Unpopular opinion:
I don’t see any dignity in pharmacy first service. I see an elderly lady explaining her UTI symptoms with a queue of 7 people behind her listening to the convo. There must be some privacy, a tiny room !?
@NHSuk
@PharmacyFirst
#MedTwitter
🔴 Physician Assistants strike again from the wards,
An F1 Doctor was forced by PA to prescribe Abx to penicillin allergic patient 💀.
⛔️PAs target junior Doctors as they’re less likely to resist
⛔️Enabled by some consultants
⛔️Doctors must refuse to px for PAs without seeing pt
🆘 A PA randomly asked a Doctor to prescribe Antibiotics and request CT brain for a septic kidney transplant patient on immunosupressants 💀 :
⛔️Renal transplant pts cannot have any Abx+ dose must be adjusted
⛔️If the new kidney is destroyed, doctor might be struck off the GMC
🟢Shout out to the Physician Assistant who quit their job after two weeks in GP land
⛔️The PA quickly realised that it’s unsafe to learn things on the job
⛔️GPs see patients of all ages ē complex clinical needs
⛔️PAs might have a role in GP land as” Doctors Assistants only “
🆘 A PA in GP land sticks out like a sore thumb:
She fobbed off a patient with high Blood pressure and spinal fluid leak 💀
⛔️PAs can’t recognise high BP?
⛔️They are notorious for not listening to patients
⛔️where is the supervising GP? set loose ?
🆘 PAs’ innovation will never come to an end:
A patient with decompensated heart failure was drenched by PA in A+E:
⛔️HF patients must not be given IV fluids
⛔️PAs have zero clinical skills and judgement
⛔️Supervising Doctor failed to safeguard his pt
#MedReddit
🆘 When it comes to Orthopaedics,This Physician Assistant is in a league of her own.
A PA is faffing around whilst the patient is septic with infected spinal wound ☠️
⭕️Med Student recognised that PA was clueless
⭕️Septic Pts requires prompt IV Abx,fluids and O2 mask+ Senior r/v
📛 is it legal the PAs introduce themselves as “ one of the Registrars ?
I’m aware that they’re already doing middle grade shifts but what‘s the definition of Registrar.
A senior +ST3 doctor with relevant MRCX diploma ?
#MedTwitter
#MedX
#Medreddit
📛 Is it normal for GP surgery
@BridgewaterGP
to have FIVE Physician Associates ?
This means:
⛔️ 5 potential salaried GPs are jobless.
⛔️ Less space for GP trainees .
⛔️? Poor quality of service.
#MedTwitter
#MedX
🆘Physician Assistants strike again from Manchester ED.
A PA missed heart haemorrhage ( Aortic dissection) in young “nearly qualified Solicitor “ 💀☠️
⛔️PA fobbed off the young lad+told him it’s “panic attack”
⛔️Coroner confirmed A+E Cons didn’t r/v the patient
#Telegraph
🛑A PA (who is a cut above Cardiologists ) is fiddling with patient’s medications prescibed by her consultant Cardiologist with +30y of experience 💀
⭕️Not aware of limitations.
⭕️PAs had no training/course in Pharmacology + cannot prescibe !
⭕️Zero supervision
⛔️The new Trend: PA Hackers ⛔️
Apparently, the PAs have moved from defence to attack by creating fake accounts pretending to be hackers. But how did they know I’m using Iphone ? Check out this kid 👇
#Medtwitter
#MedX
#MedReddit
📛 This is the same PA fiddling with Cardiologist plan. He claimed to be “ Consultant Physician in GP land “
⭕️Patients working in healthcare can easily recognise lies, so be careful
⭕️He wants the cardiologist to speak to him ! ( as if they have time to argue with PA? )
📛 Physician Assistants strike again from GP land:
⛔️Using GP login to prescirbe
⛔️ Near zero knowledge in pharmacology and drug classes
⛔️ Telling everyone abt unsafe practice with no shame
⛔️ Enabled by some GPs
Patients, pls ask to see a DOCTOR
@gmcuk
#MedTwitter
☢️A physician Assistant has revolutionised the treatment of severe eczema in children from GP land 💀
⛔️ PA advised the mum to “ bribe the child “ to stop intense scratching !!
