ExplosiveEnema @ExplosiveEnema Twitter profile

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ExplosiveEnema

6 months

Small disclaimer This is the account of a bright pink douche who does not claim to be a doctor As such, use discretion when following, liking, or retweeting anything that it posts Thank you

Physician Associate

@physicianassoci

6 months

@ExplosiveEnema and fingers crossed the doctor you see isn’t @ExplosiveEnema

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ExplosiveEnema

@ExplosiveEnema

6 months

👀 Spot the difference 👀 Post CCT/ST8 neurosurgeon in London commands the same salary as a PA straight out of uni 🤯 15+ years studying medicine Vs 2yr PA degree Who would you want operating on you?

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ExplosiveEnema

@ExplosiveEnema

5 months

Huge numbers of Doctors dream of working in dermatology but are turned away due to the lack of training numbers So it's a slap in the face to see these sorts of presentations given at the FPARCP National CPD Conference

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ExplosiveEnema

@ExplosiveEnema

6 months

Ok this has just become a potentially national scandal PAs should not be working at this level in paediatrics I'm lost for words... I feel sick

ExplosiveEnema

@ExplosiveEnema

6 months

PAs covering *Paediatric* SHO gaps overnight at @BWC_NHS regularly! 🤯 Whistleblowers are often afraid to speak out publicly for fear of losing their jobs Our kids deserve doctors! Not poorly trained & unregulated imitations! @DrRaviJ @LittlePersonDoc #ItsOkayToAsk

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ExplosiveEnema

@ExplosiveEnema

5 months

Boss just told me to hand over my keys so another employee (who is banned from driving in the UK) could take my car for a work errand! I said it wouldn't be safe & it would be my car that would be damaged if anything went wrong! Got told I had to #bekind and work as #oneteam ...

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ExplosiveEnema

@ExplosiveEnema

6 months

"PAs aren't here to replace Drs" Yet here is one covering the renal SHO on-call 🤷‍♀️

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ExplosiveEnema

@ExplosiveEnema

6 months

PA studies are *unaccredited*. This is a massive deal that has been swept under the rug Accredited courses have external bodies who come in to audit & review the content being taught to ensure it is of a high standard PA studies do not have this external audit process… 🤯 1/3

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ExplosiveEnema

@ExplosiveEnema

6 months

PAs covering *Paediatric* SHO gaps overnight at @BWC_NHS regularly! 🤯 Whistleblowers are often afraid to speak out publicly for fear of losing their jobs Our kids deserve doctors! Not poorly trained & unregulated imitations! @DrRaviJ @LittlePersonDoc #ItsOkayToAsk

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ExplosiveEnema

@ExplosiveEnema

9 months

Professor Jeannie (Jean) Watkins ( @jeannie_watkins ) Former President @FPARCP Current Programme Director and Professorial Lead for PA studies at Swansea One of the top PAs in the country 🧵

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ExplosiveEnema

@ExplosiveEnema

6 months

Guidance from @FPARCP on prescribing for PAs in GP "If the duty doctor is very busy, the PA will send an urgent message via clinical system so that the GP/supervisor can issue between patients" THIS IS NOT HOW PRESCRIBING SHOULD WORK! Not discussing scripts is so dangerous!

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ExplosiveEnema

@ExplosiveEnema

6 months

🚨Trusts hiring PAs who haven't completed any PA degree @RCSEd which site is responsible? Given the evidence we need - Pause on recruitment - Audit of every site utilising PAs looking at qualifications, safety, job role, scope, rotas, & impact on Drs training #AlwaysGetsWorse

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ExplosiveEnema

@ExplosiveEnema

6 months

My concern has always been patient safety. This is not a win, but a dire warning as to the direction of travel of UK medicine No PA should be on any Dr rota. It's that simple PAs support, not replace

Concern after unqualified medics given senior Birmingham hospital roles

Physician associates have been used in responsible positions at Birmingham Children's Hospital.

www.bbc.co.uk

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ExplosiveEnema

@ExplosiveEnema

4 months

There is a lot of talk about the PA National Exam So here are 6 of the top performing Unis for the written PANE, all achieving a 100% pass rate! Amazing! Nothing strange about that at all…

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ExplosiveEnema

@ExplosiveEnema

9 months

From the outside it looks like you've been promoting a new and largely untested model of working over the last number of years through your research, while simultaneously benefitting monitarily by supplying these PAs

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ExplosiveEnema

@ExplosiveEnema

4 months

Each year @FPARCP conduct a census of PAs In 2017 they asked: "Have you ever been asked to cover trainee rota gaps at your hospital?" The results were damning with ~60% responding "YES" This question was dropped from subsequent census reports PAs are replacing Drs

