Dr Who (or the Physician Associate)

One of the things I’ve always found confusing in hospital is trying to work out who’s who. Is the person taking my blood pressure a nurse? If he or she is the same person who makes my bed, then possibly not. Is the person making decisions on my care a consultant with many years experience or a registrar who has only just stopped being a student, possibly more knowledgeable about Minecraft than medication?

Well now the government plans to confuse us patients even more with what they are calling ‘ a new class of medic’.  The Physician Associate.  A sort of Doctor’s Assistant if you like,  with fewer time travelling duties than Sarah Jane ,Rose or Clara, but with the responsibility of examining us, deciding on our treatment and admitting and discharging us from hospital.  Sitting somewhere in the hierarchy between nurses and doctors, the Physician Associate will be a science graduate with two years intensive training. They won’t be able to prescribe drugs.

Inevitably my initial reaction to this, along with most of the other patient groups, is one akin to Clara when she sees her doctor change from a youthful Matt Smith to a grizzly Peter Capaldi.  I want a real doctor please.  With seven years training, a stethoscope and notches in his or her belt of complicated cases.  And while you’re on my case, NHS, can I also have a proper nurse to take my blood pressure, an eagle-eyed cleaner with obsessive qualities, and a Michelin starred chef to make my toast?

Ah. My Utopian NHS. We all know the NHS hasn’t got enough money and unless we fancy paying a load more taxes, that isn’t going to change. It doesn’t mean we shouldn’t all be entitled to see a doctor when we need to of course. Mark Porter, chairman of the British Medical council,  is right when he says these posts cannot replace doctors. They can ease the burden though, so that when we do need to see one, they are able to give us their full attention for more than a couple of minutes.

But it is absolutely vital that we patients are completely clear about exactly WHO is standing at the end of our bed, something which is a tad hit and miss at present. Then, if we’re not happy with the level of experience of our Physician Associate,  we can ask to see a real doctor.

So NHS, here’s what I propose. For a start make everyone wear a name badge with their rank on it. No, I mean really make them. It seems to me it’s a rule followed by some nurses and healthcare workers but not all, and virtually no doctors. Make it a disciplinary issue if they don’t. Us patients need to know who they are.
Then in every ward put up a notice explaining the different levels of experience that different staff have. That’s right – there’s plenty of space between the Clean your Hands posters and the leaflet telling us your survey showed everyone was happy with the food. And when you do it bear in mind barely anyone outside the Health service knows what a registrar or a house officer is. And don’t kid yourself in thinking that we can tell who someone is by what they wear. Thats a sort of NHS secret code that us patients generally can’t decipher. Frankly a white coat can mean the person is a doctor, a pharmacist, a dietician, a physio, a student nurse, an agency nurse or that science kid from Cloudy with a Chance of Meatballs. How are we supposed to know?

So by all means bring in your Doctor’s Assistant. The physician associate might be able to get on with some of the routine stuff leaving my doc to scratch her head over complicated issues. Just make sure I know who I’m dealing with. More Dr Know please. Less Dr Who.