⛔️Severe eczema requires prompt treatment with steroids/topical Rx
⛔️PAs do not seek senior advice
☢️ Physician Associates dropped a bombshell again in Primary Care:
A PA fobbed off a patient who turned out to have Kidney Cancer later on 💀
⛔️Backache+Wt loss are Red flags that must be investigated
⛔️PAs help to destroy supervising GP career
⛔️They miss fatal diagnoses
📛 PAs wrongly managing airway in Resus and telling specialist Paramedics “ they know better “
⛔️Paramedics are 1st responders and trained to manage critically unwell pts/airway /intubate.
⛔️PAs are learning on the job
⛔️PAs must not fiddle with airway without supervision
🛑 A dodgy Physician Associate was caught red-handed by patient falsifying medical notes 💀
🔴 Vital signs must be recorded accurately, this PA just made it up.
🔴 It’s a criminal offence to record false vital signs / entries in medical notes for your pt
#MedTwitter
🛑 The reputation of PAs has reached eldery patients in Nursing homes.
⛔️ The public, regardless of age , can no longer be fooled
⛔️ They demand to be seen by a proper Doctor
⛔️PAs have no role in the NHS other than “ Assistants “
Viva La Revolución 🦀
🆘 Wonders will never cease ( PAs @ Care home ) :
The coroner is investigating a potential negligence in patient’s care which might have led to DEATH 💀+ PA introduced herself as“ Doctor “
⛔️PAs are deliberately misleading the public and target vulnerable adults
⛔️?Pt safety
⚫️ Dear Physician Assistants:
This chap in the photo is a medical student ( Now Doc ) who went through most of these reference books + handouts during 6 years in Med School + rigorous exams/assessments .
There is nothing called crash course or shortcuts 👍🏼
🔵 A PA in GP land fobbed off a concerned mum again and missed pneumonia in a child 💀
📛 PAs cannot pick up pneumonia signs when listening to the chest
📛 Such children can end up in paediatric intensive care if not treated promptly
🛑 Physician Associates are head and shoulders above the rest in GP land
A PA missed diagnosis of meningitis in patient with learning difficulty 💀
⛔️ PAs have tunnel vision and always focusing on one possibility
⛔️They’r a burden on NHS syst
🛑PA students are shoved down the throat of Doctors working at South Tyneside hospital.
⭕️PA students should be taught by PAs
⭕️Doctors should be paid for this Extra-contractual activity
⭕️Doctors have no time or obligation to teach their future replacements
📛 PAs strike again: a physician associate on snapchat claiming he’s done his first robotic surgey!
⛔️ Absolutely deceitful and misleading
⛔️ PAs can only assist in surgery
⛔️ They are not independant
⛔️The British public should be made aware of their lies
#MedTwitter
@gmcuk
🛑 PAs strike again from Neurology ward in SouthWestEngland.
A PA is leading on LP procedure (needle in the back )
⛔️This is a high risk procedure
⛔️Without appropriate knowledge, patient might end up with spinal cord injury/paralysis
⛔️Since when PAs can do it independently?
📛 Is it normal to have a NON-MEDICAL stroke consultant to manage patients with acute Stroke?
⛔️Unsafe
⛔️ Unfair for patients
⛔️?paving the way for PAs/ACPs to works at consultant level
#MedTwitter
#MedX
@gmcuk
@RCPhysicians
🔴 A Physician Assistant claims to be working at the level of junior consultant / senior Reg 💀.
⛔️The unregulated PAs have gone too far with their 2y degree
⛔️ Are they just naive or dodgy ?
🛑 PAs and some other HCPs are fighting tooth and nail to stop anon Doctors raising concerns:
⛔️ We will contin to expose your lies
⛔️The public are more aware of scope creep now
⛔️They no longer entrust you to look after their loved ones.