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ExplosiveEnema

@ExplosiveEnema

6 months

What the fuck is happening in UK medicine!? When a GP with at least 10years training refers a patient for 2ww they want the patient reviewed by an expert in that field. Not an unregulated, poorly trained imitation If you're a patient #ItsOkayToAsk who's treating you #WhyNotSAS

Richard Fitzgerald 💙 🦀

@r1chardf1tzg3r1

6 months

Are #PhysicianAssociates In #BreastSurgery Safe ? 1/2 2yr #PA Training ⁦ @RUHBath ⁩ Job Description ⁦ @SteveBarclay ⁩ ⁦ @BreastCancerNow ⁩ ⁦ @TMitchellFRCS ⁩ ⁦ @ABSGBI ⁩ ⁦ @NHSEmployers ⁩ ⁦ ⁦ @wesstreeting ⁩ ⁦

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ExplosiveEnema

@ExplosiveEnema

8 months

If you were looking up your GP surgeries "Meet the team" page as a member of the public, would you know this person is not a medical doctor?

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ExplosiveEnema

@ExplosiveEnema

6 months

36 hours & no statement from @BWC_NHS Here's a redacted rota & description of what LD on the rota entails. Was someone without a medical degree working in paeds hepatology LD on 4/3/22? Whistleblowers, every Dr in the country stands behind you on this 1/6 @drcolinm @KeeleyMP

ExplosiveEnema

@ExplosiveEnema

6 months

Ok this has just become a potentially national scandal PAs should not be working at this level in paediatrics I'm lost for words... I feel sick

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ExplosiveEnema

@ExplosiveEnema

9 months

Your research is pointed to as evidence of how the PAs are valuable, vital, & safe But with this undeclared conflict of interest, much of your body of research *has* to be called into question, alongside any policy documents that have used it as justification to push PAs

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ExplosiveEnema

@ExplosiveEnema

9 months

Since then you have published numerous pieces of research, all about how PAs are a vital part of the work force and should be expanded You do not appear to have declared this conflict of interest in any of it

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ExplosiveEnema

@ExplosiveEnema

6 months

An early slideshow from a former President of @FPARCP Suggests that ~94% of patients seen by PAs require *no* supervision, and that they are autonomous decision makers Tired and feeling like a broken record... 😮‍💨

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ExplosiveEnema

@ExplosiveEnema

8 months

I mean... mildly amusing that you were blocked for doing medicine, by a PA whose research profile states they're a "medical doctor" Maybe it's just jealousy?

Donya Mighty

@dx_mighty

8 months

I have been blocked by the above accounts which are supposedly networks to support PAs. I have also been blocked by Susan's personal twitter @SwanCArt despite never interacting via twitter with her until now. (7/9)

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ExplosiveEnema

@ExplosiveEnema

7 months

So PAs are going to become regulated professionals without ever actually being regulated.... All the GMC are doing is keeping a list This is seriously bad. Paves the way for prescribing, rads and limitless scope without any guardrails whatsoever!

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ExplosiveEnema

@ExplosiveEnema

5 months

This analogy encapsulates the breakdown of how work is viewed between PAs & Drs PAs see job opportunities as a right. Something that Drs should share with them like it's a mince pie Drs view it as a responsibility that you should only advance to after rigorous training

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ExplosiveEnema

@ExplosiveEnema

5 months

Thanks to all the kind people who genuinely replied to this. You are all beautiful humans I can reassure you that my boss hasn't asked me to hand my keys to someone without a driving license, but the situation with Drs & Physicians Associates & your NHS is just as bonkers 1/🧵

ExplosiveEnema

@ExplosiveEnema

5 months

Boss just told me to hand over my keys so another employee (who is banned from driving in the UK) could take my car for a work errand! I said it wouldn't be safe & it would be my car that would be damaged if anything went wrong! Got told I had to #bekind and work as #oneteam ...

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ExplosiveEnema

@ExplosiveEnema

6 months

They say they are assured it's safe but give no evidence to back that up Fortunately I have the job advert Confirms everything exposed so far... And includes the fact you can apply straight from uni! 🤯 Paediatricians, do you feel this is safe!?

ExplosiveEnema

@ExplosiveEnema

6 months

36 hours & no statement from @BWC_NHS Here's a redacted rota & description of what LD on the rota entails. Was someone without a medical degree working in paeds hepatology LD on 4/3/22? Whistleblowers, every Dr in the country stands behind you on this 1/6 @drcolinm @KeeleyMP

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ExplosiveEnema

@ExplosiveEnema

6 months

Assured it's safe yet? For a Reg to be on that rota they would have completed ST4+ (intense exams & rotations across numerous departments) How do they ensure a PA whose 1st job from uni is at @BWC_NHS has the same level of rigorous training/experience/knowledge as an ST4?

