Jason @Dr_JSA Twitter profile

Last Seen Profiles

@Memme

@Dustinx_Bs12

@kingtwytr

@DanForcella

@choco_zzz_

@Baladria

@BlackBone_io

@westendholland

@GHSHoops

@SD_Sailencer

@Gizmyyy

@xaviext

@useteller

@BigRedBronchos

@2023Token

@yasertam

@HIEE5EUNG

@JVargovcikova

@clementmaosa

@jtwheat27

@BsYuriSnow

@Animanay

@shoshanade

@DKSC_U1819_ECNL

@peterbachmd

@RFlakfizer

@crflames

@AuriVsevold

@_sadique_a

@kitara101

@Kap_Ka01

@GAYLETTER

@JeffConawayTFA

@Jasiri_9line

@BohoArtRunway

@JohnstoneYT

Jason

@Dr_JSA

11 months

There's no way of me writing this, without it being taken the wrong way by someone - but I'll tweet it anyway... If you think 50% of your medical school teaching was useless - you haven't seen enough patients, and you haven't seen enough zebras...

Misha Voikhansky

@MVoikhansky

11 months

My medical degree took 5 years to complete. I'm very confident that at least 50% of it was useless and forgotten by everyone within a week. I learnt the vast majority of my skills as a junior doctor in Stoke. Apprenticeship med training is a great idea and 4 years is long enough

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Jason

@Dr_JSA

2 months

"The BMA does not dictate, represent, or have a role in the training, education or working arrangements for Physician Associates (PAs)." The BMA *membership* do. By virtue of being doctors and supervising PAs. It's not wise to publish statements when you're irate. It shows.

Physician Associate Association UK (PAAUK)

@PPaauk

2 months

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Jason

@Dr_JSA

1 year

Looks like Weston has had a Super Mare.

The BMA

@TheBMA

1 year

We have revoked the derogation granted to Weston General Hospital. It has become apparent that both the BMA and NHS England were misled over the level of staffing cover. Either local management were unaware they had sufficient senior cover, or they deliberately misled us.

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Jason

@Dr_JSA

2 months

All I'm saying is that if I presented data like that at a Royal College or medic conference outraging thousands of people - I don't have an Anglo-Saxon surname like Clarke or Read to protect me from the GMC arguing I broke code on probity, honesty and integrity. #RCPEGM

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Jason

@Dr_JSA

12 days

If your role can only exist with supervision, then by definition you are not an expert in your area. I'm all for hearing arguments in favour of PAs from organisations. There's no need to bastardise the English language in the process, for example redefining medical professional.

RCHT

@RCHTWeCare

12 days

@Xeon4f145d96s1

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Jason

@Dr_JSA

3 months

Physician and Anaesthesia Associates aren't medical professionals. They don't practice medicine because they don't have a medical degree. I'm trying my best to zone out from the noise on PA/AAs. Certain organisations and people aren't interested in listening.

GMC

@gmcuk

3 months

🧵The updated #GoodMedicalPractice2024 uses the term ‘medical professionals’ as a collective term for doctors, physician associates (PAs) and anaesthesia associates (AAs), rather than listing out each individual role for every reference. We haven't removed doctors from the

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Jason

@Dr_JSA

1 year

This is an absolute travesty. I cannot put into words the amount of contempt I have for this. @drcolinm , I know you're not involved directly but as an Executive Officer - would feel comfortable defending this decision to @bbcnickrobinson on @BBCr4today ?

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Jason

@Dr_JSA

10 months

I was an instructor on an ALS course yesterday. It was quite heavy with FY1 doctors. To pass the course they had a scenario where they had to recognise that a pulmonary embolism had occurred & state the definitive management (thrombectomy/thrombolysis). They all did correctly.

Medlife Crisis (Rohin)

@MedCrisis

10 months

A very sad case which raises several questions, one of which is how a physician associate saw the same patient for the same problem twice in a week & prescribed a medication without GP involvement, and the patient & family thought they’d seen the doctor.

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Jason

@Dr_JSA

2 months

Reflecting on this a bit more, if I were a Royal Medical College I'd be fuming about the BMAs intervention today. They have stolen the benefit of the first mover advantage. Any document that comes after today is going to be compared to the BMAs output and that's a problem.

𝗗𝗿 𝗔𝗷𝗮𝘆 𝗠 𝗩𝗲𝗿𝗺𝗮

@UKGastroDr

2 months

My view in the @BMA guidance on PAs. Many sensible points which I personally welcome. However doing this without consultation with @RCPhysicians or @FPARCP means further conflict sadly. Also will make it interesting in the future if/when the BMA feels RCP are out of “their

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Jason

@Dr_JSA

7 months

"I don't recognise that." This is the answer a politician gives when they do not have the ability to objectively refute an accusation, but nonetheless wish to diminish it. It is also plainly obvious why someone might want to talk about their experiences in medicine anonymously.