#MedTwitter
🛑 Physician Assistants strike again from Reddit:
A PA is interviewing the Medical Registrar 💀:
⛔️ Assistants must not interview Doctors with more than 6y post grad experience
⛔️This is systematic humbling/belittling of Senior Doctors
⛔️Your career is in PAs’ hands
#MedX
📛 Another Physician Associates adventure from GP land ,a PA missed a diagnosis of 💀 Meningitis in a child 💀
⛔️PAs should not see unwell children.
⛔️ There should be direct GP supervision
⛔️Children can deteriorate quickly if not managed promptly by Doctor with appr expertise.
☢️ The mainstream media are now aware of the rising Doctors concerns regarding Physician Associates dangerous pratice in the NHS.
I received a message from a producer in ITV news asking for more information
The entire UK will soon be aware of the truth
Viva La Revolución 🦀✊🏼
⭕️ A snarky receptionist had a go at patient asking to see a Doctor, she believes PAs have same qualifications as Doctors !
📛Nah , 2y PA studies VS 5-6y at med school?
📛PAs don’t know how to perform basic Gynaecological examination
🆘 A glamorous Assistant in primary care ignored symptoms of potential GI Bleeding 🩸☠️
⭕️Pts with such symptoms require prompt assessment/ camera test at hospital for potential bleeding/cancer.
⭕️ It is impossible that this PA discussed the case with supervising GP
📛 Fully qualified F2 Doctors doing GP:
⛔️ No equipment provided by GP Partners.
⛔️ No specific room allocated so they can use to see patients.
⛔️ PAs get private room and equipment provided.
P.S. GPs get paid to have FP Doctors working in General Practice.
#MedTwitter
📛 Norfolk Hospital has come up with new “innovative” role:
⛔️ Skin Cancer and Dermatology Registrar Nurse Specialist.
⛔️Isn’t Registrar a protected title ?
⛔️ Does she have MRCP ?
⛔️ Tell me I made it up ??
🆘 A Physician Assistant strikes again from GP land:
He examined a lady patient’s abdomen without offering a chaperone 💀 ,yet documenting they did so !
⛔️Maintaing patients dignity and wellfare are at the heart of medical profession
⛔️2nd example of Dodgy PA documentation.
A PA refused to treat patient in ED as blood tests were normal:
📛 Patients with mini heart attack might have normal bloods as well
📛Failure to address patient’s concerns/welfare can result in “fail” in medical school exams.
🛑 Physician Assistants from GP perspective:
⛔️Some GPs have zero confidence in PAs assessment, clinical judgement and suggested plan
⛔️ GPs trust medical students more than PAs
⛔️a GP explicitly advised his/her family to refuse to see PA in primary care
Viva La Revolución 🦀
💀 A physician Assistant was about to shock Anaesthetic Registrar ( 360 Joules ) during cardiac arrest :
🔴 PAs should not be allowed to deliver shocks in stressful situations.
🔴They must stick to scribing/cannulation during CPR.
🔴They compromise patient as well as Docs safety
🟡 A very nice neonatologist with a law degree (( not sure if they want their name mentioned )) has also come forward to support the F1 who might face GMC referral/investigation. Thank you 👍🏼
🔴 Physician Assistants strike again from the wards,
An F1 Doctor was forced by PA to prescribe Abx to penicillin allergic patient 💀.
⛔️PAs target junior Doctors as they’re less likely to resist
⛔️Enabled by some consultants
⛔️Doctors must refuse to px for PAs without seeing pt
📛 People who should be questioned on this tragic incident:
⛔️ ED Nurse Triage
⛔️ ED Coordinator/sister
What’s the reason this was not escalated if her BP was unrecordable ( usually extremely low )
Why waiting for patients to collapse then playing staff shortages card ?
Horrific. 56-year-old - 5hrs in ED without a blood pressure reading or repeat observations
@uhbtrust
. By the time bloods are taken and return 10hrs later.,Tracey Farndon, is dead!
