Uproar as British regulator welcomes physician associates

4 minute read

Physician and anaesthesia associates will be regulated by the General Medical Council, but they’re not doctors. Confused yet?

The UK is going full steam ahead on its plan to expand the roles of physician associates, even going so far as to bring the burgeoning profession under the auspices of the General Medical Council, its equivalent of Australia’s Medical Board.

Like Australia, health professionals in the UK have individual registers and regulatory boards for each healthcare profession.

The GMC regulates doctors, the General Pharmaceutical Council regulates pharmacists, the General Optical Council regulates optometrists and the Nursing and Midwifery Council regulates nurses and midwives.

It’s not difficult to follow – the name of the regulator directly indicates what kind of health professional an individual is trained as.

Which is why doctors argue that expanding the GMC’s oversight to include physician and anaesthesia associates could be a disaster in the making.

Physician associates were first introduced in the UK in 2003 and are currently without a statutory regulator.

To qualify under the current system, a person just has to complete one of the 37 physician associate courses offered around the UK.

Then, they have to pass a pre-registration assessment delivered by the Royal College of Physicians in London, but that’s only a requirement for those who want to join the voluntary register held by the Faculty of Physician Associates at the Royal College of Physicians.

Most physician assistants wind up working in general practice, where they can take medical histories, examine patients with undifferentiated diagnosis and long-term chronic illness, formulate differential diagnoses, request diagnostics and deliver treatment plans.

The only duties they’re specifically prohibited from doing are prescribing and requesting ionising radiation scans.

As regulator, the GMC will be able to sort through the physician associate courses on offer and withdraw approval of courses that don’t stack up to certain standards.

Introducing a regulator also effectively makes the optional pre-registration assessment mandatory.

The GMC was tapped to become the physician and anaesthesia regulator earlier this year, but the issue garnered renewed attention after GMC chair Dame Carrie MacEwen publicly called for “multidisciplinary respect” at a conference last week.

She acknowledged that the current environment for medical associate professionals was “clearly very challenging”.

“Multidisciplinary respect and courtesy is fundamental within our professional standards but there are going to be situations and times when that is challenging to deliver,” she said.

“Leaders have a significant responsibility to establish a culture where this is expected, even in the face of a tough external environment, and where all doctors hold each other to high standards on inclusivity.”

Yesterday, the GMC confirmed via X (formerly Twitter) that it would be welcoming physician associates into regulation from late 2024 and said that regulation would help increase patient safety.

They will “have a responsibility” to clearly communicate who they are to patients, the regulator said.

Doctors on X responded immediately and with not a little bit of snark.

“I hope they will be paying the same fee to use the same organisation,” one doctor wrote.

Multiple others pointedly suggested that physician associates have their own council to avoid any confusion with doctors.

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