Dr Simon Merritt

@dr_merritt

7 months

I don’t recognise that. I think if people want to truly engage in this debate they shouldn’t do it anonymously.

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Jason

@Dr_JSA

6 months

NHS England's "Freedom to speak up" guidance (based on recommendations of Sir Robert Francis' review into NHS whistleblowing) clearly states that it is possible to raise a concern anonymously and without hard proof. Speaking up "external" to organisations e.g. Twitter is allowed

Prof Colin R Melville

@drcolinm

6 months

Is it reasonable to attribute provenance to multiple anonymous anecdotes posted from an anonymous account? Formal processes exist to report concerns about access to training: Student > med school > GMC Trainee > DME > PGDean > GMC Im more than happy to consider genuine concerns

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Jason

@Dr_JSA

1 year

@joelgiblett @drcolinm @bbcnickrobinson @BBCr4today There was a consequence. Fine & criminal record. If you want to argue that the children awaiting heart surgery at Great Ormond Street Hospital will be better off with delayed operation dates - because there is one less Paediatric Cardiac Anaesthetist for 6 months - be my guest.

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Jason

@Dr_JSA

1 year

Very well said. Getting a bit irritated with the anonymous "woe is me and my trust" comments from Trust executives. If they actually had to recruit and retain junior doctors, rather than being allocated them by HEE, they'd value them a lot more than they currently do.

Andy Cowper

@HPIAndyCowper

1 year

There has been much weeping and rending of garments about this strike among NHS system leaders, on the grounds of the risk of harm to patients.

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Jason

@Dr_JSA

5 months

I disagree. One of the things that has been making my blood boil about Physician Associates is a mixture of well meaning and not so well meaning people, pretending that PAs are a means of widening access. Absolute b******t. It takes a lot of restraint to avoid responding...

𝗗𝗿 𝗔𝗷𝗮𝘆 𝗠 𝗩𝗲𝗿𝗺𝗮

@UKGastroDr

5 months

Sadly, it is only financially viable to go to medical school & take a traditional training route if you come from an affluent background & don’t have to take too large a student loan. If from a less affluent background, probably better (& easier) to take the PA route into a

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Jason

@Dr_JSA

2 years

Trusts can make a emergency BACS payment outside payroll. I never understand doctors who accept or allow Trusts to wait until the next month's payroll. Failure to pay wages is unauthorised deduction from wages. It's one of the few occasions where you can justifiably go nuclear.

Dr Tanya

@veggieequallife

2 years

I didn't get paid. Trust thought they weren't responsible for paying me Urgent payment is promised, no details of how much ? insufficient for my mortgage & bills No access to payslips system, emails ignored. I emailed & asked for a payslip & told they can't provide it.

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Jason

@Dr_JSA

3 months

Too many doctors come from middle class backgrounds with state (grammar) education grounded in compliance to authority. The few of us that routinely had to challenge authority as kids, recognise the seeking of appeasement - and this thread epitomises that - for what it is.

Hayley

@hayleymagill

3 months

No matter what your stance is on PAs, the NHS is not just going to get rid of the role. I’ve described an example of what I experienced a good use of the role was and received backlash. Either you can get angry and create divide, or you find a way to make it work for everyone.

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Jason

@Dr_JSA

3 months

It won't be cheaper. That's the really amusing thing about this brazen push for PA/AAs. 1. PA/AA salaries have been set way too high. 2. PAs will eventually want senior or "consultant" status so their career earnings will grow from what they are predicted to be now.

Tim Ricketts

@timricketts_

3 months

@sh_abbers Cheaper for government, breaks the power of doctors in the NHS, but won’t affect him personally Win win

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Jason

@Dr_JSA

2 months

Having read the RCP by-laws, a second EGM is required - with two motions to add at least two bye-laws. 1. Allowing a VoNC in RCP council members 2. Outlining what occurs if a VoNC passes e.g. ejection, suspension, eligibility to participate in further elections etc.

Jason

@Dr_JSA

2 months

Think of a vote of no confidence as akin to Hercules second labour. Doable if you're strategic but you'll need help. People should start planning now. We've all heard enough. Things won't change until a few heads roll (pun very much intended). #RCPEGM

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Jason

@Dr_JSA

7 months

Every Foundation Doctor does need ALS. It provides a common framework and language to managing an arrest but also *peri-arrest* scenarios. Why practice BLS, when in a hospital setting, the defibrillator is less than a minute away? Care quality & standards appear not to matter.

Stephen Hines

@hines_stephen

7 months

@CCWearmouth Not every doctor needs ALS Teach and reinforce good BLS for all, then target the ALS for those in roles that need it.

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Jason

@Dr_JSA

8 months

I absolutely wouldn't. It used to provide a solid route to social mobility and with social purpose. There are better ways to achieve both without being £100K in student debt and dealing with the nonsense medical educationalists and the Treasury have turned UK medicine into.