Blood pressure machines couldn’t pick up low bp and no-one could use a manual machine!
🟡 People living on budget resort to private GP services as they’re repeatedly offered appts with PAs
⭕️ Have we sleepwalked into two tier healthcare system? (dental services already left the chat)
⭕️ It’s clear that the PA project failed failed to address patients needs
🛑 A conversation with Nurse Practitioner in ED:
⛔️N: I’ve got 20 years of experience and gonna go for PhD in Philosophy.
⛔️Me: Smashing, but why?
⛔️N: To get the “Dr” title on my badge.
ANPs have same PAs logic, spending 4yrs on PhD (misleading pts) to avoid Med School !
🟡From DMs: Consultants with at least 10 years of post graduate experience are paid 65£/h in Wales ( Locum Rate ! )
⛔️This is absolutely ridiculous and unfair
⛔️Locum Physician Associate rate is 50-70£/h across the UK
⛔️Why blaming Docs for leaving the NHS ?
⛔️ A physician Assistant explicitly threatens to refer a Doctor ( One of the BMA leaders ) to the GMC.
⛔️GMC ref have been weaponized to shut Doctors down
⛔️The entire process should be r/v to prevent misuse by PAs.
⛔️PAs have no argument and resort to GMC when stuck in convo
🛑A PA student on TikTok claims she’s done Ascitic tap (abdominal fluid sampling)💀
I appreciate this might be just a show off,but even Doctors don’t usually do it as students
PA students
⛔️0% Ultrasound
⛔️0% Anatomy
⛔️Can’t consent Pts
⛔️Can pierce through bowels/bladder 💀☠️
🆘 Physician Associates are now working as consultants + managing mini stroke ( TIA ) in clinic 💀
⛔️They work on shared rota with consultants NOT juniors !
⛔️If a mini stroke is mismanaged you are more likely to have full-blown stroke
⛔️ Do they have indemnity?
@SWBHnhs
Josh looks stuck forever on SDEC doing bloods, cannulas, discharge letters whilst PAs managing patients in Resus 🤔 you didn’t even give Josh the professional courtesy by addressing him as Dr XY
🟣 Faulty of Sexual & R health endorses PAs doing hysteroscopy( camera test for womb) and working in sexual health despite zero knowledge in Reproductive sys anatomy ❗️
⭕️There was 8 jobs only in 2023, competition ratio 34 : 1
⭕️If they cause perforation, who is responsible 🤔
🛑 Breaking:
Pro PA Trolls have bombed some Anon Doctors accounts ( Pizza and Enema) into submission and forced them to share their content to avoid being trolled online.
⛔️Pizza and Enema cannot be Doctors with such low IQ
⛔️ Conker lover nailed it and exposed their stupidity.
🔴PAs are definitely a false economy.
A Physician Assistant in GP land was unable to do a basic breast examination.
⭕️If u don’t know the normal Anatomy, how can u identify the lump?
⭕️Faffing around+Wasted patient and GP time
⭕️Receptionists are not aware of PAs’ limitations
🟡 Still wondering , what’s the point of shoving PAs down the throat of foundation doctors?
Doctors have been put on waiting list this year due to limited places in FP
🔘PAs can work anywhere following grad
🔘 F1 Doctors must only work in foundation prgrm post
@nw_foundation
☢️ Is anyone able to diagnose streptococcal throat infection by eyeballing a child with fever ?
🟡This is the second time I hear abt PA ignoring a potential meningitis
🟡Also it doesn’t look professional to google symptoms in front of pts
🟡Throat swab is there for a reason 👍🏼
⛔️ Do GP receptionists actually consent patients before being seen by Physician associate ?
Most patients don’t even know yet what PA is ( as acronym )!
#MedTwitter
#MedX
🟤 Student PAs , the future pride of primary care , are looking for cheat sheets for Antibiotics !
⛔️Since when we learn pharmacology / Antimicrobials from cheat sheets ?
