The medical care practitioner: Newspeak and the duping of the public

[摘要] As the GP lead for the organisation employing the longest serving American physician assistant in this country, you may be surprised that I am in agreement with your editorial writer Iona Heath,1 that our patients need and deserve highly trained and skilled professionals on the front line, to ensure the welfare and safety of patients. You will find that I have frequently voiced my concern about the direction of the Change Workforce Programme's (CWP's) pilot programme for the development of a medical care practitioner grade. Fortunately, I believe there has been a major change in the direction of that programme, driven by our experience with American physician assistants. Originally, the CWP's intention was for pilot sites to train nurses, and allied professionals while in post, to do front-line work. There is huge pressure from chief executives and the government for this model of ‘training on the job’, because of the workforce crisis and the current demand for front-line workers. Like Dr Heath, I believe that the best front-line workers are doctors, but when there are insufficient of these, we can bury our heads in the sand and let practices — particularly those serving the most needy — go to the wall; or we can look for alternative solutions. The RCGP seems to be taking the former route, whilst the Royal College of Physicians has taken the view that if the only way out of the crisis is to have a mid-practitioner grade, then we need to properly define the grade — so that everyone, including the patient, knows what they are getting. Work is being completed by the Royal College of Physicians in conjunction with our physician assistants and a medical school to define what those competencies should be. Unfortunately, by taking the stance it has, the RCGP will not be able to influence these.

[学科分类] 卫生学