Margaret McCartney

@mgtmccartney

8 months

I really don’t think I’d apply to go to medical school again

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Jason

@Dr_JSA

1 year

@joelgiblett @drcolinm @bbcnickrobinson @BBCr4today If that's your line of argument, I'm afraid you're going to be sorely disappointed when you find out how many junior doctors are borrowing Netflix and Disney+ accounts. If the GMC finds out you'll probably have to draw lots with colleagues to step down onto the SHO rota.

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@Dr_JSA

11 months

This is why, in the long run, you can't completely replace doctors with physician associates, advanced practitioners or artificial intelligence. Doctors value is when patients don't fit a common protocol. If people want to dilute that on the basis of cost pressures… Good luck.

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Jason

@Dr_JSA

10 months

They aren't "associate doctors". @katlay wouldn't have written the headline in fairness but the headline inadvertently highlights the problem with the current terminology. Maybe something for @RSylvesterTimes and the Times Health Commission to look at.

The Times & The Sunday Times

News and opinion from The Times & The Sunday Times

www.thetimes.co.uk

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Jason

@Dr_JSA

1 year

Questionable reporting when it comes to jr doctors strikes isn't new. Happened in 2015 and predictably, happening again now. What's interesting this time is the unlikely sources. @NickTriggle normally your output isn't bad, but this isn't your best work.

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@Dr_JSA

2 months

The leadership of the RCGP has stated that SAS doctors can't segue straight into GP to see patients. They have to go through the current training process. Making a coherent case in a policy document for PAs to be utilised as they are presently - with the above in mind - is hard.

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Jason

@Dr_JSA

11 days

It'll never be proven, because it isn't measurable, but the fall in NHS productivity is at least partly down to the loss of goodwill and discretionary effort from staff. The culture around working when unwell and staying behind (rightly IMO) is night and day from when I started.

Paul Johnson

@PJTheEconomist

11 days

Public sector productivity 6.8% down on Q4 2019 is pretty worrying. Huge drop. Consistent with what we know: genuine increases in spending, but struggling public services. E.g. activity in hospitals nowhere near reflecting additional resources.

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Jason

@Dr_JSA

1 year

Charlie Massey argued that @gmcuk is a patient safety organisation. How does this decision improve the safety of patients or maintain the esteem of the profession? How does it improve, the already low, esteem of the GMC amongst doctors? Summary:

From the JuniorDoctorsUK community on Reddit

Explore this post and more from the JuniorDoctorsUK community

www.reddit.com

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Jason

@Dr_JSA

2 months

The other issue is that many colleges hadn't formally considered the views of their members. Some are only beginning that process. The prevarication by the GMC and Colleges over who sets scope of practice has allowed the BMA to pick up the baton and get to the finish line 1st.

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Jason

@Dr_JSA

9 months

Does the general public, let alone other clinicians and health policy experts, genuinely believe that scrapping the 2 week urgent cancer referral pathway will lead to faster diagnosis & treatment? Pray tell, what happened in the hospitals where the 4-hour A&E target was dropped?

Shaun Lintern

@ShaunLintern

9 months

The Govt will announce plans to scrap the 2 week urgent cancer wait time and nine other cancer targets on Thurs in favour of 3 new targets the NHS believes will lead to faster diagnosis and treatment:

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Jason

@Dr_JSA

2 months

They have a set level of supervision for 18-24mnths, passing of exams and completion of WPBAs to practice independently as a GP seeing undifferentiated patients. How can you cogently argue a PA fresh out of their course should have *less* supervision than that doctor as a GPST?

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Jason

@Dr_JSA

1 month

The lack of fortitude by senior doctors involved in the GMC, Royal Colleges and NHSE is absolutely embarrassing. Probably a part of ageing, but I remember as a medical student being in awe of leaders such as Bernard Ribeiro and Liam Halligan.

Secret Physician

@SecretPhysician

1 month

@jim_crawfurd @DrPastry @john_brittenden @DrEilidhMaria That it is out of their hands. It is accepted as fact. That is how it is and the only thing to make the NHS better in the face of that fact is PAs so we must get behind them.

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Jason

@Dr_JSA

11 months

... but you remember enough to go and look it up. A doctor saying out loud "Could this be chemical poisoning?" is exactly how Sergei and Yulia Skripal came to be diagnosed with novichok poisoning. Most doctors, around long enough, will have multiple stories about zebra cases.

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Jason

@Dr_JSA

3 months

I don't disagree with this. But, unfortunately, there's a but. The medical profession doesn't feel listened to right now. Significant changes are being made to the way in which they work - via supervision - without the express consent of rank and file doctors.

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Jason

@Dr_JSA

2 months

The big takeaway is the gap in perception between consultants and trainees. This isn't surprising because PA/AAs have been able to proliferate and work in the way that they have - because a large enough group of consultants don't care about trainees.

