The Role of the Physician Associate

Report
OUTLINE OF SESSION
 Definition of the Physician Associate
 Development of the Profession
 PA Responsibilities and Attributes
 Employment
 Professional Issues
 Training Programmes
WHAT IS A PHYSICIAN ASSOCIATE?
“…a new healthcare professional
who, while not a doctor, works to the
medical model, with the attitudes,
skills and knowledge base to deliver
holistic care and treatment within the
general medical and /or general
practice team under defined levels of
supervision.”
(The Competence and Curriculum Framework for the
Physician Assistant, Dept. of Health, Sept 2006)
Note: CCF updated in 2012.
http://www.ukapa.co.uk/files/CCF-27-03-12-forPAMVR.pdf
DEVELOPMENT OF THE PROFESSION
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Developed by doctors
Need for primary care services
Medical Education Model
Increased capacity and access
PHYSICIAN ASSOCIATE RESPONSIBILITIES
 The PA is trained to:
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Take Patient History
Perform Physical Exam
Formulate Differential Diagnosis
Create Treatment and Management Plans
Perform Procedures
Select/Recommend Medications
Request and Interpret Diagnostic studies
 … All with doctor supervision
(the PA works to the scope of practice
of the supervising doctor)
PHYSICIAN ASSOCIATE ATTRIBUTES
 PAs are trained to be:
 Aware of the limits of their competence
 Team players
 Lifelong learners
 Autonomous decision makers within their
scope of practice and level of experience
HOW DOES A PHYSICIAN ASSOCIATE WORK?
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To the medical model
With doctor supervision
Within the scope of practice of the supervisor
As a dependent clinician
In a relationship between doctor and PA which is
based on mutual trust and respect
From within the Doctor-PA relationship,
the PA exercises autonomous medical
decision-making, to extend healthcare
to the doctor’s patients
PHYSICIAN ASSISTANTS GLOBALLY
 USA – 47 year history with > 100,000 qualified
 UK – 220 PAs, growing demand (outpacing supply)
 The Netherlands – ~1000 PAs from 5 programmes
 Canada – >300 PAs
 Sub-Saharan Africa – similar models; various titles;
unknown numbers
 Australia – now training PAs
 Germany – training in progress
RATIONALE: UK ROLE
 The PA profession helps to meet UK health care
needs by:
 Building capacity
 Expanding skills mix
 Redistributing doctor workload
 Developing a defined health profession to expand
midlevel staff without depleting current roles
 Help meet demand for increased quality of care
PHYSICIAN ASSOCIATE EMPLOYMENT IN THE UK
~220 trained PAs working in:
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A&E
Trauma & Orthopaedic Surgery
ENT
Paediatric Intensive Care
Paediatric Surgery
GI
Acute Medicine
Haematology
Derm/Lymphoedema
Infectious Disease
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General Practice
Cardiology
Respiratory
Oncology
Urology
Psychiatry
Vascular Surgery
Plastic Surgery
GUM (Sexual Health)
Geriatrics
DH SPECIFICATION
FOR PA EDUCATION
Competence and
Curriculum Framework
Updated 2012
Competencies
Procedural Skills
Matrix of Conditions
2006
Programme Specification
~ 3200 hours over 2 years
~ 50% clinical
(incl. 200 simulation hours)
~ 50% theory
http://www.dh.gov.uk/en/Pu
http://www.ukapa.co.uk/files/CCF-2703-12-for-PAMVR.pdf
blicationsandstatistics/Publi
cations/PublicationsPolicyA
ndGuidance/DH_4139317
PGDip PA STUDIES - CLINICAL PLACEMENTS
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General Practice
Acute Medicine
A&E
Obs/Gynae
Paediatrics
Mental Health
Surgery
Electives: Cardiology, Gastroenterology,
Dermatology, Neurology etc.
NATIONAL EXAM
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Taken after completing university course
Required to practise as PA
SBA + OSCE
Ensures minimum standards across UK PA
programmes
 Re-certification exam EVERY 6 YEARS
CURRENT ISSUES
 Registration & prescribing
 Voluntary list √ → voluntary register √ → statutory register
 Prescribing as integral to role rather than extension
 UKAPA - Leading Organisation (www.ukapa.co.uk)
 Registering Body
 Salary
 Band 7 (£30-39k) to 8a (£38-45k)
 Occasional Band 6 internship job post
PA MVR
PA TRAINING PROGRAMMES
Current programmes
 Aberdeen
 Birmingham
 St George’s,
University of London
 Worcester
 Wolverhampton (Oct
2014
Coming soon
 Plymouth (Jan 2015)
In development or interested
 ~20 other universities
GENERAL REQUIREMENTS
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Excellent interpersonal skills
Motivated
Self-directed learner
Professionalism
Maturity
Strong communication skills (verbal & written)
FINAL THOUGHTS
 Newly qualified PAs will still function as beginners
 Can make a substantial contribution in continuity for
 Patients
 Health care teams
 Pioneering as a Physician Associate
 Still relatively new role to the UK
 Opportunity to participate in change/creation
 Not THE solution, but PART of the solution!
SUMMARY
 Intense Training
 Student Enthusiasm & Dedication
 Demand for PA role
 Opportunity to be part of a profession in the
making

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