Physician Assistants have been an integral part of the healthcare model in the USA for over 50 years. The role was developed to meet a need to increase healthcare services and now there are over 100,000 Physician Assistants in the US who undertake a range of activities contributing directly to patient care.
Physician Associates in the UK
Physician Associates are a recent addition to the NHS workforce. At present there are only around 200 Physician Associates practicing in a range of specialities and locations.
Physician Associates are defined as “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.”1
1Department of Health. The Competence and Curriculum Framework for the physician assistant. Leeds: DH, 2006.
What do Physician Associates do?
Common tasks that Physician Associates undertake are as follows:
- Formulate and document a detailed differential diagnosis, having taken a history and completed a physical examination;
- Develop a comprehensive patient management plan in light of the individual characteristics, background and circumstances of the patient;
- Maintain and deliver the clinical management of the patient on behalf of the supervising physician while the patient travels through a complete episode of care;
- Perform diagnostic and therapeutic procedures and prescribe medications (subject to the necessary legislation); and
- Request and interpret diagnostic studies and undertake patient education, counselling and health promotion.
The difference in names - Physician Associates and Physician Assistants
In the UK the term ‘Physician Associate’ has replaced that of ‘Physician Assistant’ due to the particular connotations of the term ‘Assistant’ in the NHS Agenda for Change. This also serves to differentiate those professionals who have completed training in line with the Competence and Curriculum Framework for Physician Associates as set out by the Department of Health.
Despite the difference in names there is no difference in the tasks that Physician Associates and Physician Assistants carry out. They are the same versatile, generalist healthcare professionals, able to provide direct clinical care to patients and support to wider clinical teams.
Physician Associates in the UK must complete a Postgraduate Diploma in Physician Associate Studies, this will qualify them to practise as a Physician Associate in the UK.
Physician Associate training programmes are currently delivered by a small number of Higher Education Institutes in the UK. In order to gain entry to one of these programmes candidates must have completed a science-related first degree (e.g. Biology, Biochemistry, Medical Science, Nursing, Physiotherapy) or equivalent qualification. Courses last for two years and will include theoretical learning in key areas of medicine and clinical training which takes place in a range of settings. At the conclusion of the course all candidates sit a national examination, including a Multiple Choice Question (MCQ) paper and an Objective Structured Clinical Examination (OSCE).
Currently there is no regulatory body for Physician Associates, although efforts are being made to compel a move towards statutory regulation. We are hopeful that the success of this project will further support efforts in this area.
At present there is a voluntary register that qualified Physician Associates are able to join, the Physician Associate Managed Voluntary Register (PAMVR). The Faculty of Physician Associates at the Royal College of Physicians and the UK and Ireland Universities Board for PA Education (UKIUBPAE) recommend employers make this a compulsory criterion for employment.
A day in the life of a Physician Associate