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Jason

@Dr_JSA

8 months

Cackling into my cornflakes. Because @RoshanaMN is a legend and also because I'm certain she wrote "I fix bones, not boners" and the editors thought that language was too uncouth for The Times.

𝗗𝗿 𝗔𝗷𝗮𝘆 𝗠 𝗩𝗲𝗿𝗺𝗮

@UKGastroDr

8 months

Wow @RoshanaMN !!

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Jason

@Dr_JSA

2 months

Do you *honestly* believe @KamranAbbasi that the President of the Royal College of Physicians has no competing interests when writing an article about physician associates? It's not as if physician associates have a faculty that is hosted by the RCP... Not a competing interest?

Kamran Abbasi

@KamranAbbasi

2 months

Ahead of the @RCPhysicians extraordinary general meeting, president @DrSarahClarke explains why there is a role for physician associates in the NHS @bmj_latest

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Jason

@Dr_JSA

11 months

There's the saying "If you hear hooves, think about horses before you think about zebras." Lots of clinical practice is routine, but every once in a while you come across something that triggers something obscure you learnt in medical school. You may not remember all of it...

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Jason

@Dr_JSA

4 months

Laughing at the clip, but also at the people saying that the call was harsh. @amolrajan was correct. Jungle and 'Drum and Bass' *are* different. The latter is Jungle's younger brother, more technically refined, and less or no ragga. Think we need a @BBCRosAtkins explainer...

Amol Rajan

@amolrajan

4 months

Well it does summarise my early 20s rather well

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Jason

@Dr_JSA

9 days

This is an argument that GPs - who endorsed the use of PAs - now have no effective rebuttal to. It was a foreseeable argument and therefore it was utterly moronic to allow PAs to be used anyway. Just because "some help from the Government was better than none."

Tim Ricketts

@timricketts_

9 days

Post F2 unemployment is becoming an increasing problem, whilst primary care is on it’s knees. It’s time we let locally employed resident doctors into primary care. No one can complain about the supervision requirements when MAPs with <1/3 the training are running loose

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Jason

@Dr_JSA

2 months

Some of you lot are celebrating way too early. There needs to be a second EGM for two good reasons 1. To vote on the original unamended wording for motion 5 2. To ensure that a PRCP cannot act in this way again for fear of being ousted. #RCPEGM

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Jason

@Dr_JSA

1 year

@drphiliplee1 @drbenwhite That's because the system is undermanaged. Britain's pathological aversion to NHS managers has led to the reduced productivity of clinical staff in recent years. Precisely because they are having to deal with this type of thing. The DHSC haven't put 2 + 2 together yet...

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Jason

@Dr_JSA

7 months

Genuinely extraordinary. If there's been a need for change to adhere to the rules, then that suggests that the rules were broken previously. This is a big test for @gmcuk and @CQCProf . Rarely do I see something online where regulatory investigation is required, but this is one.

platinumpizza™

@Xeon4f145d96s1

7 months

This is what happens when you worry about getting a seat at the table not realising you’re the meal

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Jason

@Dr_JSA

3 months

PAs have been created for economic objectives and to disrupt a global model of healthcare that requires doctor-delivered care. The UK has implemented PAs in a way even the US thinks is bizarre, and the argument is "They aren't going away, so let's find a way to make it work?"

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@Dr_JSA

8 months

This thread is excellent. I thought twice about tweeting the following in response but I'm going to do it anyway. The events regarding physician assistants adds weight to the argument that Doctors, collectively and at times, are not the most savvy bunch.

Ollie Burton

@ollieburtonmed

8 months

Have said this in another thread but important as standalone - I genuinely think that until/unless Royal Colleges can publish the instructions from DHSC/NHSE about implementation of MAPs, they've got little hope of winning back any meaningful faith from doctors

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@Dr_JSA

7 months

@AnnaBatchelor @DrLKVaughan The problem is what happens if the unexpected occurs, such as a spontaneous pneumothorax during your anaesthesia. The utility in doctors isn't in the scope of the protocol. It's to do with the unexpected, or the medical conditions where management is in conflict with each other.

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@Dr_JSA

7 months

@UKGastroDr GMC regulation isn't going to help you in the long run. I'd be fighting tooth and nail for MAPs to have their own regulator, if I were you. There's precedent with non-medical public health consultants on a different register - who perform the same duties as medical consultants.

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@Dr_JSA

4 months

It's not 2015. This dispute has always been nakedly and purely about pay. A really interesting piece of journalism would be something that investigates and explains the shift in doctors. From the 2015/16 argument of "patient safety" to the 2023 argument of "pay up or I'm off".

Kate Andrews

@KateAndrs

4 months

WhatsApp messages sent this week by the BMA to junior doctors make crystal clear what the real intentions of these strikes are. The real reason junior doctors are striking 👇

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Jason

@Dr_JSA

5 months

That's a shame. However it confirms what I and others such as @Azeem_Majeed have been saying - we are experiencing the consequences of the institutional/regulatory capture of the GMC. It appears to now primarily serve the interests of the Department for Health and Social Care.