ExplosiveEnema

@ExplosiveEnema

6 months

They say they are assured it's safe but give no evidence to back that up Fortunately I have the job advert Confirms everything exposed so far... And includes the fact you can apply straight from uni! 🤯 Paediatricians, do you feel this is safe!?

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ExplosiveEnema

@ExplosiveEnema

8 months

My concern with finding so many Physicians Associate willing to claim "Dr" online or even in official gov docs is that it is only the tip of the iceberg 1/4

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ExplosiveEnema

@ExplosiveEnema

7 months

@Dr_Done_ Zero credit deserved here for physician associate Gill. Most Drs & PAs knew that this was a hugely unethical way to represent himself Both him and his partners responsible should be ashamed that it took a statement from @FPARCP to change this. Reflects very poorly on them all

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ExplosiveEnema

@ExplosiveEnema

6 months

@gmcuk There were around 250,000 doctors in the UK when that consultation was completed 738 were involved in the consultation That is less than 0.3% in an 8 week period! Yet when >2,800 doctors in 24hrs sign a letter of concern about it you completely ignore it Very dangerous

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ExplosiveEnema

@ExplosiveEnema

6 months

Next time someone claims words on the internet are hurting PAs feelings… Remind them that some PAs reported dozens of doctors in an attempt to have them punished for raising valid & reasonable concerns about patient safety & scope creep You wont stop this debate... So #bekind

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ExplosiveEnema

@ExplosiveEnema

5 months

Real toxicity? - saying "not replacing Drs" but working on Drs rota - declaring support for Drs learning but taking theatre/clinic time - paying more for extra contractual work for less responsibility/liability - dismissing the upset of Drs re: the above as a vocal minority Etc

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ExplosiveEnema

@ExplosiveEnema

5 months

Interesting podcast as always from @PApodcastUK Underqualified, unaccredited, and unregulated PAs are doing the following after "a few months": - Running 2ww cancer clinics - Learning dermatology & surgery from Instagram/YouTube NHS in 2023 people

The Physician Associate Podcast: Physician associates in dermatology

Physician associates can work in lots of different medical specialities. In this episode we hear from David Harnett who is a Physician Associate in Dermatology. We discuss his current work in skin ...

podfollow.com

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ExplosiveEnema

@ExplosiveEnema

9 months

This is incredibly worrying and needs to be looked at seriously Particularly given the real world examples of the PA role failing spectacularly 1 - 2 -

Call for physician associate clarity after misdiagnosis death

Emily Chesterton saw a physician associate twice before she died, thinking they were a GP.

www.bbc.co.uk

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ExplosiveEnema

@ExplosiveEnema

7 months

How could someone who owns a company promoting locum PAs & advocates not being too "prescriptive" in scope have ever been allowed to become Lead for Regulation & Legislation of PAs at @RCPhysicians !? We've been asleep at the wheel while others controlled narrative & policy

ExplosiveEnema

@ExplosiveEnema

9 months

Professor Jeannie (Jean) Watkins ( @jeannie_watkins ) Former President @FPARCP Current Programme Director and Professorial Lead for PA studies at Swansea One of the top PAs in the country 🧵

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ExplosiveEnema

@ExplosiveEnema

9 months

If the research around PAs is tarnished by profiteering, then the whole model needs to be placed on hold until further research and analysis can be done

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ExplosiveEnema

@ExplosiveEnema

5 months

Hi @edgehill Despite numerous attempts to contact you to correct this it still remains in place @FPARCP guidelines state that only individuals with a level 8 doctorate degree should use the title Dr in the academic setting. An online DMSc won't do @gmcuk @FPARCP

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ExplosiveEnema

@ExplosiveEnema

4 months

87.9% of surgical trainees thought PAs misrepresented the role to patients This whole thing is damning

Claire M Dee 💙

@deeleyc6

4 months

@ASiTofficial 70.5% reported negative impact 15.5% being supervised by PAs 47% reported negative impact on patient care 88%believed trainees should be involved in defining the scope for PAs 70% did not believe PAs should have a role in surgical procedures @KeeleyMP @shaungw @ShaunLintern

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ExplosiveEnema

@ExplosiveEnema

8 months

WHY ARE THERE SO MANY PA'S CALLING THEMSELVES DOCTORS!? 😩

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ExplosiveEnema

@ExplosiveEnema

5 months

📣 GPs I'd love your opinion - Locum PAs covering GP sickness - Locum PAs expected to do 15minute appointments & see any patients of any age - Distant supervision of locum PAs Lots of hand waving & reassurance by the Locum agency who are making money

The Physician Associate Podcast: How can physician associates pick up locum shifts?

