthcare professionals to clearly explain their role to patients?

Pett explains: “All healthcare professionals are advised through NICE guidelines to introduce themselves to patients and explain who is responsible for their care and the roles of other team members.

“This is important because it helps patients understand who it is treating them, what they can expect, and also builds trust.”

What rights do patients have when it comes to which healthcare professional they see?

Patients have the right to request a specific healthcare professional at their local surgery, but this might not always be possible due to shortages and annual leave requests.

“The NHS Constitution sets out the rights of patients,” says Pett. “Patients have the legal right to request a specific clinician for their appointment and GP practices should facilitate such preferences wherever possible.”

Lant adds: “When patients book an appointment, they need to be given a choice of which type of clinical professional they are seeing so they can make appropriate trade offs between the speed of being seen and the person in front of them having the right skills and knowledge to treat them.”