Jeeves Wij

@AskJeevesWij

5 months

We have seen concerns from many calling for professional standards for Physician Associates and Anaethesia Associates. Regulation provides long awaited clarity & assurance to clinicians, professionals & patients. It is a step in the right direction, with more to be done.

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@Dr_JSA

7 months

I don't agree with the GMC being the regulatory body for Physician Associates. It's really interesting to me how many organisations unthinkingly believe that this is a good thing. @KamilaRCGP @ClareGerada @CNagpaul how can GPs/members make their representations to Council?

Iona Collins.DOCTOR.

@Doc_IonaCollins

7 months

Here is the October 2023 updated position of the Royal College of GPs in relation to PAs.

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Jason

@Dr_JSA

18 days

The British approach to general practice is increasingly becoming used globally as an example of how not to deliver services. In the meantime RCGP members are getting gerrymandered surveys on the role of PAs...

Royal Australian College of GPs (RACGP) President

@RACGPPresident

18 days

The NHS is run down, its doctors have been run down. The UK faces a GP exodus. Low pay, conditions, role substitution. We must make sure Australia doesn't take the wrong lessons from their mistakes. Great to speak to Lexi Hamilton-Smith for an upcoming ABC story with @kamingock .

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@Dr_JSA

11 months

The value of doctors is in being able to spot the obscure/rare & managing conditions where there is conflict in best practice. E.g. the patient with a heart attack & concurrent upper gastrointestinal bleed. Giving clopidogrel let alone Ticagrelor (contraindicated) is dodgy.

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@Dr_JSA

11 months

@aroradrn Try telling that to a metabolic paediatrician. Just because you don't use that information, doesn't mean others don't. We're supposed to be pluripotent stem cells at medical school. After specialising, different nuggets of information will be drawn on depending on what you do.

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@Dr_JSA

5 months

The appropriate response to this oft argued, and wrong, viewpoint has been made by @adamsonjon .

Dr Richard Pile

@DrRichardPile

5 months

I’m putting it out there: I don’t believe it takes 5 years to get a medical degree. And I do believe that you can learn on the job if you already have a clinical role. Doctors should be honest with themselves. Was every minute of your degree spent in learning/working? Was

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@Dr_JSA

4 months

Yes, that's me. When I started medical school, house officers had free accommodation. That was taken away around 2008. There was also the change to the NHS pensions scheme from the 1995 scheme to the less generous 2008 scheme. Then there was Modernising Medical Careers...

Alison Moore

@AliJaneMoore

4 months

Some junior docs will have started their degree courses before he start of this decline in their real wages…..

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Jason

@Dr_JSA

2 months

@JohnLan87441503 What independent research exists that supports the introduction and regulation of PAs as currently planned? A drug cannot be given to the general public without evidence being submitted to the MHRA first. Why should PAs be different?

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Jason

@Dr_JSA

2 months

Because if you, as a College, match what the BMA says on an area of supervision, then you are validating the BMAs judgement. If you state that the guidance should be loosened in an area, you struggle to maintain credibility without being able to cogently explain why.

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@Dr_JSA

2 months

Logically incoherent mess. Just like all documents in relation to the rationale and supervision of PAs are tbh. Also the brazenness of asking that debate around PAs always remains "evidence-based", when no Royal College has provided a robust evidence base for their introduction

Selvaseelan Selvarajah

@DrSelvarajah

2 months

High level principles concerning physician associates (PAs) Academy consensus statement from @AoMRC . Statement supported by 23/24 Royal Medical Colleges. RCGP has deferred until after Council meeting this week.

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Jason

@Dr_JSA

1 year

@joelgiblett @drcolinm @bbcnickrobinson @BBCr4today The point is none of the three GMC statutory objectives are met here. The public won't care about a criminal infringement like this. Furthermore there are plenty of examples of more egregious acts, typically by doctors with Anglo-Saxon surnames, who received lesser punishment.

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@Dr_JSA

7 months

This requires a regulator and medical royal colleges that are prepared to listen to their members. The fact that an emergency general meeting has had to be triggered in one college, and clarifications issued by the GMC and others - makes patently obvious where the issue lies.

Prof Colin R Melville

@drcolinm

7 months

Really helpful historical perspective from @DrLKVaughan although I’d prefer we have a constructive, respectful and challenging dialogue to shape the future for PAs and AAs rather than an ‘argy bargy’ approach

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@Dr_JSA

2 months

Think of a vote of no confidence as akin to Hercules second labour. Doable if you're strategic but you'll need help. People should start planning now. We've all heard enough. Things won't change until a few heads roll (pun very much intended). #RCPEGM

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@Dr_JSA

5 months

Part of the problem is that the groundbreaking science - and relationship between the NHS & private sector - is driven by clinician scientists or clinical academics. The majority are drs, and we are losing them fast. They are the canary in the coalmine of the retention crisis.