In this episode, we talk to Joe and Alex from Locum PA about how and why they set up their bespoke PA locum company. We also touch on the benefits of locum work for PAs, and how PAs can prepare the...

podfollow.com

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ExplosiveEnema

@ExplosiveEnema

5 months

It was a fiction that PAs were calling themselves Drs… Until we sampled the PA register and found 7% of them were brazenly doing it online Some even bought dodgy "doctoral" degrees online But keep making us out to be conspiracy theorists. We'll keep digging & gaining support

Ogidi 💯

@JoOgidi

5 months

@caspertown42 @TheSalariedPA @AnalysisDrawer @MutteringWildly @FrankCoffey26 If you meet this secret network, do let me know. As far as I'm aware, not planned by faculty. Even recent document was encouraging trusts to avoid this as below.

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ExplosiveEnema

@ExplosiveEnema

8 months

Joseph Ormerod @Ormerod84 founder of @LocumPA_Ltd Claim to have >80% of the PA workforce registered with them. Also sponsor the @RCPhysicians via @FPARCP events as previously documented They advocate for PAs to replace Drs: 1/3

ExplosiveEnema

@ExplosiveEnema

8 months

"PAs aren't here to replace Drs" Anyone want to tell that to one of the main sponsors of @RCPhysicians and @FPARCP , "Locum PA LTD" who on their case study page outline reducing expensive GPs by replacing them with PAs?

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ExplosiveEnema

@ExplosiveEnema

8 months

@dan_wilkes Used to be called "Physicians Assistants" Then changed to "Physicians Associates" In the last 2 weeks we saw "Associate Physician" Quickly followed by "Doctor of Medical Science" The slow creep continues. Those of us ringing alarm bells aren't doing it without cause...

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ExplosiveEnema

@ExplosiveEnema

5 months

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ExplosiveEnema

@ExplosiveEnema

5 months

As an aside they say they've done an advanced driving course in a compressed time and I can trust them... Don't think I'm being unreasonable but my boss and his boss are both pressuring me and I don't know what to do. I don't understand why they just don't hand their keys over…

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ExplosiveEnema

@ExplosiveEnema

5 months

Inspired by @IncogAssociate and @Xeon4f145d96s1 I thought it was appropriate to utilise the same graphic to demonstrate why doctors don't feel PAs should be examining med school finals Hopefully this makes it easier for some to understand

IncogPA

@IncogAssociate

5 months

@DocShivSharma @Doctors_Vote @Xeon4f145d96s1 @MichelePaduano @TomStocks1982 @Doc_IonaCollins @DocAnonX @DrPhilBanfield You do realise it's not just doctors that are competent and have the skillset and experience to examine medical students. Medical education is a seperate discipline in its own respect. An experienced PA who also has an academic role can examine medical students.

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ExplosiveEnema

@ExplosiveEnema

6 months

I expect strong statements from every single college denouncing any organisation that puts a PA on the same rota as a Dr PAs should only support a fully staffed Drs rota. This shouldn't be a controversial statement for any organisation to make @KeeleyMP @gmcuk @RCPhysicians

EmilyK_Geeson

@ek_geeson

6 months

@iDrSunny @DrRaviJ I cannot comprehend even why it is up for debate for non-doctors to take up a Doctor's shift. How is it even on the table?

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ExplosiveEnema

@ExplosiveEnema

6 months

This explains the exponential rise in PA schools… Easy to set up when nobody's looking at what you provide Also explains why every other PA seems to be a lecturer... They are literally marking their own homework! Not safe for patients 3/3

Jim Crawfurd 💙 🇺🇦

@jim_crawfurd

6 months

@SandipP64097927 @Xeon4f145d96s1 @HealthRegLawyer @MercurialRx I’m genuinely not sure. One other point to make is that the “PAs have been around in UK for 20 years” narrative is very misleading: Tiny numbers of PAs have been around for 20 years and hardly any of us would have worked with them prior to 2019.

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ExplosiveEnema

@ExplosiveEnema

6 months

GMC are playing an incredibly dangerous game Pushing this through against the advice of Drs will call into question their legitimacy as a regulator When Drs say @gmcuk is being unsafe, how are the public supposed to rely on them as a regulator? #PatientSafety #ProtectPatients

GMC

@gmcuk

6 months

GMC as the regulator: The Department of Health & Social Care held a public consultation on who should be the regulator of PAs and AAs. They decided in 2019 that it would be the GMC (2/8)

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ExplosiveEnema

@ExplosiveEnema

5 months

Doctors fighting eachother for dermatology training after completing med school, foundation, and core training... Not to mention audits and publications While PA needs PgDip and basic life support 🙃