⛔️ Student PAs are set loose to learn on the job
⛔️ Patients and their families are no longer safe
🛑 The public feel that Doctors are happy about Physician Assistants doing experiments on them:
⛔️ Doctors are only 1-2% of the entire UK population.
⛔️The public should refuse to see PAs to stop this plague
⛔️Real Twitter accounts are being referred to GMC to shut them down.
🔴 Does it make any sense to anyone that a Physician Assistant is getting paid more than a consultant Dermatologist specialising in rare subsepcialty ( micrographic surgery) 💀
⛔️They undermine senior doctors everyday
⛔️Cons to refuse such pathetic pay
Viva La Revolución 🦀
🟠 Heads up people, The UK healthcare system has become the laughing stock for other countries like Egypt 🙂
My friend translated this :
“ The amount of nonsense/ messing around in the UK healthcare system will be enough to write dozens of books “
📛 The NHS is no longer attractive for IMGs. I personally witnessed a two Gastro Regs who jointed from Pakistan. After being stuck on the ward doing Caths, ABG, TTOs. They decided that they had more dignity in pakistan and left !!!
@RCPhysicians
#MedTwitter
🟢 Follow up on this post:
I received a kind offer from
@amh_1975
@FutureExecCoach
A doctor , lawyer and ex-MDU medicolegal advisor to help the F1 who might be facing GMC investigation due to PA mistake. Thank you for coming forward to help Dr Harrison 👍🏼
🔴 Physician Assistants strike again from the wards,
An F1 Doctor was forced by PA to prescribe Abx to penicillin allergic patient 💀.
⛔️PAs target junior Doctors as they’re less likely to resist
⛔️Enabled by some consultants
⛔️Doctors must refuse to px for PAs without seeing pt
📛 ACP consultant lecturing Medical consultants on plans to replace Doctors with ACPs working at Registrar level ?
⛔️ ACPs have no scope of practice and can be as dangerous as Physician Associates
⛔️ Younger Doctors will face inevitable unemployment after F2.
@MTWnhs
ACP expansion (working at ST3+?) planned at
@MTWnhs
to replace JCFs/IMGs/locums. What do you want F2 doctors to do when they don't get a training post? The gall of this cons ACP
R Colleges gave noctors legitimacy and now theyre taking the p**s. There is no equivalency to doctors
📛 Faculty of Physician Associates demands that Employers should pay indemnity fees for their PAs.
⛔️Non Training Medical Specialty Doctors pay approx 700£ indemnity fees/y
⛔️No comment from RCP regarding these fees.
@RCPhysicians
@FPARCP
@rcpsglasgow
@gmcuk
@RCPEdin
🐍 The president of
@RCPhysicians
Dr
@DrSarahClarke
has decided to lock her profile due to daily insults and criticism as well as fellows encouraging her to resign.
#RCPEGM
📛 Physician Associates strike again from
#TikTok
,They claim to be 9-5 DOCTORS 💀:
⛔️ It is a criminal offence to impersonate a Doctor
⛔️False info re PA course competitiveness
⛔️They must be reported to
@gmcuk
once inevitably regulated.
Please retweet 📡
📛 Physician Assistants strike again from A+E:
A PA is pretending to be “ Middle grade “ + doing chest drains and pleural procedures
⛔️ The Assistants should not teach their Doctors.
⛔️Doing high risk procedures with zero knowledge in Anatomy can be catastrophic
#MedTwitter
🟣 I stumbled into this today and I just realised how exploited Doctors are in this country.
⭕️Def not having a pop at solicitors but why 🤔
⭕️ Trainee solicitors or paralegals get paid more than Med consultant with +10y of experience
@Dr_Done_
@MStott88
Look at NHS jobs website and the requirements for CF job. MBBCH, MRCP, at least 4 years post grad exp, Audits, presentations, other types of sht, and must be able to raise the dead.
All of this to end up being a ward monkey to free up PAs doing their clinics and procedures
📛 PAs have no place in Radiology but scope creep isn’t limited to PAs. It involves Radiographers( technicians) :
⛔️ Radiographers became consultants in England.