Wes Streeting MP

@wesstreeting

5 months

The UK hosts some of the best life sciences and medtech development in the world. I want the NHS to accelerate groundbreaking science and harness it for patients. Working with the private sector ≠ privatisation. With Labour, our NHS is not for sale.

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@Dr_JSA

5 months

Because as someone who came from a "widening access" background, the idea that it's better that a 18yo version me becomes a PA, because people can't be arsed to do the hard work of campaigning for bursaries, contextualised offers etc. deserves a poisoned & contemptuous response.

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@Dr_JSA

1 year

I know Twitter is tribal, but there are a lot of people I respect who have disappointed me with their tweets this weekend. It's not hard to put your emotions aside & look at an issue from the perspective of others, or using logic such as substitution. I, wrongly, expected more.

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Jason

@Dr_JSA

6 months

This BBC article isn't a consequence of a "minority" of doctors moaning on Twitter. It's a consequence of the public interest in who is providing medical care to patients, and how qualified those people are. There will be more such articles in future.

Jason

@Dr_JSA

8 months

I really don't think the British public will have it, and there are signs of that in the comments section of the newspapers politicians pay attention to e.g. the Times and elsewhere already. Even just having a 15 minute chat with a neighbour this week got this response:

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Jason

@Dr_JSA

1 year

@timricketts_ Thanks, but I think it's futile tbh. The most sense I've read has come from an anonymous pizza. The fact it hasn't come from a wisened consultant or the myriad of (who I thought were) sensible junior drs, doesn't reflect well on drs or where our social media habits have got to.

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Jason

@Dr_JSA

1 year

@joelgiblett @drcolinm @bbcnickrobinson @BBCr4today Are you sure that's the best comparator? A man who was previously cautioned for the same offence but continued to do it anyway? You've not actually answered the question about how the statutory objectives are met.

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Jason

@Dr_JSA

1 month

Doctors in training have been complaining about PAs in private for years @DanielSokol9 . One of the things that really irritates me, and I'm mild mannered, is that your argument ignores that organisations such as NHS England Royal Colleges ran roughshod over those concerns...

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Jason

@Dr_JSA

7 months

Given the pear requires the supervision of the apple, this is a more appropriate comparison.

PATH - Physician Associates

@InfoPars

7 months

3 distinctly different roles on two different pay structures. Perhaps this diagram will help. 😉

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Jason

@Dr_JSA

2 months

This the fundamental issue that the British spreadsheet approach to medical training. Those with the best CVs, are the ones who are leaving the NHS because they find it easiest to leave. Clinical academics. Prize winners. Oxbridge grads (boo me all you want, it's true...) etc.

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Jason

@Dr_JSA

7 months

Or focusing on "tone", "language" or "anonymity" because - let's be honest - that is far easier than dealing with the substantive points being raised. E.g. It's hard to celebrate that your MAPs don't rotate on one hand then justify rotational training for doctors on the other.

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Jason

@Dr_JSA

3 months

Rees-Mogg is right and people should be brave enough to not worry about the messenger, and endorse the message. I care not for arguments that Shamima Begun was groomed, her age etc. the *only* reason I'm against her losing her British passport is the argument outlined here.

Jacob Rees-Mogg

@Jacob_Rees_Mogg

3 months

There should only be one class of British citizen and that includes Shamima Begum.

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Jason

@Dr_JSA

2 months

For the record, the reason that the royal medical colleges haven't produced such guidance yet is because there are significant problems in doing so. If I use general practice as an example... Imagine a doctor who is retraining in GP from say respiratory medicine.

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Jason

@Dr_JSA

2 months

Robust evidence is really difficult to ignore. The onus is on those who want PAs and AAs to have a particular scope, to evidence that this is beneficial to both doctors and patients. The problem is that there isn't, and much of the discussion is based on vibes and feelings.

Heather Reid

@hkg294

2 months

Just a one sided, agenda-driven document that others will struggle to take seriously. There is already much talk of a much more "militant" BMA that is near impossible to negotiate with and I feel like this is somewhat reinforcing it

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Jason

@Dr_JSA

1 month

No. People who work in obstetrics or paediatrics, seeing the rising number of 23 week old babies who survive, are questioning whether the UK should be lowering the current 24 week limit. That's the discussion we should be having given medical advances since the 1967 Act.

The Guardian

@guardian

1 month

No watering-down, no new red tape: it's time to fully decriminalise abortion in England and Wales | Stella Creasy

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Jason

@Dr_JSA

2 months

Breakfast club isn't about feeding kids. It's about parents being able to make work at 9am. I can't work out whether people who believe it's about "breakfast" are either being disingenuous or genuinely haven't got a clue what it's like for two working parents to raise kids.

