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Secret Diary of a PM - November Update

This month, three issues in particular have been on my mind, and I wanted to give you my take on them, as we hurtle towards the end of the calendar year…

Physician Associates

There has been a lot of talk recently about Physician Associates, and there have been calls to stop recruiting them by the GPC. The concerns expressed are that practices are using them instead of doctors, and that it threatens patient care and safety.

Now I can see their point in some ways, but I think the discussion should go further than this.

Could the same point not be made about nurses, advanced nurse practitioners, HCA’s, etc?  

All these roles — including PA’s, if used correctly — can benefit patient care and offer extra access, however I can accept that some practices may use them purely as a cost-cutting measure.

I think the real issue, which I have highlighted before, is that patients are not aware of the new roles, how they are trained, what they can and cannot do and how they are regulated, so they are always going to come under fire.

There is not a public awareness campaign to support these positions, and we must ask why?

My personal view of using a PA is positive but like any other worker there can be issues. With daily support and a clear process in place, these workers are a valuable source of care in the right circumstances.

We do need a varied workforce, but we should educate practices in how to use these new resources in a patient-safe way.

Covid Update and the Enquiry

Listening to some of the evidence being given at the current Covid enquiry is worrying, the culture alleged to have taken place in No 10 was so much at odds with what we should be able to expect from government, and what the public heard about.

Whilst we in primary care were working through the worst period probably known to us, there was a blatant disregard to the very rules that were put in place by the government and No 10.

As someone that was lucky not to lose someone close to Covid, but had someone in intensive care for several weeks, I can only imagine how those who suffered first-hand can be feeling with the evidence coming out as it is.

Whilst I would hope lessons have been learnt, I am somewhat pessimistic that this will be the case. 

Even now there is denial that Covid still exists, and general advice is being given to let staff come into work, even if they have Covid and feel well enough — sheer folly.

We are still operating with masks and testing where necessary and will not let staff work in the practice even if they feel well enough, so we ask that they work from home.

Healthy / Unhealthy Stress

The latest article on the FPM blog on Healthy stress got me thinking.  We all handle stress differently and we are often affected by our own personal views. Advising others on how to handle these situations is easier than perhaps handling them ourselves.

A short while ago I had a course of Cognitive Behavioural Therapy (CBT) which aims to rationalise our own behaviour.

I found it very good, and it has worked for me. When things get on top of me, I try and stop and ask myself the following questions:

  • What’s the issue?
  • What is the very worst thing that could happen?
  • How likely is it to be that bad? (Usually the answer is no)
  • Will stressing out make it easier to cope with it? (Again, the answer is usually no)

Those questions get me to calm down and put the problem back in an imaginary box and I feel better.

Maybe it could work for you too - it certainly works for me!


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