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ExplosiveEnema

@ExplosiveEnema

5 months

Yes

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ExplosiveEnema

@ExplosiveEnema

5 months

Every single vote on the issue of PAs and AAs has been overwhelmingly against The reasonable approach is pause, thorough review of working practices, scope, and safety data, then move What possible motive could any sensible person have against that? #TrustDoctors

ITV News

@itvnews

5 months

Plans to extend physician associate roles rejected as 87% of doctors worry about patient safety, reports @staceyitv

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ExplosiveEnema

@ExplosiveEnema

8 months

We are finding numerous PAs in high level roles, obfuscating their title @RCPhysicians or @FPARCP do you have any comment on this given their sponsorship links to the college and faculty as well as the fact that the **VAST** majority of PAs are registered with them? 3/3

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ExplosiveEnema

@ExplosiveEnema

9 months

Posted this all late last night with some other stuff but I feel this specification needed drawn out separately Hopefully @jeannie_watkins can provide some clarity and this is all just a big misunderstanding...

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ExplosiveEnema

@ExplosiveEnema

5 months

@DocEd @PApodcastUK The scariest parts for me is we are at a stage where an underqualified, unaccredited, unregulated PA working in a GP surgery could refer to secondary care for an expert opinion from an underqualified, unaccredited, unregulated PA It's madness of the highest order

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ExplosiveEnema

@ExplosiveEnema

9 months

According to companies House as well as the roles above you are a director of a PA recruitment agency: As we can see you were appointed on 19th September 2013

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ExplosiveEnema

@ExplosiveEnema

8 months

Now completely changed her profile! No longer school of Medicine No longer Medical Doctor You are not fit for a leadership role Susan. I hope any time you try to push yourself into one that these incidents are raised. PAs would be better served by someone with common sense

ExplosiveEnema

@ExplosiveEnema

8 months

I mean... mildly amusing that you were blocked for doing medicine, by a PA whose research profile states they're a "medical doctor" Maybe it's just jealousy?

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ExplosiveEnema

@ExplosiveEnema

5 months

From another ex-president of PAs in 2014 - Patients are better off being treated by PAs than junior doctors - They're a new kind of medic Why are PA leaders throwing punches at Drs? This thinking is systemic rot that's percolated down from PA leadership since its conception

Dr Done

@Dr_Done_

5 months

PAs are the gift that keeps on giving It sounds like Theresa wants to be… a doctor? But it’s the last clip that is MOST representative of PAs…

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ExplosiveEnema

@ExplosiveEnema

4 months

These fine establishments obviously show how rigorous and thorough the PA training scheme is There could not possibly be anything wrong with the PA National Exam... 😬

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ExplosiveEnema

@ExplosiveEnema

5 months

If a PA who is under distant supervision refers a patient to secondary care and speaks to another PA who refuses the referral, does the legal responsibility fall on the GP supervisor?

Dr Goblin

@DrGoblin3

5 months

Animesh is 100% correct. This applies in ALL scenarios, including if the other doctor is part of your team e.g. SpR or Consultant. Remember Bawa-Garba? 1/5

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ExplosiveEnema

@ExplosiveEnema

8 months

"PAs aren't here to replace Drs" Anyone want to tell that to one of the main sponsors of @RCPhysicians and @FPARCP , "Locum PA LTD" who on their case study page outline reducing expensive GPs by replacing them with PAs?

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ExplosiveEnema

@ExplosiveEnema

6 months

This is not rogue departments or rogue PAs This presentation was given at the national conference in 2019 clearly stating what was going on at @BWC_NHS It was open knowledge among @FPARCP leadership It's sensible to pause recruitment until all departments thoroughly reviewed

IncogPA

@IncogAssociate

6 months

@gem1509 Individual departments recruiting and using PAs inappropriately does not mean stopping PA recruitment completely. It means regulation needs to happen. It means the FPA need to challenge such cases. The majority of PAs are hired, trained and utilised appropriately.

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ExplosiveEnema

@ExplosiveEnema

8 months

Just reported this post. Completely unacceptable for PAs to be using people's families to threaten their well-being and future... all just because they are becoming a Dr. Please consider doing the same

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ExplosiveEnema

@ExplosiveEnema

5 months

This suddenly got very serious If you are one of the AAs, Consultants, or trainees involved it would be far better to be the first one forward with the truth, and quickly Certainly wouldn't want someone else to beat me to it lest I be accused of covering things up… Oh wait…

Dr Done

@Dr_Done_

5 months

Now, let me draw your memory back to a plucky little sailing ship called HMS AA… There have been many FOIs. This one was received today I post it alongside the original email outlining the ‘reforms’ the made whilst being watched You can decide if the answers are honest. ☠️

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ExplosiveEnema

@ExplosiveEnema

7 months

IEA - You know their work. They're a right wing thinktank responsible for Trussonomics & have advocated privatising the NHS So it's disappointing to see the Lead for Regulation & Legislation of PAs being thanked for their contribution to IEAs post-pandemic briefing paper...