Tom Jones

@93vintagejones

2 months

I’m confident offloading basic parental responsibilities like feeding your children to the state won’t result in poor outcomes for kids.

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Jason

@Dr_JSA

8 months

I think you're missing the point of publishing this letter. IMO it's a good thing that they did. It highlights the persistence of misogynistic attitudes. Anyone trying to argue that the behaviours that women have spoken about are by a minority of men, can't be taken seriously.

Simon Fleming 🛠

@OrthopodReg

8 months

Hey @thetimes You appear to have published a hateful piece of sexist, misogynist tosh. It also appears to be apologist for bullying, sexual harassment, sexual assault What you permit, you promote; You promote gender based violence. Do better H/T @rosieICM #MedTwitter

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Jason

@Dr_JSA

8 months

@MedCrisis UK Treasury brain. The paper economic calculations would show that PAs are cheaper than doctors. The reality is that it won't be ULCH putting them on consultant rotas. It'll be Cumberland Infirmary and Blackpool Victoria Hospital. It'll do wonders for health inequalities.

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Jason

@Dr_JSA

1 year

Given I've diagnosed a metastatic cancer due to back pain - this is quite offensive actually. I know some people haven't had great experiences with GPs, but that really doesn't give the right to denigrate an entire group of people - who are mostly trying their best.

Victoria Freeman

@v_j_freeman

1 year

Completely hilarious notion GP would consider any of these conditions as cause of persistent back pain. GPs are hopeless with musculoskeletal pain IME & the quicker treatment from a physio can be accessed the less likely the pain is to become chronic & normal life resumed

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Jason

@Dr_JSA

1 month

This is the output of an org that doesn't have the intellectual or communications capacity to effectively navigate the public relations car crash they're overseeing. "Something happened before, we're now doing something vaguely similar in a different context ∴ it's okay."

GMC

@gmcuk

1 month

The regulation of physician associates (PAs) and anaesthesia associates (AAs) is the next step towards wider regulatory reform and will mean we’ll become a multi-disciplinary regulator again for the first time since 1956. There have been many changes to the role of the GMC in the

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Jason

@Dr_JSA

1 month

To my mind there are three options. None of them are particularly palatable. 1. Redundancy. The practice has to be financially resilient enough to afford this - few are. 2. A period of training akin to GPST. Give them 30 minutes appointments. Simple cases and build from there.

Dr Lucy Pocock

@drpoco

1 month

Hypothetical question for fellow GPs - let’s say your practice has employed a PA (hindsight is 20/20 and all that, we are where we are) and is now wondering how they might best utilise their skills, whilst keeping patients safe etc. Any constructive ideas?

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Jason

@Dr_JSA

1 month

If this is the quality of defence I had to employ to defend the obviously incorrect use of "medical professional" for both doctors & AA/PAs - I'd be a tad embarrassed. There is reputational risk to the GMC, and the standing of individuals with the current implementation process.

Prof Colin R Melville

@drcolinm

1 month

“Our professional standards directly tackle issues around working within competence and being honest about experience, qualifications, and current role.” BMJ 2024;385:q790

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Jason

@Dr_JSA

7 months

Hi @doctorhelgi I understand the point about a lack of enforcement powers. However, given various organisations were *very* keen to have the involvement and endorsement of the RCoA in the creation and scope of AAs - perhaps you might consider utilising your college's soft power?

Dr Helgi

@doctorhelgi

7 months

@deeleyc6 @Dr_Done_ @RCoANews @RCoAPresident @drjonchambers1 @Platform_crocss @gmcuk Hi, With the EGM around the corner I don’t think it’s right to comment in detail, but I know our members will have a chance to tell us their opinion on Tuesday and I know many will take this into account. We do set standards and give guidance, we would expect trusts to follow

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Jason

@Dr_JSA

1 year

I seem to recall @alisonleary1 got hammered for arguing that nursing associates were a gateway to cheaper nurses. I also have seen quite a few doctors on twitter get hammered for arguing about the future risks of PAs... A = B doesn't mean X will equal Y. But still...

Shaun Lintern

@ShaunLintern

1 year

This exploitation of nursing associates and using them in place of registered nurses is what many warned about when the role was just a bad idea. Have you seen @alisonleary1 @maxwele2 ?

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Jason

@Dr_JSA

3 months

What about those of us that are (or were) working class? The assumption that doctors are well off, is part of the reason UK medicine is in the mess it is. The number of times people have assumed my wife and I have a nanny is ridiculous. We're not well paid enough to have one.

Leanne Patrick QN

@LeanneHPatrick

3 months

@cannula_service Oh come on 😂 "This allows connected people to enjoy an elite life denied to real doctors who are honest and hard working." 80% of doctors come from private schools or grammar schools. 4% are working class.

