PoliticalSpeak: the race-to-the-bottom speeds up

Neurology is being threatened from two fronts; technological innovation and AI on the one and semi-skilled labour on the other. #ThinkSpeak #PoliticalSpeak

"The article below, in this week's BMJ, highlights another change to the NHS; the training and expansion of physician associates (semi-skilled doctors). Physician associates are not medical doctors, but will be trained to take on a lot of the mundane jobs we don't like doing; possibly doing the neurological examination. They will also cost a lot less to train and hire; the main reason why the NHS wants to expand their numbers. My University will be running a course to train this new generation of semi-skilled doctors. 

The medical profession is under attack from many fronts. We are being deskilled by technology, overburdened by administration and governance checks, and are expected to be more efficient with less. It will be interesting to see how physician associates play out in neurology. Will they make our lives easier or simply add another layer of complexity to the current system? Will NHS managers prefer to expand neurological services with less skilled staff? Austerity is challenging the practice of medicine in many different ways; we have entered a very disruptive era."

Abi Rimmer. Physician associates—what do they do? BMJ 2016;354:i4661

Excerpts: 

.... Physician associate roles have been proposed as a way of filling workforce gaps and freeing doctors’ time. But doctors themselves have raised concerns about the scope of physician associates’ practice, their length of training, and the possibility that their training will encroach on that of junior doctors.....

...... The first UK trained physician associates graduated from the University of Birmingham in 2009. Health Education England announced in 2014 that it would create a further 205 posts to support emergency medicine and primary care....

...... Currently 27 UK universities offer postgraduate training for physician associates, with further courses in the process of development. Most require at least a 2:1 honours degree for entry into the postgraduate diploma course, as well as some prior health or social care experience.....

...... Once qualified, physician associates take on similar roles to junior doctors and work alongside them to carry out procedures, see patients, and make decisions, .....

...... The physician associate role is distinct from that of a nurse, because of the way that physician associates are trained, Carr says. “The essential difference between physician associate training and the training of nurses and other healthcare professionals is that physician associates are trained to the medical model,” she says. “This means that they learn as a doctor does, to deal with people who have got symptoms and signs that don’t necessarily fit into a clear diagnosis.”.....