ExplosiveEnema

@ExplosiveEnema

7 months

How could someone who owns a company promoting locum PAs & advocates not being too "prescriptive" in scope have ever been allowed to become Lead for Regulation & Legislation of PAs at @RCPhysicians !? We've been asleep at the wheel while others controlled narrative & policy

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ExplosiveEnema

@ExplosiveEnema

8 months

Given his advocacy for PAs, I find it curious that in 2016 he decided to incorporate: "NEST EGG CAPITAL & PROPERTY LETTINGS LTD" And guess what he put as his occupation.... "Physician" 2/3

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ExplosiveEnema

@ExplosiveEnema

8 months

@Dr_Done_ So only controlled drugs are questioned and discussed!? THIS IS NOT HOW PRESCRIBING RIGHTS WORKS! Let's say for the sake of argument... He knocks and wants propranolol for an anxious lady with long COVID and a sprained ankle....

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ExplosiveEnema

@ExplosiveEnema

7 months

Pretty disgusted that people would lodge complaints against someone who is literally only trying to have an open and honest conversation Credit to Partha but I worry about more junior Drs dragged into meetings due to voicing an opinion on PAs And they wonder why Anons exist 🤷‍♀️

Partha S Kar 🇮🇳🇬🇧🏏🎥

@parthaskar

7 months

@iDrSunny @Molly2323232323 @RCPhysicians @trishgreenhalgh @UKGastroDr @DrLKVaughan @RowanHarwood @FPARCP @DrSelvarajah @NHSE_WTE @VirtueOfNothing @OrthopodReg @doctor_oxford Can’t account for the whole of RCP. I will do my bit as elected councillor. We shall see with time how all this pans out Already have complaints lodged against me. The fun has just begun 😊

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ExplosiveEnema

@ExplosiveEnema

7 months

Consultancy firms offering to show practices how to replace "expensive locum GPs" with "use it or lose it" funding for ARRS roles... But ARRS isn't being used to replace GPs...

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ExplosiveEnema

@ExplosiveEnema

4 months

This is the trust that threatened striking Drs with the GMC Their apology was for the "sense of intimidation" taken, not for their clear act of intimidation No retraction of the specific GMC threat Doubled down that it was sent with "good intent" Poor @SuzRankin

Cardiff and Vale University Health Board

@CV_UHB

5 months

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ExplosiveEnema

@ExplosiveEnema

9 months

What does "supervision" mean for PAs in 1° care? 1) GP discussion of all patients = inefficient Better to hire 2nd GP 2) GP discussion of only complex patients = dangerous Relies on PAs *independently* deciding who is complex 3) Word salad explanation that provides no clarity

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ExplosiveEnema

@ExplosiveEnema

7 months

@mmamas1973 "A PA can do everything a doctor can do except order ionising radiation and prescribe... But they'll be able to do that once regulation comes in" This is what they truly believe... Unless told they specifically cannot do it, they will crack on... Absolutely bonkers

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ExplosiveEnema

@ExplosiveEnema

4 months

Main character checklist on PAs ✅ Don't add anything of value to the debate for months ✅Claim you knew it was unsafe all along ✅Signal your virtue by saying be kind To everyone else who has been working hard both on & offline to raise and fix this issue - you are amazing

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ExplosiveEnema

@ExplosiveEnema

5 months

@PAalice19 Gut wrenching for the sensible heads in the room Drs pissed for obvious reasons But again, PAs who have kept their heads down & noses clean look at this & can only see all of the worst caricatures made of their profession being validated PA leadership have failed their members

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ExplosiveEnema

@ExplosiveEnema

7 months

@FPARCP President gave a lecture in 2018 speaking of the importance of a PR campaign & giving titles to PAs (lead/ambassador/senior) to "give PAs a voice at higher levels" Incredible clever move using arbitrary titles to subvert normal paths of progression that Drs adhere to 🧵

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ExplosiveEnema

@ExplosiveEnema

6 months

There are only 3 groups to blame for this @FPARCP for actively opposing any definition of scope Employers who exploited the above to replace doctors on rotas & in theatres PAs who fervently grabbed those opportunities It didn't have to be like this... 😔

Drawer Analysis

@AnalysisDrawer

6 months

Today is a hard day to be a Physician Associate. I have understanding and sympathy for @theBMA 's statement yet feel disheartened seeing individuals celebrating as if to claim victory over the "Evil PA".