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Jason

@Dr_JSA

1 year

Every year the DDRB compares doctors pay to other professions. No one seems to bat an eyelid at these comparisons. Or the fact that they show a divergence of medical/dental pay from comparator professions over the last 10 years. Are the DDRB being elitist/snobby too?

Tim Ricketts

@timricketts_

1 year

The comparison thing has come around again. If you’re offended by comparing pay, why do you not take issue with Agenda for Change, the DDRB, any job listing site, etc? I’d have some more respect if the thinking was consistent, but the offence is reserved for doctors.

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Jason

@Dr_JSA

2 months

@DrLKVaughan I've long come to the view that there needs to be a USMLE equivalent for the UK. Certain medical schools finding out where their students place nationally might focus minds on the strength of their curricula.

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Jason

@Dr_JSA

1 month

The problem with all of these options is that none of them are cost effective for a practice. Whilst much ire has to be directed at RCGP, I'm afraid that practices that have hired PAs because of the free ARRS funding need to take a moment to reflect too.

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Jason

@Dr_JSA

2 months

Another thread providing further evidence of the institutional/regulatory capture of the General Medical Council.

Louella Vaughan

@DrLKVaughan

2 months

While everyone has been distracted by the happenings at the RCP, @gmcuk has released its new 'vision' for medical education and training. And frankly, it deeply bothers me (my stomach lining can't take much more!). Here's why. 🧵 1/

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Jason

@Dr_JSA

2 months

@UKGastroDr @RCPhysicians @FPARCP The RCP has had ample time to develop its own framework in conjunction with the FPA. It's not the BMAs fault the RCP/FPA has dilly-dallied. Or that that the College has developed a perception of not representing its members true views on the matter.

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Jason

@Dr_JSA

2 years

As you can imagine this happened to me just the once and it was resolved incredibly promptly. There's no excuse for doctors allowing themselves to go for months without pay. If you don't respect yourself and your rights no one else will. You'll get trampled over like a doormat.

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Jason

@Dr_JSA

2 months

@Leicnut @ShaunLintern With respect, I don't see how you can draw that conclusion if you'd considered the confounders. How were members informed of the survey? What reminders were sent? What is the usual response rate to surveys sent by the RCP? What proportion of members/fellows are consultants? Etc

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Jason

@Dr_JSA

4 months

@theveindoc So your initial reaction is to effectively discredit the character of those reporting. Your next reaction is to argue that the actions of a minority shouldn't be used to govern or judge the majority - when that is precisely what happens to doctors.

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Jason

@Dr_JSA

3 months

There's institutional capture of the GMC, who at the very least should have consulted doctors in the way they consult about changes to Good Medical Practice. Legislation is being passed which has purposely avoided Parliamentary scrutiny.

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Jason

@Dr_JSA

7 months

Arsenal FC were the first to play 9 black players in a XI. They used an afrobeats track to announce their record signing and only last year had a yellow, black and green training top in homage to Jamaica. Identity politics leads to this manufactured and nonsensical outrage.

SPORTbible

@sportbible

7 months

🚨 Arsenal break silence after backlash from all-white women’s team photo

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Jason

@Dr_JSA

2 months

The onus is on @DrSarahClarke to declare her interests. The fact she chose not to, when doctors are always encouraged to over-declare, speaks volumes. But as editor @KamranAbbasi you really should have challenged a lack of declaration. This doesn't reflect well on the BMJ.

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Jason

@Dr_JSA

10 months

I needed a holiday to make the time to read - after getting it on release day - but finally finished @tomowolade 's book. It is *brilliant* and I thoroughly recommend it to anyone and everyone. Deserves the praise it has already had, and will continue to get.

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Jason

@Dr_JSA

5 months

We already know that training more doctors to become GPs, doesn't lead to more GPs. The suggestion that streamlined pathways will solve the problem has zero basis in the reality of the current GP workforce issues. It's arguably dishonest to pretend it will - given what we know.

NHS England Workforce, Training and Education

@NHSE_WTE

5 months

"If we want to tackle the crisis in GP numbers, we should establish a pathway for physician associates to go on to train as doctors and for newly qualified doctors to go straight into five years’ training as GPs."

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Jason

@Dr_JSA

5 months

PAs are only going to entrench socioeconomic inequalities in medicine. Because the informed widening participation entrants from Sunderland or Newham, will do the above. Or not pursue medicine at all. Those with family wealth will predominantly be the ones pursuing medicine.

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Jason

@Dr_JSA

1 month

3. Use them as a Doctors assistant. They can call back the patient whose urine dip is positive and inform them of their antimicrobial prescription being available. Inform the patient of test results or of home BP monitoring etc. All assuming the PA accepts this. Many won't.

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Jason

@Dr_JSA

1 month

Were I a GP partner I'd have used ARRS for physios, pharmacists and paramedics. I'd have avoided PAs and hoped that eventually nurse practitioners would be added to the list - which it looks like they probably will. Sorry @drpoco for the lack of a more positive answer.

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