The BMA strategy around PAs is starting to spectacularly backfire

For the last two years the British Medical Association (BMA) under the control of a pressure group called DoctorsVote (DV) has sought to campaign against Physician Associates (PAs) in the UK. The DV/BMA has been very successful, they have managed to get the Leng Review implemented and influenced, they have managed to get the Faculty of Physician Associates disbanded from the Royal College of Physicians and they have managed to get various Royal Colleges to come out against PAs. However, this strategy is starting to backfire in spectacular fashion.

Doctors created PAs. Doctors brought the highly successful PA concept to the UK and started to implement it over 20 years ago. No one is disputing that the PA implementation in the UK was/is not perfect but having medically-trained professionals that are a permanent part of the medical team (PAs) makes sense, for doctors and patients. Doctors in training are rotating all the time so having permanent junior medical professionals brings continuity to the team.

The DV/BMA campaign against PAs has probably taken out about 25% of the PA workforce – most being made redundant. It has been messy with multiple unfair dismissal claims. But now there is another trend which the DV/BMA might find more disturbing.

In getting rid of PAs, the DV/BMA has opened the path to everyone and his wife becoming some kind of diagnostic medical professional. There are plans to increase the number of Advanced Clinical Practitioners. Pretty much any allied health professional can become an ACP – Podiatrists and Art Therapists can potentially become ACPs and work in any medical specialty. Paramedics are to get enhanced prescribing rights in order to fill the medical professional gap. Pharmacists are getting enhanced prescribing rights for the same reasons. And so the list goes on.

With PAs, doctors had medical professionals who they were intimately involved with the development of. There is a need for PAs and if you are not going to have PAs then it is a massive range of multiple different allied healthcare professions with multiple training programmes that are not standardised that is starting to fill the void. All these allied healthcare professions are all outside the control of doctors. They belong to different unions, report to different Royal Colleges, they have different registrations and regulations. It is basically a big chaotic mess which the BMA, and doctors generally, will be completely unable to control and shape going forward. This is the DV/BMA legacy in the campaign against PAs.

The more prudent strategy would have been to embrace and shape. The BMA could have opened membership to PAs and started to shape and develop the profession in a positive way. Instead, by campaigning against PAs, the DV/BMA cut the head off the Hydra.