The REAL REASON why the BMA opposes Physician Associates

The BMA’s opposition to Physician Associates (PAs) is simply part of a strategy to increase Doctors’ pay that involves the corporate bullying of a minority group of fellow healthcare professionals

Not so long ago the British Medical Association took a positive and supportive view of PAs. PAs work alongside and support Doctors in their work and there is good evidence that they increase safety, increase patient satisfaction, reduce the potential for legal action against doctors and help doctors do their work more efficiently. For seventeen years PAs and Doctors have lived a happy co-existence in the UK. For over 60 years PAs have successfully worked alongside Doctors in the USA. PAs are used in many countries around the World but only in the UK is there any significant acrimony or controversy. The acrimony stems from the British Medical Association.

In 2022, the BMA started pay negotiations for junior doctors which lead to a series of well-known strikes. At the same time as this was happening the BMA changed its position on PAs from one that was supportive to one that was vehemently opposed. They also started a highly vocal and successful campaign, aimed at doctors, against PAs. The BMA viewed PAs as a threat to their ability to negotiate a pay deal for Doctors.

The timing speaks volumes

This view has continued. The timing is extremely pertinent. In August 2024 the BMA switched its campaigning towards GP pay. In September/October 2024 the BMA GP committee voted in favour of opposing a role for PAs in General Practice. Also in September/October 2024 the Royal College of GPs published details of a similar vote opposing PAs. What is critical about the timing is that it highlights that the BMA’s opposition to PAs is simply part of a coordinated and cynical plan that forms part of their negotiation strategy for their membership.

Why pick on PAs?

PAs are an easy target for the BMA. PAs are a small, defenceless group. As such they have little in the way of representation and little in the way of collective power to oppose the BMA. Advanced Clinical Practitioners (ACPs) are (typically) nurses who fulfil very similar roles to PAs and in similar numbers. Everything the BMA says it does not like about PAs applies equally to ACPs. But the BMA dare not oppose ACPs because that would pit them against nurses (a fight they know they would lose).

Increasingly the BMA is presenting survey evidence from their membership opposing PAs. The problem with this is that these surveys are conducted after the BMA has been running a continuous high profile campaign against PAs. So all these surveys show is simply how effective the BMA’s campaign is against PAs.

The BMA is not acting in the best interest of Doctors, PAs work alongside and support Doctors. Doctors who work regularly with PAs have lots of good things to say about PAs. When you use PAs correctly, PAs make Doctors’ work easier and safer. PAs are the staff group most closely associated with and supportive of doctors. The BMA does Doctors a disservice when they campaign against PAs because they deprive Doctors of support which they sorely need.