23% ‘do not know the difference’ between a physician associate and a doctor

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

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.”

Three in five (60%) adults said that during their last NHS appointment, the person providing their care clearly explained their role, according to the survey, conducted by Savanta on 1,677 people across England.

Ms Ansari added: “People think it’s important to know who is treating them, and NHS staff are meant to identify themselves.”

Healthwatch England and National Voices have set out a series of measures which they say could improve clarity about the role. These include:

– Practising physician associates and those in training must explain their role to new patients.

– Before an appointment, patients should be told the types of clinician available, waiting times for different professionals, and that if a physician associate cannot address their issue, they may be referred to a GP or senior doctor.

– A call for more information on the scope and content of initial training and ongoing assessment and validation for physician associates.

– More information for the public about physician associates in the NHS.

– Healthwatch England and National Voices also called for “clarity on effectiveness” saying that health officials should formally evaluate people’s experience of physician associates in GP and hospital settings.

Medical associate professions, also known as MAPs, have been under increased scrutiny after the death of Emily Chesterton, 30, in November 2022.

She had been under the impression that she was seeing a GP, but was actually seen twice by a physician associate, who failed on both occasions to spot that her leg pain and breathlessness was a blood clot, which ultimately travelled to her lungs.

The British Medical Association (BMA) has said that there is a “dangerous blurring of lines” for patients between doctor and assistant roles.

Leading medics, including the Royal College of GPs and the BMA, have called for a halt to the recruitment of physician associates while concerns about the roles are addressed.

The NHS’ Long Term Workforce plans sets out an ambition to establish a workforce of 10,000 physician associates by 2036/37.

An NHS England spokesperson said: “We recently published summary guidance for trusts to set out the expectations on the deployment of medical associate professionals to ensure clarity of responsibilities, and expectations around safety, accountability and transparency.

“We are working with Healthwatch and the Patients Association on producing materials for patients and the public to explain the roles of medical associate professionals and will continue to work with organisations ahead of the GMC regulation coming into effect at the end of the year.”

A Department of Health and Social Care spokesperson said: “Physician associates have played an important role in the NHS for over two decades, but we are clear they should be supporting, not replacing, doctors and receive the appropriate level of supervision by healthcare organisations.”