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ExplosiveEnema

@ExplosiveEnema

6 months

Interesting podcast - PA only stroke expert in hospital & led neurologists in how to manage it - Applied for ANP job & got it as they were a better fit (not just replacing Drs) - Important role as compensates for ⬇️SpRs in palliative care @doctor_oxford

Physician associates working in palliative medicine by The Physician Associate Podcast

In this episode I spoke with the UK’s first PA in hospice medicine, Jovy Giles, about tough workplace experiences, going after your goals and getting into the heart of why palliative medicine feels...

podcasters.spotify.com

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ExplosiveEnema

@ExplosiveEnema

6 months

Further official guidance making light of prescribing PAs should have their histories & examinations scrutinised in detail before any GP prescribes any drug. Not simply signed off after reading the documentation! So dangerous to only to discuss scripts "very rarely" 🤯

ExplosiveEnema

@ExplosiveEnema

6 months

Guidance from @FPARCP on prescribing for PAs in GP "If the duty doctor is very busy, the PA will send an urgent message via clinical system so that the GP/supervisor can issue between patients" THIS IS NOT HOW PRESCRIBING SHOULD WORK! Not discussing scripts is so dangerous!

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ExplosiveEnema

@ExplosiveEnema

4 months

Yes, it's perfectly reasonable if those accounts have a solid track record Anonymous accounts are the canary in the coalmine that you ignored @drcolinm you are dangerously wrong on PAs. Everyone is now telling you to stop Time to listen Pause recruitment, reasses, then move

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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ExplosiveEnema

@ExplosiveEnema

5 months

I could be wrong but I think this is the beginning of the beginning of the end of the PA project... Passing legislation is the easy part and even if the stars align on that, the headwinds for HMS PA are incredibly strong

Partha S Kar 🇮🇳🇬🇧🏏🎥

@parthaskar

5 months

#PhysicianAssociates My view & suggestions-via @bmj_latest "Survival of PA/AA is, as things stand, dependent on doctors—both seniors & other grades. If that relationship is fractured there’s a big problem. A pause, a rethink, with calm heads is needed"

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ExplosiveEnema

@ExplosiveEnema

4 months

Why I hate #BeKind and why you should too 1/🧵

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ExplosiveEnema

@ExplosiveEnema

8 months

Big shout out to James from the BMA who has been a huge font of knowledge, support, and advocacy for Drs His tweet below was sent at 6:25am! The man's not even clocked in and he's representing Drs! 👊 Give him some love! ❤️

James Steen

@BMA_James_Steen

8 months

“it is clearly wrong that a newly qualified doctor… is paid over £11,000 less per year than a newly qualified PA, while the Dr role, remit and professional responsibility is far greater… this is a 35% differential, which is manifestly unjust.“ We move. ✊🏼

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ExplosiveEnema

@ExplosiveEnema

6 months

PA educationalist will point to the 🌈 matrix🌈 as the be all & end all guide as proof of the content being taught... There are many problems with the matrix itself but even if it was perfect, without accreditation this is only a guide to what unis need to teach 2/3

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ExplosiveEnema

@ExplosiveEnema

5 months

@JonnyGucks Neither Exams are just one of many filters. That's why opening up exams to non-medics is a terrible idea. There are a litany of other barriers Drs have to pass to get where they need to be Would you drink water filtered just through the rock layer?

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ExplosiveEnema

@ExplosiveEnema

6 months

With ~3000 PAs in the country, a short survey by @TheDA_UK had ~400 reports of concerns That's 10% 👀 This is a bigger problem than even I realised!

Woman's death shows health chiefs must tackle physician associates

A young mother died earlier this year from aggressive breast cancer after delays caused by a misdiagnosis from a physician associate (PA) at her GP surgery, this newspaper has learned.

www.dailymail.co.uk

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ExplosiveEnema

@ExplosiveEnema

6 months

6mnths ago nobody was speaking against PAs We made a rationale & cohesive argument to convince people of the merits of our points We did not rely on our status, we lived & died by the words we spoke Trying to use our anonymity against us will not work to delegitimise our views

DrG

@DrJPGannon

6 months

Letter: 'GPs need to speak out against the online abuse PAs face' - Pulse Today 👍Such a change from the usual anons or those who have never worked with PAs

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ExplosiveEnema

@ExplosiveEnema

5 months

@emmdechen @EduMed_UK @FrankCoffey26 I really hate when people use the term noctor to describe a PA who is simply trying to drill into a patient's skull while learning anatomy on the job It's certainly one of the most pressing issues when this debate is brought up Thank-you for highlighting it

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ExplosiveEnema

@ExplosiveEnema

5 months

When I talk about PA "culture" I evidence 3 PA presidents own words & actions, the FPARCP, numerous PA companies, a PA "Dr" news commentator & more to demonstrate the systemic rot You've referenced a Peppa pig avatar with a tiny account We are not the same

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ExplosiveEnema

@ExplosiveEnema

7 months

It would appear Sheffield have well and truly drunk the coolaid - 2023 grad getting to shadow cons in day clinics. How many F1s are getting this opportunity? - Lung cancer clinics & chest drains by an unregulated profession 🤯 @SheffieldHosp @MajorKirsten1

Dr Done

@Dr_Done_

7 months

Now, I get lots of DMs But this has to be in the TOP 5 WORST❗️ ‘Unhappy vocal minority’ - how dare you raise concerns? ‘We need to be careful, but only while we’re under the microscope’ Storm analogy again when in fact a tsunami is coming 🫠 @SheffieldHosp @MajorKirsten1 ?