⛔️They report polytrauma/brain scans
⛔️They supervise Specialty doctors.
⛔️?patient safety
#MedTwitter
#MedX
🆘 From MedTwitter: PA missed diagnosis of Cancer again in a lady patient💀 leading to late presentation and big operation.
⛔️ Examples of PAs ignoring red flag symptoms are endless
⛔️ Let’s keep this snowball rolling
@gmcuk
Stop waffling and cut to the chase, you want to make PAs/AAs wquivalent to doctors. Stop mentioning “innovation” becauae there is nothing innovative abt PAs
🛑 Me delivering some teaching to my Medical students.
⛔️Me: Can you see this picture folks ? This is the size of the Earth compared Jupiter
⛔️ Med Students: Yes why?
⛔️Me: This is the knowledge gap between Physician Associates and Doctors.
📛 GP Registrars in Primary care are obliged to shadow Physician Associates with 2-year qualification:
⛔️GP trainees/Regs shouldn’t shadow PAs
⛔️GPs are funded by NHSE to teach GP trainees
⛔️GPs should not favour their children over GP trainees ( massive COI )
#MedTwitter
The NMC rhetoric :
'The intention is for Nursing Associates to support, not substitute... '
The reality:
31 full-time Band 5 Registered Nurse posts replaced with Band 4 Nursing Associate posts at Surrey and Sussex NHS Trust.
📛 From DMs:
PAs causing widespread concerns amongst medical students starting as F1s this August
⛔️ PAs will be ur seniors on some wards
⛔️They also have zero liability for the poor advice they provide+ will be on your shoulders
⛔️Please refuse to let the assistants supervise u
☢️ From Reddit: A PA is claiming to be “ Associate Physician “
⛔️ PAs are utilising every opportunity to deceive NHS staff and mislead their patients.
⛔️ Associate Physician ≠ Physician Associate, these are specialist Docs with MBBCh + 4 to 8 years of post grad training.
📛 Anonymous Doctors’ accounts from ANP perspective (pic)
⛔️Doctors prefer to remain anon due to gaslighting and recent weaponization of GMC referrals to preven Doctors from speaking up.
⛔️Lucy Letby killed many neonates cuz Doctors not listned to and forced to apologise.
🔴 Who gave Matrons permission to bully/ intimidate staff to such disgusting point?
⛔️Doctors get +14 MDT members to comment on their behaviour /yr
⛔️Matrons/Sisters are typically toxic/rude only in the NHS with no conseq
⛔️No one is keen to report such behaviour
#MedTwitter
🔴 Me trying to have sensible convo with PA in ED:
⛔️PA: cant wait to get my prescribing rights.
⛔️Me have u studied pharmacology bud?
⛔️PA: Nah mate but we’ve got the pharmacist checking all presciptions in ED
⛔️Me: True story, patient safety ensured ✌🏼
@fascinatorfun
Unfortunately, PAs have full consultants support act as “ senior Medics “. F1s may not be signed off if negative feedback received by ward gangs.
📛I got a message from ITV news politics producer regarding the issue of Physician Associates.
Can I ask you guys if you are aware of any Doctor who was investigated by Trust or even referred to the GMC for raising patient safety concerns regarding PA
⭕️Pls send me DM
💀 Senior Paediatrician missed a diagnosis of Meningicoccal septicaemia in her child.
⛔️Doctors can also make mistakes, but they went through rigorous +10 yrs post grad training
⛔️They can be held accountable
⛔️PAs are unregulated and their mistakes are counted on supervising Doc
⛔️ Anyone interested in calling this nurse a “ Misandrist “ and reporting her to
@nmcnews
?
She is accusing doctors of worshiping a man called sharkdick ?
Nah because she is “ just a feminist “
@gmcuk
@Alison6123
In real life there are many challenges:
-PAs target F1s who are less experienced and don’t want to get -ve feedback from PAs
-Senior docs might be busy and want them fobbed off by px what they want.
I personally check even discharge letters again before sign off .