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ExplosiveEnema

@ExplosiveEnema

5 months

@Dr_Done_ You didn't get the meme-o...

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ExplosiveEnema

@ExplosiveEnema

5 months

@timricketts_ @physicianassoci Look on the bright side Given your intense 6 hour training course you can now call yourself a paramedic associate This grants you the ability to come out with asinine statements like those you see above! P.S. hope all is ok ♥️

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ExplosiveEnema

@ExplosiveEnema

8 months

This is not a Dr, they do not have a PhD, nor do they even have a DMSc... They are in fact a PA... When your own trust isn't able to understand the difference between a PA and a Dr, what hope do the general public have? (This individual shouldn't be blamed for the trusts error)

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ExplosiveEnema

@ExplosiveEnema

4 months

A lot has been said about anons on medtwitter, but seeing repeated attempts to label them all as "x" is clearly aimed to shut down debate Here is my view of Anons on medtwitter, why they exist, and why established hierarchies & cliques are scared of them 1/🧵

Partha S Kar 🇮🇳🇬🇧🏏🎥

@parthaskar

5 months

An interesting yet pertinent DM “All these anon accounts raising issues of PAs- you know they will turn against IMGs one day. What do you do then” The answer is the same as always It doesn’t matter who you are. You object to IMGs &their progression? I will be right here.

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ExplosiveEnema

@ExplosiveEnema

6 months

To any Trusts thinking about utilising PAs… they are there to support Drs, not replace them… an addition, not substitute If a rota has a doctor on it, then it cannot be "shared" with a PA If you can't afford to staff a Drs rota then you can't afford PAs. It's that simple 3/6

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ExplosiveEnema

@ExplosiveEnema

8 months

Today's PA comes early this morning! Nearly slipped through the net but Companies House to the rescue again! (Before anyone says it, no PhD or DMSc listed in their education and hospital & local newspaper articles do not refer to them as "Dr") #aPAadaykeepsDoctorsaway

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ExplosiveEnema

@ExplosiveEnema

5 months

Wondering what the legality of an unregulated, unaccredited member of the public doing this is? Similarities/differences to 'Dr Evil'? Anyone know any lawyers who could speak to this? Please tag them in! Be interesting to see how RCP scope tailors this back too!

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ExplosiveEnema

@ExplosiveEnema

4 months

Many "leaders" who have been full throated supporters of the PA project should (and probably do) know better, but in for a penny in for a pound eh? This has always been about calling out the obvious

ASiT

@ASiTofficial

4 months

📢 New #ASiT Report on Physician Associate Impact on Surgical Training and Patient Care 🏥👩‍⚕️ 🔍 Largest ever ASiT survey: 1,978 doctors across all surgical specialties in the UK. 🤝 Focus: Physician Associates (PAs) impact on surgical training and patient care 📈 73.8% worked…

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ExplosiveEnema

@ExplosiveEnema

5 months

@theveindoc They'll put their candidates forward who will make their arguments and people will vote in a fair an democratic way I welcome increased participation in democracy

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ExplosiveEnema

@ExplosiveEnema

9 months

In its original guidance to employers, the Faculty of PAs had some rather interesting opinions on how PAs were superior to ANPs Apparently it's the ANPs with "many gaps in basic science"... *In view of transparency, I believe this section was removed/edited in later iterations

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ExplosiveEnema

@ExplosiveEnema

5 months

Challenge to any PAs or Doctors out there in secondary care Can you show us a redacted rota for PAs where they aren't replacing doctors in some way? Supporting not substituting Let's show some shining examples of best practice to find a path through this mess!

Ollie Burton

@ollieburtonmed

5 months

@parthaskar @RCPhysicians @rcgp This also should be an easy win that PAs can also get on board with. Scope locked down to the point where a PA can never functionally be used in lieu of a doctor, which PAs should not be used for anyway, and presumably (?hopefully) never wanted to do anyway.

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ExplosiveEnema

@ExplosiveEnema

4 months

Swansea 100% pass rate for 3 years running! Amazing! 🥳

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